Dr. Thompson on Prostate Biopsy Problems and Solutions

Ian M. Thompson, MD, director, professor, Department of Urology, Cancer Therapy & Research Center, The University of Texas Health Science Center, discusses the problems with prostate biopsies and some possible solutions.

Thompson says approximately 1.5 million prostate biopsies are done each year and the majority of them are unnecessary. A biopsy is unnecessary if the biopsy is negative or the biopsy detects inconsequential prostate cancer, Thompson says.

While some people might look at a negative biopsy as a good thing, Thompson believes a negative biopsy is bad because it puts the patient at risk and wastes money. When a patient is diagnosed with inconsequential prostate caner because of the biopsy, the patient is now burdened with the stress of knowing they have cancer and may decide to undergo unbeneficial treatment.

Thompson says that a trial is underway to test if short-term treatment with finasteride can be utilized as a screening tool to prevent unnecessary prostate biopsies. This study randomizes men who are eligible for biopsy to placebo or 3 months of 5-mg finasteride. The goal is to ascertain whether finasteride can reduce PSA and prostate size to the point where a biopsy is no longer indicated.