Transrectal Prostate Biopsy in low risk prostate cancer patients may lead to greater temporary health impact than Prostate MRI

In men with a low risk of prostate cancer, a transrectal prostate biopsy is usually done as a confirmatory phase with a goal of identifying otherwise occult clinically important prostate cancer. A study has revealed that Transrectal prostate biopsy has a greater temporary health impact (lower testing-related quality-of-life measure) than prostate multiparametric-MRI (mpMRI). The study was published in the Journal of the American College of Radiology.

Prostate cancer develops when cells in the prostate start multiplying uncontrollably. Prostate cancer is one of the types of cancer with the best chances of recovery. This is because it often grows very slowly so it is generally possible to treat it effectively. Therefore, detection isn't easy.

A prostate biopsy is a procedure to remove samples of suspicious tissue from the prostate. There is a concern regarding this procedure as it may produce health-related complications such as bleeding at the biopsy site, blood in the semen, blood in the urine, trouble urinating, infection. These complications make it important to explore new alternatives for the diagnosis of prostate cancer.

The study aimed at assessing the temporary health impact of prostate multiparametric MRI and transrectal prostate biopsy in an active surveillance prostate cancer population. To evaluate and compare the health impacts the authors conducted a HIPAA-compliant prospective observational patient-reported outcomes study from November 2017 to July 2018. Inclusion criteria were men with Gleason 6 prostate cancer in active surveillance undergoing either prostate mpMRI or a transrectal prostate biopsy. A survey instrument was constructed using validated metrics in consultation with the local patient- and family-centered care organization. Study subjects were recruited at the time of diagnostic testing and completed the instrument by phone 24 to 72 hours after testing. The primary outcome measure was the summary testing-related quality of life (summary utility score), derived from the testing morbidities index (TMI) (scale: 0 = death and 1 = perfect health). TMI is stratified into seven domains, with each domain scored from 1 (no health impact) to 5 (extreme health impact). Testing-related quality-of-life measures in the two cohorts were compared with the Mann-Whitney U test.

It was observed that the temporary quality-of-life impact of the transrectal biopsy was significantly greater than that of prostate mpMR.

The authors concluded that transrectal prostate biopsy has a greater temporary health impact (lower testing-related quality-of-life measure, or utility score) than prostate mpMRI. The quantified health utility scores associated with prostate mpMRI and transrectal prostate biopsy can be used to inform cost-effectiveness studies, decision tree modeling, and quality improvement initiatives.

For futher reference, please click on the link https://doi.org/10.1016/j.jacr.2018.11.031