Prostate Biopsy: Psychological Impact

Dr Julia Wade PhD Research Associate University of Bristol, Clifton, Interview with:
Dr Julia Wade PhD
Research Associate
University of Bristol, Clifton, Bristol What are the main findings of the study?

Dr. Wade: We hope that our study provides men with more information about diagnosing prostate cancer.  A diagnosis of prostate cancer can only be confirmed through prostate biopsies after the finding of a raised PSA.  This biopsy process requires 10 or so samples to be taken rectally, with a local anaesthetic, and this has some side effects.  Most men describe prostate biopsies as uncomfortable, but around 40% report pain and many experience bleeding; a small number, 1%, are admitted to hospital and 10% need to see a doctor because of post-biopsy symptoms.   We found that the men who experienced post-biopsy symptoms as ‘problematic’ at 7 days post biopsy also experienced raised anxiety compared to men who experienced symptoms as non-problematic Were any of the findings unexpected?

Dr. Wade: Although most men experienced biopsy symptoms as not a problem or a minor problem, the proportion of men who reported symptoms to be problematic was higher than has been previously reported (11% of those experiencing pain, 22% of those experiencing fever and 26% of those experiencing blood in the ejaculate). What should clinicians and patients take away from your report?

Dr. Wade: We think that men should have as much information as possible about the possible consequences of having a PSA test before they decide to take the test. Most men having a PSA test will hope that it is negative, but it is important that they know that if the PSA is raised, they will be advised to have a prostate biopsy. The biopsy process is uncomfortable for most, and for some will be painful and lead to symptoms including bleeding and infection, which may last for 5 weeks and if severe, may lead to them becoming anxious.  Having clear information about the possible consequences of biopsy may reduce anxiety What recommendations do you have for future research as a result of this study?

Dr. Wade: Future research is needed to identify ways of reducing the incidence of adverse effects after biopsy and to evaluate whether improved information provision about effects of biopsy may reduce anxiety.


Psychological Impact of Prostate Biopsy: Physical Symptoms, Anxiety, and Depression

Wade J, Rosario DJ, Macefield RC, Avery KN, Salter CE, Goodwin ML, Blazeby JM, Lane JA, Metcalfe C, Neal DE, Hamdy FC, Donovan JL.

Julia Wade, Rhiannon C. Macefield, Kerry N.L. Avery, C. Elizabeth Salter, Jane M. Blazeby, J. Athene Lane, Chris Metcalfe, and Jenny L. Donovan, University of Bristol, Clifton, Bristol; Derek J. Rosario and M. Louise Goodwin, Royal Hallamshire Hospital, University of Sheffield, Sheffield; David E. Neal, University of Cambridge, Addenbrooke’s Hospital, Cambridge; and Freddie C. Hamdy, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
J Clin Oncol. 2013 Oct 21. [Epub ahead of print]


Last Updated on November 25, 2013 by Marie Benz MD FAAD