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Getty Images (Jacob Wackerhausen)
Prostate cancer is the most common cancer in the developed world. The most widely used method of diagnosing prostate cancer involves a biopsy that passes a needle through the lining of the lower bowel (the rectum) and into the prostate gland, which is performed under local anaesthetic. This is called the transrectal route. Researchers and doctors have been looking for ways to improve the needle biopsy process, largely due to the concern of infections from the biopsy process. One option has been to change the route through which the needle passes into the prostate, which would be for it to go through the skin instead of the bowel lining.
In a new trial, published in Lancet Oncology and funded by the National Institute for Health and Care Research (NIHR), researchers recruited 1,126 men from around the UK who were undergoing investigation for possible prostate cancer, and allocated them to receive their prostate biopsy either through the traditional “transrectal” route, or through the skin in the newer “transperineal” route through the skin in the area between the scrotum and the anus. Their goal was to find out which approach was better at diagnosing clinically meaningful prostate cancer which might require treatment, while also recording the impact from complications like infections, difficulties with sexual function, or passing urine. In all cases the biopsies were performed under local anaesthetic in the clinic, and the researchers evaluated how well the patients tolerated the biopsies using patient reported outcomes (PROMs) questionnaires immediately after the biopsy procedure, and for up to 4-months afterwards.