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How the cancer is finally confirmed?

Once suspected, urologist does prostatic biopsy. This is done under ultrasound guidance using an biopsy gun. Depending upon the size, upto 12 biopsies may be done. If the cancer is palpable, it can be done without ultrasound also. 

The procedure is done under local anesthesia and under antibiotic cover. One must stop blood thinners like aspirin 3-5 days before biopsy. There are insignificant incidence of fever, blood in urine or in stools.