Prostate cancer is the most common malignancy among American men. But among the millions of men tested for prostate cancer around the world each year, doctors are detecting an alarming trend: An increasing number of patients are getting sick from potentially lethal, drug-resistant infections introduced during the needle biopsy procedure.
Studies emerging during the past year have uncovered that a small, yet growing percentage of those undergoing routine needle biopsy tests are becoming critically ill and dying from bacterial infections. Infectious complications, including sepsis, from prostate biopsies have more than doubled in less than a decade, studies from three countries show. Nine out of 10,000 men whose tests were negative for cancer died within a month, researchers in Toronto reported in the Journal of Urology in March last year.
The newly uncovered risk of dangerous infections adds to concern that the tests are being overused. The PSA screening, a blood test for a protein produced by prostate cells known as prostate-specific antigen, is performed on about 30 million American men annually, costing at least $3 billion. But the exam is flawed because it does not detect prostate cancer or distinguish between benign tumors and deadly malignant ones. If a man has an elevated PSA level, then a needle biopsy is typically recommended. More than 1 million transrectal prostate biopsies are done in the U.S. each year to diagnose cancers in men whose screening blood tests suggest they may have the disease.
Doing a tissue biopsy of the prostate to detect cancer typically entails sending an ultrasound-guided needle about a dozen times through the rectum to collect specimens from the walnut-sized gland that sits under the bladder. The test carries an infection risk because the needle can take bacteria from the bowel into the prostate, bladder and bloodstream. The 15-minute procedure, usually performed in a doctor’s office, can be dangerous if the bacteria are resistant to antibiotics given at the time of the biopsy.
An estimated 217,730 men were diagnosed with prostate cancer and 32,050 men died of the disease in the U.S. last year. U.S. medical costs linked to prostate cancer care were estimated at $9.9 billion in 2006. One in six men in the U.S. will be diagnosed with prostate cancer during their lifetime, according to the National Cancer Institute in Bethesda, Maryland. Even still, fewer than 3 percent of men will die from the malignancy.