Prostate Biopsies Riskier Than Previously Believed

Thursday, 22 September 2011 12:24 PM

Men who receive prostate cancer biopsies are more than twice as likely to end up in the hospital from complications than those who don’t get the procedure, a report says, highlighting risks with the practice.

The study, the largest of its kind, looked at data from 150,000 Medicare patients 65 and older from 1991 to 2007 and found a 6.9 percent hospitalization rate in the 30 days following the procedure, compared with 2.9 percent of men who didn’t receive the treatment. Patients should be made more aware of the possible complications associated with the often life- saving process, according to the analysis released today.

“Prostate biopsy is an essential procedure for detecting prostate cancers,” Edward Schaeffer, a Johns Hopkins University School of Medicine urologist and oncologist and the study’s senior investigator, said in a statement. “However, it is important for men to be aware of the possible risks of prostate biopsies, which are often described as simple outpatient procedures.”

A prostate biopsy typically entails sending an ultrasound-guided needle about a dozen times through the rectum to collect specimens from the walnut-sized gland that sits under the bladder. The 15-minute test carries an infection risk because the needle can take bacteria from the bowel into the prostate, bladder, and bloodstream.

Serious Infections

While the overall rate of hospitalization in the 30-day period following the procedure has declined steadily since 1991, the rate of men who had serious infections rose, to 1.2 percent in 2007, compared with 0.5 percent in 2000, the study found. An increase in drug-resistant germs may be to blame, Schaeffer said.

“Antibiotics are routinely given to men at the time of biopsy, and the fact that infections serious enough to cause hospital admissions have been on the rise makes us think that these types of complications are occurring because of a steady increase in antimicrobial resistance rates in America,” Schaeffer said.

Previous studies have found a small, growing percentage of men undergoing prostate biopsies becoming critically ill and dying from bacterial infections.

Today’s study found no increased risk of mortality in those who had biopsies compared with the group of men with similar characteristics who didn’t undergo the procedure.

Prostate cancer is the second-leading cause of cancer death in men, according to the American Cancer Society. More than 240,000 men will be diagnosed with the disease this year, and it will lead to about 33,730 deaths, the organization said.

The study was released online in advance of its publication in the November issue of The Journal of Urology. It was funded by the Howard Hughes Medical Institute, the National Institutes of Health, an American Urological Association Astellas Research Star Award, and the Patrick C. Walsh Prostate Cancer Research Fund at Johns Hopkins.

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Thursday, 22 September 2011 12:24 PM
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