Joakim Örtegren: Prostate biopsy – cancer detection and infection risk
Prostate cancer is the most common form of cancer in Sweden. Joakim Örtegren’s thesis investigates whether tissue samples from an additional part of the prostate gland lead to more cancer detections. He has also mapped out risk factors for infection following tissue sampling.
JOAKIM ÖRTEGREN
Dissertation defense: 27 September 2024 (click for details)
Doctoral thesis: Prostate biopsy - cancer detection and risk of complications
Research area: Urology
Sahlgrenska Academy, The Institute of Clinical Sciences
More than 12,000 men were diagnosed with prostate cancer in Sweden in 2022. Overdiagnosis and overtreatment are common, causing anxiety and suffering for many. In most cases, a tissue biopsy from the prostate gland is performed to diagnose prostate cancer.
“All procedures involve risks for the patient. Each biopsy must be justified, have a good chance of detecting cancer, and carry minimal risk. The most serious complication after transrectal biopsy is infection,” says Joakim Örtegren, a doctoral student at the Institute of Clinical Sciences and a specialist in urology and general surgery at Växjö Central Hospital.
A transrectal biopsy involves taking a tissue sample from the prostate gland using an ultrasound probe inserted through the rectum. The ultrasound helps the doctor visualize and take the sample from the correct area of the prostate.
Identified risk factors
What is your research about in brief?
“We studied whether adding biopsies from the anterior parts of the prostate gland, in addition to the traditional method of sampling from the posterior part of the gland, leads to more cancer detections,” says Joakim Örtegren, and continues:
“We also analyzed whether a routine urine culture before a prostate biopsy could reduce the risk of infection as a complication. Additionally, we identified risk factors for infection following a biopsy and examined the significance of having multiple risk factors simultaneously.”
Potential to inspire further research
What are the most important research findings?
“We found no evidence that biopsies from the anterior parts of the prostate gland increase the cancer detection rate. Additionally, the clinical routine of performing a urine culture before a transrectal biopsy does not reduce the risk of infection.”
What did you find regarding risk factors for infection after tissue sampling?
“We showed that having diabetes or a history of urinary tract infections nearly doubles the risk of infection. Having been prescribed antibiotics or experiencing symptoms of benign prostate enlargement also increases the infection risk,” says Joakim Örtegren.
“It also became clear that the occurrence of infection significantly rises with the number of risk factors. Infection rates increased from 4 percent in patients without risk factors to 12 percent in those with three risk factors simultaneously. These results could inspire me or others to conduct further research on risk factors and how they may influence outcomes.”
“The teamwork is the best part”
What has been rewarding and challenging about the doctoral project?
“The doctoral period has been incredibly stimulating and challenging. It feels like the start of something that will shape the rest of my career, even if I stay at a county hospital. It is important to show that clinical research can become part of everyday life even at county hospitals,” says Joakim Örtegren, and continues:
“Even though many aspects of the work are done solo by a doctoral student, completing a project is a team effort. Doing it together is the most fun part. Working with other researchers to carve out an interesting project, and then evaluating the results and clarifying our findings, has been demanding but very satisfying.”
Text: Jakob Lundberg