Is It Safe To Have a Prostate Biopsy?

by Ben Ong
Reading Time: 10 minutes

prostate biopsy safe

Getting a prostate biopsy is one thing that you shouldn’t do if you want to maintain your prostate health. It’s the next thing that a doctor orders if you flunk the PSA test and the digital rectal exam.

Sure, it confirms prostate cancer, but it’s a risky test that comes with a lot of potential problems. Here we’ll tell you everything you need to know about prostate biopsy and why getting it is the wrong thing to do.

Overview: What Is A Prostate Biopsy?

A prostate biopsy is a procedure used to detect prostate cancer. Small samples of the prostate are removed and then observed under the microscope.

A urologist or surgeon usually performs this procedure, and looks at the prostate cell samples to see if they are cancerous. Cancer cells are often irregular in size and shape, and exhibit aggressive growth.

Doctors usually recommend a biopsy of your prostate gland based on certain findings. One is when your prostate-specific antigen (PSA) blood test results are higher than normal for your age. Another is when your doctor detects some signs of a prostate problem during your digital rectal exam (DRE).

Although the PSA and DRE indicate a possible problem with your prostate, a biopsy is needed to confirm if it’s cancer.

A prostate biopsy involves collecting minute samples of the prostate gland. The doctor passes a needle through the rectal wall or makes a small cut in the area between the anus and rectum to obtain the samples. A CT or MRI scan is also used to guide them through the procedure.

Prostate biopsy takes about 10 minutes and is usually done in the doctor’s office. The samples will be sent to a lab, and will be looked at under a microscope to see if they contain cancer cells.

If cancer is detected, it will also be assigned a grade. The results are available after 1 to 3 days, but it can sometimes take longer. 

2 Main Types of Biopsies

There are 2 main types of biopsies a doctor will recommend: a transrectal ultrasound (TRUS) guided biopsy and a transperineal biopsy. Let’s talk about these types in detail.

prostate biopsy safe

TRUS Guided Biopsy

The TRUS Guided Biopsy is the more common type of prostate biopsy. A thin needle is passed through the rectal wall to take tissue samples of the prostate.

If you’re getting a TRUS guided biopsy, you’ll be asked to lie on your side on a table, with your knees brought up towards your chest. The doctor will use a probe that is about the width of a finger, and is lubricated before it is placed in your rectum. The probe produces sound waves that enter the prostate.

Echoes are then created, and the probe picks them up. A computer turns these echoes into an image of the prostate. The doctor will then use the image as a guide to select the location to get tissue samples.

After this, the doctor will inject a local anesthetic to numb the area around your prostate. This will also reduce any discomfort. The doctor will then insert the needle next to the probe, through the rectal wall and into your prostate. About 10 to 12 tissue samples will be taken from different areas.

This type of biopsy usually takes about 10 to 15 minutes. After the procedure, the doctor may ask you to wait until you’ve urinated before you go home. As for the results, it normally takes up to 2 weeks.

If cancer is detected, it is graded according to the Gleason system. Grades are based on how much the cancer looks like normal prostate cells:

  • Grade 1: If the cells look a lot like normal prostate cells.
  • Grade 5: If the cells look abnormal.
  • Grades 2-4: If the cells have features in between normal and abnormal (precancerous). Our recommendation is to make changes to diet and lifestyle and take appropriate supplements.
  • Grade 6-9: Cancerous; the higher the number, the more virulent cancer.
  • normally, Gleason 6 or 7 will not require any immediate attention. However, doctors will often prescribe watchful waiting. Our recommendation is to make urgent changes to diet and lifestyle and take appropriate supplements while monitoring the progress of the cancer.
  • normally, Gleason 8 or 9 will normally mean a doctor will recommend early invasive intervention. Our recommendation (if you can afford it) is to have less invasive and more natural procedures at an integrative cancer clinic. But most medical insurance will not cover procedures at an integrative cancer clinic so it needs to be paid privately.

Prostate cancers often have areas with different grades. Because of this, a grade is assigned to the 2 areas that make up most of the cancer. These 2 grades are then added to obtain the Gleason score.

prostate biopsy safe

Transperineal Biopsy

Unlike the TRUS Guided Biopsy, this is where the doctor inserts the needle into the prostate through the skin between the testicles and the anus. This area is called the perineum. The needle is inserted through a template or grid.

It takes more tissue samples from more areas of the prostate with this method. The number of samples may vary, but it is around 30 to 50. One advantage of this method is that there is a greater chance of finding prostate cancer cells.  

The doctor will recommend this procedure if you have problems that make a TRUS guided biopsy risky. This method may also be done as a follow-up procedure if no cancer was found with a TRUS biopsy. Cancer may still be present, and the doctor sometimes uses this method to double-check.

This type of biopsy is often done under general anesthesia, so you’ll be asleep and won’t feel any discomfort. A spinal anesthetic may also be given so that you won’t feel anything in your lower body.

The doctor will then put an ultrasound probe into your anus. Like the probe used in TRUS biopsy, it will produce an image of the prostate, and this will guide the doctor in taking the samples.

A grid will be placed over the perineum, and the doctor will insert the needle through the holes in the grid and into the prostate.  

This procedure takes a longer time, about 20 to 40 minutes. Because of the effects of anesthesia, you need to wait a few hours before going home.

It also advised that someone takes you home to ensure your safety. Your doctor will also recommend that you only engage in light physical activities for at least 48 hours.

Results are obtained in a few weeks. Like a TRUS biopsy, cancers are graded according to the Gleason system.

Are Prostate Biopsies Accurate?prostate biopsy safe

A prostate biopsy produces accurate results when samples are taken from the right locations of your prostate.

But even if you take many samples, biopsies can still sometimes miss a cancer. This occurs if none of the biopsy needles pass through the rights areas. Thus, the biopsy will have a false-negative result.

This is one major disadvantage. One study has found that the detection rate with a 12-core biopsy in prostate cancer patients is very low. The research team collected and compared pre-op and post-op biopsy results of 90 prostate cancer patients. And they also analyzed the influence of age, prostate weight, PSA levels and each patient’s Gleason score.  

The study reveals that the biopsies detected only 67.8% of prostate cancers. This is despite the overwhelming evidence of prostate cancer that was obtained from the patients’ other assessment data. The research team concluded that the accuracy of the procedure might be influenced by other patient characteristics.

Even so, a repeat biopsy is often recommended if the doctor strongly suspects the presence of prostate cancer. Such assumptions are valid if signs and symptoms are found, like high PSA levels or an enlarged prostate.

However, prostate biopsy does have certain risks, and you need to make sure that the benefits outweigh them before deciding to go for it.

How Safe Are Prostate Biopsies?

Although one of the most common procedures for detecting prostate cancer, biopsies carry many potential risks and side effects:

1) Bleeding

Just like any invasive procedure, bleeding will occur. Although it’s normal to see a small amount of blood in your semen or urine for about 2 weeks, it becomes a major problem if bleeding takes a longer time or if it gets worse.

If you experience severe bleeding or are passing a lot of blood clots, then you need to contact your doctor right away.

2) Pain

You’ll expect some pain or discomfort in your back passage for a few days or weeks after the procedure. This is because of the injury caused by the needle on your prostate cells. While some may find it very painful, some people only report a slight discomfort.

Regardless, pain is a very important symptom to monitor. Worsening and persistent pain may indicate a bigger problem. If this is the case, you need to see your doctor for a follow-up.

prostate biopsy safe

3) Infection

Surgeons will normally prescribe strong antibiotics before the procedure to reduce the risk of infection.

However, infection almost always occurs and sometimes can be very severe. In some cases, the result of the infection is that there is long-term sexual dysfunction. Occasionally, the infections can turn into life-threatening sepsis.

4) Acute Urine Retention

About 1 in 50 men who have undergone prostate biopsy experience acute urine retention. The procedure does injure the prostate gland, causing it to swell. And this makes it hard for you to pass urine.

Acute urine retention is a medical emergency, and you need to seek help at once. The doctor often inserts a catheter to drain the retained urine, and it will take a few days for you to recover.

5) Sexual Problems

Some men who have undergone prostate biopsy find it hard to get and keep and erection. This happens rarely and should improve over time. If it persists, you should consult your doctor so that the problem can be assessed further.

Do Biopsies Risk Spreading Cancer Cells?

In February 2008, there was widespread fear over a press release that prostate biopsy spreads cancer cells. The term “track seeding” was coined.

Studies reveal that new tumors are formed in “tracks” or the path within the prostate gland where biopsy needles are inserted. Some experts believe that the new tumors are implanted when tumors extracted by biopsy needles are “seeded” along the path of insertion.

A 2014 study provides evidence for this. The research team reviewed related papers about the incidence of seeding and clinical findings. They also looked at some risk factors like the type of needle used, TRUS guided biopsy vs transperineal biopsy, and the cancer’s grade and stage.

The study reveals that 26 published papers reported 42 cases of track seeding.

prostate biopsy safe

Safety Of Biopsy Under Scrutiny

Though critics acknowledge the results as valid, they think that the fear caused by the news is overblown. They emphasize that cases of track seeding are very rare. And that there’s almost no evidence to suggest that the spread of cancer cells through biopsy led to a “true spread” of prostate cancer.

Yet the findings are enough to compel us to think twice about the safety of the procedure. Over the past 20 years, there has been a massive increase in the number of prostate biopsies done each year. In 2013, about 2 million prostate biopsies were carried out in the US. Think about these numbers.

There is no doubt that biopsies risk spreading cancer cells. Though it is the standard way to detect prostate cancer, it might do more harm than good to you.

That is why it’s very important for you to talk to your doctor about the pros and cons of the procedure, and if it’s truly necessary for your case.

Indeed, there are cases in which prostate cancer is slow-growing and non-aggressive, and it wouldn’t make a difference if a prostate biopsy will confirm it or not.

MRI vs. Biopsyprostate biopsy safe

A recent study suggests that MRI is twice as likely to spot prostate cancer. A group of researchers at the University College London led the Prostate MRI Imaging Study (Promis), and showed that MRI can pick up 93% of aggressive prostate cancer cells.

Unlike prostate biopsy that tends to miss cancer, MRI scans can easily detect it in a non-invasive way. The research team was also able to use MRI to see if the tumor is aggressive or slow-growing.

And because it has become much easier to identify tumors that are not life-threatening, it’s much easier to determine if treatment is needed or not. The study was also able to reduce cases of overtreatment by 5%.

Lead author Hashim Ahmed says that unlike MRI, a prostate biopsy does miss cancer because tissue samples are taken at random. Though it can detect its presence, it cannot confirm if the cancer is aggressive or not.

The findings are a breakthrough and could bring about change of practice in prostate cancer detection and treatment. Prostate Cancer UK helped fund the research, and is now working on bringing MRI scans into prostate cancer treatment facilities.

It’s only a matter of time before the practice of using MRI to detect prostate cancer becomes universal.  

Alternatives To Prostate Biopsies

Doctors have long relied on biopsies to determine prostate cancer. And biopsies are proven to be dangerous. Often, a prostate biopsy finds traces of low-grade cancer that don’t need to be treated.


But in recent years, doctors have found out that new imaging studies like high-resolution MRI and ultrasound can be alternatives to prostate biopsy.

They have proven to be very accurate and safe. A multi-parametric MRI or a color Doppler ultrasound has a 95 to 98% chance of determining the location and grade of prostate cancer cells.

According to the Diagnostic Center for Disease, an MRI scan predicts and confirms the presence of prostate cancer more frequently than a biopsy. A hi-res MRI features the most sensitive and specific imaging modality that allows it to produce a very clear picture of the entire prostate and pelvic region.

Experts claim that this is a quantum leap from the blind biopsy approach. It will minimize the need for biopsies, and could potentially save millions of dollars for the healthcare industry.  

PCA3 Test

The PCA3 test is another alternative. PCA3 stands for “Prostate Cancer gene 3”, a protein that is produced by prostate cancer cells at much higher levels. PCA3 leaks into the urine when the prostate gland is stimulated.

Unlike the PSA test, a high PCA3 test can only result from cancer – not from an enlarged prostate, inflamed prostate or other non-cancerous prostate problem.

For this test, you need to undergo a DRE. This will stimulate PCA3 to leak into the urine. A urine sample is then collected and sent to the lab. It takes about 1-2 weeks to get the results. The higher the PCA3 score, the more likely you have prostate cancer.

This test is also used to determine the effectiveness of cancer treatment. The higher the score, the more aggressive is the prostate cancer.

Should I Get a Prostate Biopsy?prostate biopsy safe

You don’t need to undergo a prostate biopsy.

Prostate cancers are often slow-growing and non-aggressive. It wouldn’t matter if a non-aggressive cancer is detected or not, and it doesn’t need any treatment.

And even if you have an aggressive prostate cancer, there are alternatives to a prostate biopsy, like MRI and the PCA3 test. These methods are non-invasive and accurate. Plus, they don’t have the negative side effects that result from a prostate biopsy.

I wish you good health,


Is It Safe To Have a Prostate Biopsy?
3.3 (66.67%) 12 votes


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About Ben Ong

Ben Ong is a best-selling author and widely regarded as one of the world’s leading experts on natural treatments for metabolic conditions such as prostate disease and type 2 diabetes. He founded Ben’s Natural Health and has worked for over 20 years providing a range of high quality, clinically effective, all-natural supplements for BPH, high PSA, high blood sugar, sexual dysfunction, and others.
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  1. Robert Kern

    a urologist ordered a prostate biopsy without any warnings of the dangers. She had also told me that surgery for BPH contains zero risk of less sexual potency if SHE PERFORMED THE OPERATION. She took THIRTEEN samples. Can a prostate biopsy cause decreased sexual potency? Could she have lied about my PSA results? She also was going to remove bladder stones AT THE SAME TIME as performing the BPH surgery..luckily she didn’t even know how to schedule an operation. I still have potency, but wonder if it has been diminished?

  2. brenda

    hi my partner had trouble passing urine for about a week he is better now but his dr examind himand said he should have abiopsy is this wise hes 85

  3. John

    I am 68 yrs old, had a bout with prostatiis last fall, was put on antibiotics,but psa stayed at 10, have done the PCA3 and just finished MRI, and now they want to do a biopsy because mri showed lesions that are suspect. MRI was rated 4 whatever that means. Would I do the biopsy….?

  4. Peter

    I’m 61 years old. I’ve had some urinary discomfort for several weeks and been treated with anti-biotics by my family doctor which did improve things. I was referred to the local urology department and was examined. My PSA is 3.1 and I know has been stable around this level for 2-3 years – the consultant said this was normal. My urine sample was also normal. The DRE confirmed I have an enlarged asymmetric prostate (I have been told this before in routine health tests) and that it felt benign. I was sent for an MRI and have now received a letter inviting me for a prostate biopsy. Any advice on what I should make of this and what choices I have would be appreciated.

    • Ben Ong

      Hi Peter, glad to hear you have seen some improvement. For urinary discomfort and prostatitis I would recommend my Prostate Healer, which you can read more about here In the meanwhile I would suggest taking the Prostate Health Assessment which will tell you how healthy your prostate is and provide you with a free report. I hope this helps and I wish you good health, Ben.



    • Ben Ong

      Hi Henry, I would recommend you take the Prostate Health Assessment, which will send you a free prostate health report, suggesting lifestyle changes that you may nee dot make. Once you have your results you can contact our customer service team toll free on +44 (0) 845 423 8877 or email [email protected] to discuss this further. I wish you good health Ben.

  6. Kenneth Greathouse

    My name is Kenneth, I’m 58 my psa has went from 4.7 to 6.6 in the past year. I am scared to death over this. They want to do the biopsy on me April 30th. Do I go through it or get the MRI? All the reading I’ve been doing has me worried.

    • Ben Ong

      Hi there Kenneth, I am sorry to hear that you are worried. A high psa does not necessarily mean that you have prostate cancer and the Psa test alone is not a reliable indicator, this blog goes into more depth about Psa and what it means I would suggest avoiding a biopsy as they have some dangerous risk and to have a MRI. If you need any further advice please get in touch with [email protected] and we can discuss your issue further. I wish you good health and hope this information helps you. All the best, Ben.

  7. Douglas B.

    Does anyone know why a biopsy would be suggested AFTER an MRI is done for prostate cancer?

  8. John Trewatha

    Your articles are ALL top notch and this one is one your best. VERY informative to say the least. My father died of cancer of the prostate in the late 70s and has caused me to have yearly and at times by bi-yearly exams caused my experience of what he went through.
    Again your advice and products are the best.
    Thanks John

    • Ben Ong

      Hi John, I am glad that you are enjoying my articles. I am sorry to hear about your father and I would definitely say that awareness is key to fighting prostate cancer and the fact you are getting checked yearly is an important step. It’s great to hear that my advice and products are helping you and if you ever have any questions, feel free to ask. I wish you good health, Ben.

  9. Terry Roulland

    I want a course of supplements

  10. Carl Forman

    I am 63 years old. My Urologist is concerned that the velocity of my PSA results has gone from 2.4 18 mos ago to 3.5 2 mos ago. In addition, I had a 4K blood test within the last 30 days, which resulted in a score of 8. The Urologist is recommending a biopsy, if after having another PSA test in the next 30 days it shows the same or higher results. I have read your book, and am now now taking recommended nutrients in addition to increasing my intake of tomatoes, almonds, green tea and pomegranate juice. I am not anxious to have a biopsy, but am concerned about the potential spread of cancer spreading if not caught early enough. Your thoughts?

    • Ben Ong

      Hi Carl, its great to hear that you have read All About The Prostate and are making healthy changes to your diet. Yes, generally biopsies can have a number of negative side effects, which you learn more about in this article => Other options such as watchful waiting and active surveillance are alternatives. Active Surveillance is a means of monitoring prostate cancer when it hasn’t yet spread outside of the prostate. It is suitable for men with low-risk prostate cancer which has a low risk of spreading (localized prostate cancer). Active Surveillance includes grade group 1 or Gleason 6, a PSA level <10, cancer that is confined to the prostate. While it has been ingrained in us by doctors to treat a problem with drugs and surgery immediately, alpha blocker drugs, surgery and radiation can have side effects that lessen a person’s quality of life. A benefit of monitoring low-risk cancer is that you might avoid having unnecessary surgery. In fact, one study of men undergoing active surveillance found that, 15 years later, less than 1% of men developed metastatic disease. However, it of course depends on the individuals case. If you would like to discuss this in further detail please contact [email protected] or call our toll free number to speak with our support team on our toll fre number +1 888-868-3554.

      • Carl Forman

        Since my last post my PSA jumped to 4.4 in 9 months, then 5.7 six months later. Decided to have an MRI fusion guided biopsy, which resulted in a diagnosis of stage 4 metastatic PC and Gleason 9/10. So much for active surveillance. Now on ADT and PSA is down to 0.12.

  11. Bill spalthoff

    two years ago we moved to Nashville Tennessee I have a heart doctor out of Palm Springs who every six months does a complete bloodwork up and he’s been tracking my PSA number for eight years that a nine. my new primary doctor here in Nashville recently drew blood and said my PSA was at 18.6 And has referred me to a
    Urologist, I have a phone consult with my heart surgeon Stephen Gundry in Palm Springs in February of next year, was hoping to get some guidance from you about your preference and cost of the MRI versus the pca3

    • Bill spalthoff

      wanted to give you a little more information about me I am 53 and weigh the same amount as when I was 18 and in key ptosis eat no grains or dairy and about 60% of my day is good fat, Me and my dad have tried most of your supplements and still appreciate the information on the two alternatives to a biopsy and approximate cost

  12. Glenn

    I would like to know where the MRI scan you talk about is available. I have searched the Internet and asked a few doctors with no success. Could you please let me know? Thank you.

    • Ben Ong

      Hi Glenn, a MRI scan should be available in a hospital. I’d suggest asking your GP about it and if you are still struggling to get information get in touch with [email protected]. Wishing you good health, Ben.

  13. Michael Gray

    I have been diagnosed with prostate cancer in May2017,PSA is 8.5. My age 71, type ll Diabetic since since 1973, gluecos A1C 8.5, vasectomy in 1982, what should I do at this time?

    • Ben Ong

      Hi Michael,

      Thanks for getting in touch with me.

      If one wishes to lower their PSA I always strongly recommend getting the right balance between diet, exercise, and supplement use. I have found in my 20 years of research into the subject that maintaining an active lifestyle and having a ketogenic diet are the most effective measures in combating high PSA levels. However equally important is using the right supplements to allow your body to naturally fight the causes of prostate disease. Given your diagnosis, I would recommend our Advanced Prostate Health Program. This consists of three supplements, the first of which is Total Health Advanced which is designed to lower your PSA levels whilst at the same time slow down the speed of cancer cell growth. The second, Prostate Power, is a urinary symptom alleviator. The third, Prostate Healer, is designed to improve your prostate health more generally.

      If you need any more information please do not hesitate to get in contact with my customer service team at [email protected].

      Wishing you good health,

  14. Timothy J. Tvrdik

    I often hear the term “high PSA numbers”. I know that one can have low PSA and still have cancer or high PSA and be cancer free. What are the range of PSA numbers that are considered good bad and in-between? Do those numbers vary by age?

    • Ben Ong

      Hi Timothy,

      It is very normal for your PSA levels to increase gradually. By age 60 it is normal for a PSA level to go up to around 4.5, and 6.5 by the age of 70.
      I have written extensively on the subject of PSA levels, please have a look at my blog post ‘The Definitive Guide to the PSA Test’ for a far more comprehensive analysis of PSA levels in the link below.

      I Wish you good health,

  15. Harold L Belyeu Sr

    Thanks for letting me know that there are safe non-invasive options other than a biopsy for detecting prostate cancer.

    • Ben Ong

      Not a problem, Harold. I just want to make sure you’re aware of all the options.


    • Michael Gray


  16. George

    What are you referring to here when you say “DRE” ? For this test, you need to undergo a DRE. This will stimulate PCA3 to leak into the urine. A urine sample is then collected and sent to the lab. It takes about 1-2 weeks to get the results. The higher the PCA3 score, the more likely you have prostate cancer.

    • Ben Ong

      Hi George,

      It’s a digital rectal examination. The doctor will ask you to either stand and bend forward at the waist or lie on your side on an exam table with your knees pulled up to your chest in the fetal position. To start the exam, the doctor will gently insert a lubricated, gloved finger into your rectum. He or she may ask you to relax and take a deep breath as the DRE begins. The doctor will then determine the size of the prostate and feel for bumps, soft or hard spots, or other abnormalities. The doctor will also examine the wall of the lower colon/rectum.

      I hope that clarifies matters, let me or the team know if there’s anything else we can help with. I wish you good health,

    • Michael Gray

      They did the test of 12 locations and stated the cancer was real low on the 12th area. So low like “mild smoke in high clouds”. Due ro get retested in 12th of Dec. Purchase your medication?

  17. Bill Tollis

    Dr. Org,

    You promote TAKING testosterone enhancing products rather than reducing testosterone. I have P cancer and will begin the process of hormone therapy to REDUCE testosterone in my body. I have been exposed to the guys who are taking testerone, including a holeistic doc who takes it himself even after fla for P cancer, to enhance performance in the bed and good man emotional health but find myself confused with the intel from the two different camps. What say you?

    • Ben Ong

      Hi Bill,

      Please give my customer support team a call via our toll free number on +1-888-868-3554 in order to discuss this with you in more detail.

      Wishing you good health,

  18. Gene Rios

    Very good explanation.
    Thank you.
    I would appreciate if someone on your staff or you could answer my email question about the total health order I received most recently with a February 2017 sell by date??

    • Ben Ong

      Hi Gene,

      I believe that Carl in my support team has already been in touch – it looks like there has been a bit of confusion about the manufacture date as opposed to the use-by date. If you want to follow up, please feel free to email us – it’s [email protected] – or give the team a call.

      I wish you good health,

  19. Nicholas Wise

    Hi My Name is Nicholas, I am a new reader and I must say that this information is mind blowing and very useful. I have already purchased ALL ABOUT THE PROSTATE and I cannot put the book down. Thank you, Thank you, Thank you!

  20. Segundo C. Silva

    Thanks for a good research and report, I am using Ben Health Advanced now, where I can buy another set of tree bottle?.

    • Ben Ong

      Hi Segundo,

      I’m very pleased to hear it’s working well for you. If you want to make a new order, you can either visit my web store, or just give the team a call on 1-888-868-3554, they’ll be happy to help.

      I wish you good health,

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