Prostate Gland Biopsy
THE incidence of cancer of the prostate gland among men who have symptoms of bladder neck obstruction is about one out of five. The actual incidence of cancer is higher because many men are seen with symptoms unrelated to the urinary tract, such as bone pain, or who have evidence of the tumor without symptoms. It is the third most common cancer in men, exceeded only by cancer of the skin and alimentary tract in frequency of recognition.
The chief methods by which a physician discovers prostatic cancer are rectal palpation of the gland, serum acid phosphatase determination, and roentgenographic study of the urinary tract and skeleton. These are satisfactory when the tumor has spread widely beyond the prostate. In this paper methods of biopsy for establishing the diagnosis when cancer of the prostate gland is suspected or when it is desirable to corroborate the clinical diagnosis of extensive cancer will be discussed. The actual diagnosis of cancer is made by microscopic definition, preferably on a block of tumor tissue. Under study is the cytologic examination of prostatic secretion for exfoliated tumor cells,1 which requires a great deal of time and experience.
Methods of Biopsy
A. Perineal. Exposure of the prostate gland through the perineum permits biopsy of any area of the gland which has been suspected of malignancy on rectal palpation. This approach is particularly useful because more than 90 per cent of all prostatic neoplasms arise in the posterior lobe accessible to rectal palpation. The reason for biopsy . . .