question:will the prostate ultrasound always show prostate cancer?

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The above question is good one.  Reviewing the search items that get folks to my site are revealing and offer an opportunity to address issues that concern prostate cancer patients.

When the urologist does a prostate ultrasound, it usually is used as a guide to systematically sampling the prostate. For me, it allows for 12 biopsies that are equally spaced out and geographically sampled throughout the gland.

When the prostate ultrasound and biopsy first came out, we were told that prostate cancer could be seen as a hypo echogenic area in the prostate gland. Later we learned that not all prostate cancers made a nodule that could be seen as hypo echogenic. Many prostate cancers are infiltrative and as such may not be seen on an ultrasound.

So…the dirty little secret is that the prostate ultrasound is not used so much as a diagnostic tool in and of itself, its primary use is to allow for the appropriate spacing of the biopsies  to adequately sample the gland.

The answer to the question is yes and no. The ultrasound does not necessarily identify the prostate cancer, but it does aid in the diagnosis by allowing for a systematic method of obtaining specimens which in turn facilitates the diagnosis.

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