The times are changing in prostate cancer diagnosis—especially in how biopsies are performed. Recent research comparing transperineal vs transrectal biopsy points to a major shift in both safety and accuracy.

A Changing Standard in Prostate Cancer Diagnosis

For decades, the transrectal (TRUS) approach was the standard for detecting prostate cancer. However, new randomized studies suggest that the transperineal (TP) method—performed through the skin between the scrotum and anus rather than through the rectum—may offer important advantages. These include improved accuracy and a lower risk of infection.

JOIN THE CONVERSATION

Join us for a live roundtable with Dr. Jim Hu (Weill Cornell), Dr. Alastair Lamb (University of Oxford), and Dr. Badar Mian (Albany Medical College) as they discuss what these findings mean for men on Active Surveillance—and whether the TRUS era may finally be coming to an end.

Saturday, November 22, 2025 • 12:00–1:30 PM Eastern

Patients are invited to send questions in advance to contactus@aspatients.org.  There will be dedicated time for live Q&A following the roundtable discussion.

REGISTER NOW

Key Clinical Trials Driving the Debate

Recent trials have brought new insights:

• Dr. Jim Hu (PREVENT, 2024): Zero infections with TP vs 1.4% with TR, suggesting a reduced risk of sepsis.
• Dr. Alastair Lamb and Dr. Richard Bryant (TRANSLATE, 2025): TP detected 5–6% more clinically significant cancers (Grade Group ≥ 2) and often required no antibiotics.
• Dr. Badar Mian (PRoBE-PC, 2024): Both methods proved safe and effective, giving patients more choice.

Together, these studies have reshaped how experts think about prostate biopsy safety.

Guidelines and What Comes Next

In 2021, the European Association of Urology designated TP as the preferred biopsy method, emphasizing infection prevention and antibiotic stewardship. In contrast, the American Urological Association gave both approaches equal standing in 2023 but is now reviewing new data. Updated recommendations are expected in 2026.

Despite progress, questions remain about patient comfort, access, cost, and how quickly U.S. practices will adapt. This debate—transperineal vs transrectal biopsy—is more relevant than ever.

ABOUT OUR SPEAKERS

Dr. Jim Hu is the Ronald P. Lynch Professor of Urologic Oncology and Director of the LeFrak Center for Robotic Surgery at Weill Cornell Medicine. He earned his medical degree from Baylor College of Medicine and an MPH from Johns Hopkins University. Dr. Hu completed his urology residency at UCLA and a fellowship in urologic oncology at City of Hope.

Before joining Weill Cornell, he led robotic surgery programs at Brigham and Women’s Hospital and Dana-Farber Cancer Institute. Now, he leads the PREVENT randomized clinical trial, which found zero infections in men undergoing transperineal biopsy compared to 1.4% with the transrectal approach. His work continues to guide safer, evidence-based prostate cancer diagnosis and care.

Dr. Alastair Lamb is an Associate Professor of Urology at the Nuffield Department of Surgical Sciences, University of Oxford, and a Senior Clinical Lecturer at the Barts Cancer Institute, Queen Mary University of London. He holds degrees from Oxford, Edinburgh, and Cambridge, and is a Fellow of the Royal College of Surgeons (Urology).

Dr. Lamb’s research focuses on prostate cancer imaging, biopsy innovation, and robotic surgery. He co-led the TRANSLATE trial, the largest randomized study comparing transperineal and transrectal biopsies. This study found higher detection of clinically significant cancers and fewer infection-related events using the transperineal approach.

Dr. Badar Mian is Professor of Surgery (Urology) at Albany Medical College and a board-certified urologist specializing in prostate and bladder cancer. He completed his urology residency at Virginia Commonwealth University and a fellowship in Urologic Oncology and Cancer Biology at MD Anderson Cancer Center.

Dr. Mian serves as the principal investigator of the PRoBE-PC randomized trial, which compared transperineal and transrectal prostate biopsy approaches. His study found both methods to be safe and effective, helping define today’s standards in prostate biopsy safety and patient care.

Saturday, November 22, 2025 • 12:00–1:30 PM Eastern

Patients are invited to send questions in advance to contactus@aspatients.org.  There will be dedicated time for live Q&A following the roundtable discussion.

  REGISTER NOW

See our previous discussion on transperineal vs. transrectal biopsy here.