Digital rectal examinations and elevated PSA levels may raise suspicions, but only a prostate biopsy can diagnose prostate cancer.

That's why, if your primary-care physician suspects something’s wrong, he or she will refer you to a urologist, who is both a specialist in that area of the body and a trained surgeon. That urologist will likely do a prostate biopsy to find out what is going on.

The biopsy
A prostate biopsy is usually an outpatient procedure. It starts with an ultrasound examination of your prostate, to see if there are any visibly abnormal areas that need to be biopsied.

Then, using what is called a biopsy gun, the urologist will insert the barrel along the ultrasound probe into your rectum and, with the ultrasound image as a guide, aim it toward a specific section of your prostate.

When the doctor pulls a trigger, a needle shoots out of the gun and into your prostate, where it collects a sample and returns to the barrel. All of this is over in less than a second. your doctor will take from six to 14 of these so-called cores from your prostate, and then will send them to a pathologist, where they will be looked at for signs of cancer.

The results
Those of us whose biopsies come back positive now need to make a treatment plan. Those of us whose biopsies are negative can celebrate...but we need to keep our wits about us. Unfortunately, a negative result does not mean that we are cancer-free. All it means is that the urologist and pathologist didn't find cancer in the samples that were collected.

The truth is that prostate biopsies miss roughly 30% of prostate cancers. That's because, when the urologist can't see anything suspicious on the ultrasound to aim for, he or she does a 'random biopsy,' taking cores from arbitrary regions of your prostate. Any number of the needles may hit the cancer—-but then again, they may not hit it at all.

That's why, even if your results are negative, your urologist will want you to come back in six months for another PSA test. If that shows another increase, you'll probably need to undergo the whole procedure once again.In the end most of us find that it's ultimately worth the hassle. After all, you can't cure a cancer that you can't find.

See also

• Prosate cancer - introduction
• Prostate cancer - symptoms
• Prostate cancer - causes and risk factors
• Prostate cancer - detection
• Prostate cancer - treatment options
• Prostate cancer - coping with the aftermath
• Prostate cancer - finding support