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Thread: does prostate biopsy spread cancer?

  1. #1
    notme
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    does prostate biopsy spread cancer?

    I just heard a MRI technician say that if you get a biopsy and the needle hits cancer that it's 100% certain that your cancer will spread to outside the gland. read for yourself at www.mrisusa.com

    do you believe this?

    of course he is trying to sell MRIs instead of biopsy, and I agree ~ a MRI doesn't hurt. So what is the reason doctors all want a biopsy? $$?

    If you have cancer of-- say the bones, they give MRIs to locate it.

  2. #2

    if that were true

    MRI does not diagnose prostate cancer. A pathologist needs to look at the cells under a microscope. MRIs can be used to look for spread outside the prostate, and there may be a role in using it to do targeted needle biopsies.

    My reading of the literature (on the National Library of Science's PubMed, for example) is that the risk of a biopsy needle tracking tumor cells into healthy tissue is not zero, but it is on the order of a few percent. A 1991 study by Walsh and Epstein at Johns Hopkins found that 2% or so of their biopsies showed evidence of this--but this was back when needles were bigger.

    There is also the risk of infection, even though this risk is mitigated by antibiotics. (A friend of our family had a quite serious infection from a prostate biopsy).

    Therefore, prostate biopsies should not be done without reasonable suspicion. The risk needs to be balanced against the benefit of the information gained.

    Just my non-qualified view on the matter.
    Replicant

    Dx Feb 2006, PSA 9 @age 43
    RRP Apr 2006 - Gleason 3+4, T2c, NXMX, pos margins
    PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
    Salvage radiation (IMRT) total dose 70.2 Gy, Jan-Mar 2007@ age 44
    PSA 6/07 0.1, 9/07 (and thereafter) <0.1
    http://pcabefore50.blogspot.com

  3. #3

    from the website

    notme,
    from the website you linked to, I went into the diagnosis section. Indeed, this site is NOT claiming that MRI can diagnose prostate cancer. As I wrote in the other response, the site is talking about using MRI to avoid blind biopsies, to target where the needle goes.

    Quote from site (emphasis supplied by me)
    Diagnosis
    Prostate cancer is most often discovered by physical examination or by screening blood tests, such as the PSA (prostate specific antigen) test. Suspected prostate cancer is typically confirmed by removing a piece of the prostate (biopsy) and examining it under a microscope. However, blind needle biopsies spread cancer cells and only yield a 25 % success rate in finding cancer. Recent advancements in imaging technology such as prostate 3.0 Tesla MRI with Spectroscopy allow physicians to locate suspicious areas of disease and then performed targeted biopsies improving diagnostic outcomes by up to 40%. In addition to locating suspicious lesions, 3.0 Tesla with Spectroscopy can determine whether prostate cancer has spread beyond the capsule.
    http://www.mrisusa.com/Prostate%20Cancer.html
    Replicant

    Dx Feb 2006, PSA 9 @age 43
    RRP Apr 2006 - Gleason 3+4, T2c, NXMX, pos margins
    PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
    Salvage radiation (IMRT) total dose 70.2 Gy, Jan-Mar 2007@ age 44
    PSA 6/07 0.1, 9/07 (and thereafter) <0.1
    http://pcabefore50.blogspot.com

  4. #4

    More from Walsh on cancer spread by biopsy

    Walsh, in his book on pages 178-179, addresses the question of needle tracking of tumor cells. He says "This is an excellent question and a very common fear", but basically if it were a serious risk, then "the whole concept of early diagnosis and treatment wouldn't work. But many thousands of people--all of whom had initial biopsies to confirm what they had--have been cured of cancer."

    He goes on to say that sometimes cancer cells may escape into the bloodstream, and that the "circulation of cancer cells in the blood is probably a common event, even in cancers that are curable. And it's not unreasonable to assume that a few more cells may find their way into the bloodstream when the tumor is manipulated, as it is during a biopsy. The key is the stage of your cancer. When cancer is confined to the prostate, even if a few cells escape into the blood, they won't survive. This is because they haven't yet got the hang of living outside the area where they developed." A few sentences later: "So there are two different issues. One is the presence of cancer cells in the blood.; the other is the survival of these cells in distant locations. Prostate cancer cells are simply unable to live outside their normal environment until they develop this ability, called metastatic capability."
    Replicant

    Dx Feb 2006, PSA 9 @age 43
    RRP Apr 2006 - Gleason 3+4, T2c, NXMX, pos margins
    PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
    Salvage radiation (IMRT) total dose 70.2 Gy, Jan-Mar 2007@ age 44
    PSA 6/07 0.1, 9/07 (and thereafter) <0.1
    http://pcabefore50.blogspot.com

  5. #5
    A couple thoughts on this topic:

    My Conversation with Dr. Bertrand Guillonneau who performed my surgery at Sloan-Kettering

    Question: "At what point does this cancer start throwing cells out into my blood stream?"

    Answer: "Oh, you have cancer cells in your blood stream. That does not mean they are capable of establishing themselves and surviving. No one can tell what moment that may happen."

    I am not suggesting this is the last word. As Dr. Guillonneau himself says at times, "What do I know, I am only a surgeon"
    albeit a world renown surgeon.

    One other point. I can easily see how MRI can guide a biopsy and increase the odds of not missing a small tumor. It would have possibly spared me 3 biopsies if I had my endo rectal coil MRI earlier on. What makes no sense to me is how it can reduce one bit the slim risk of tracking cancer during a biopsy. A biopsy needle is still inserted into the tumor and extracted exactly like any biopsy. They obviously use a fresh needle with each core taken so the needles that miss the cancer are no risk and that is all the MRI is designed to reduce. That is unless they imply they can do the job with one or two needles because they now they hit the tumor. Even in that scenario, I only had two needles hit my tumor.
    History: PSA's every 6 months 6.7 neg biopsy - PSA 16.6 neg biopsy - PSA's 8.2, 8.1, 8.7 - Biopsy showing 4+4 Gleason 8. Lap RP Apr 2004, age 52 All neg margins, nodes, and structures. (T2a). Post RP PSA: every 6 mo. <.1 until Feb, 08 (46 mos) PSA .1 - I then got sensitive tests beginning 2008: Feb .06, May .09, Jun .10, Aug .10, Nov .15 - SRT Dec 2008
    Post SRT PSA 2009 Feb .10, May .09, Aug .06, Dec .04, 2010 Mar .04

  6. #6
    Administrator Top User brainman's Avatar
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    Notme, I have never heard or read any legitimate site (JAMA, NEJM...) that says that needle biopsy can spread cancer. I have heard about full surgery having the danger of sloffing off cancer cells. I do not have a reference for this... I am not sure this is true, it just is something that is in the back of my mind as something that I have heard.
    Jim
    Long-term cancer survivor
    1992 Astrocytoma grade 2, left motor strip
    2005 Recurrence this time said to be an Oligodendroglioma grade 3, same location.
    http://cancerforums.net/viewtopic.php?t=2405
    My Story Part 1: http://cancerforums.net/viewtopic.php?t=2528
    My Story Part 2: http://cancerforums.net/viewtopic.php?p=7350
    My Story Part 3: http://cancerforums.net/viewtopic.php?t=8029

  7. #7
    notme
    Guest
    Thanks for all your replys

    It occurred to me that doctors order a MRI to locate the suspicious site of cancer, but then, yes they always follow with a biopsy, except in the brain.
    My experience with this was the MRI was always correct, it was indeed cancer, so I still wonder if the biopsy is really needed.

    yes, brainman, I remember hearing of surgery leaving behind cells...

    "What do I know, I am only a surgeon" (:

    Replicant, agreed, we all sure hope: "many thousands of people--all of whom had initial biopsies to confirm what they had--have been cured of cancer."

  8. #8
    The bottom line is that an MRI can identify a mass or density change in the tissue. Only a trained pathologist with a microscopic study of cell structure can tell if it is cancer. Additionally, only a pathologist can give the much needed information on the Gleason grade of cancer.


    PS: I loved Dr. G's "what do I know, I am only a surgeon" remark. He was highly specialized and humble about what he did not know (nutrition etc). Some doctors try to fill in the blanks by guessing with the sound of authority.
    History: PSA's every 6 months 6.7 neg biopsy - PSA 16.6 neg biopsy - PSA's 8.2, 8.1, 8.7 - Biopsy showing 4+4 Gleason 8. Lap RP Apr 2004, age 52 All neg margins, nodes, and structures. (T2a). Post RP PSA: every 6 mo. <.1 until Feb, 08 (46 mos) PSA .1 - I then got sensitive tests beginning 2008: Feb .06, May .09, Jun .10, Aug .10, Nov .15 - SRT Dec 2008
    Post SRT PSA 2009 Feb .10, May .09, Aug .06, Dec .04, 2010 Mar .04

  9. #9
    notme
    Guest
    The guy from that web site, mrsiusa, wrote on another forum "it's not what I believe, it's a fact...Prostate Biopsies do spread Prostate Cancer. If a Doctor hits Prostate Cancer during a Biopsy, The chance of needle tracking (spreading the cancer) is close to 100%!!!"

    He certainly was clear when writing off the books.....that is, IF it is indeed him, but it certainly sounds like it is.

  10. #10
    Administrator Top User brainman's Avatar
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    notme, I am do not agree with that guy you are quoting... no matter how confined he sounds. Everyone who has had or currently has prostate cancer has had at least one needle biopsy including Hawk, Replicant, and many others. They show no signs that the needle biopsy has spread their cancers. As Replicant quoted, if the danger was indeed 100%, there is no way the medical professionals would continue to use needle biopsies.
    Jim
    Long-term cancer survivor
    1992 Astrocytoma grade 2, left motor strip
    2005 Recurrence this time said to be an Oligodendroglioma grade 3, same location.
    http://cancerforums.net/viewtopic.php?t=2405
    My Story Part 1: http://cancerforums.net/viewtopic.php?t=2528
    My Story Part 2: http://cancerforums.net/viewtopic.php?p=7350
    My Story Part 3: http://cancerforums.net/viewtopic.php?t=8029

  11. #11

    supplements

    They're big on selling proprietary herbal/vitamin supplements (click on Peenuts.com at the bottom of mrisusa.com -- the websites are nearly identical and both registered to Wheeler's medical practice).

    They have yet another website, same registration, same design, PanAmHIFU.com, with a section "Why HIFU Fails" which argues that you should have a biopsy using their special MRI equipment for targeting, before getting HIFU. They also want you to come to them for imaging if your PSA fails to nadir below 0.5 ng/ml, or if your PSA rises after HIFU.
    http://panamhifu.com/why_hifu_fails.html

    notme, is Dr. Wheeler "the guy" to whom you refer?
    Replicant

    Dx Feb 2006, PSA 9 @age 43
    RRP Apr 2006 - Gleason 3+4, T2c, NXMX, pos margins
    PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
    Salvage radiation (IMRT) total dose 70.2 Gy, Jan-Mar 2007@ age 44
    PSA 6/07 0.1, 9/07 (and thereafter) <0.1
    http://pcabefore50.blogspot.com

  12. #12
    notme
    Guest
    No, it's the MRI technician who is writing. Yes, he sites all of the web sites you mention and touts Peenuts.
    Thing is, if he is right then I think we should warn others...yes, it's too late for me as well. I don't like the fact that he is selling so much, but if he is correct.... Here's a part of what he says....

    "I'm the MRI Technologist here at the Diagnostic Center for Disease. For the past 2 years I've been fortunate enough to have my eyes opened to this horrific disease that plagues all men and their families. I have dedicated my life and career to working exclusively with patients that have Prostate disease. Helping to educate, as well as being educated by more than 400 patients that I have personally performed MRI's of their Prostates. Realizing how barbaric and ludicrous traditional Urologists in are diagnosing and treating people every day. Traditional Urologists usually don't even begin to intervene until the PSA goes above 4.0. Why, because that's been the "GOLD STANDARD". Well, I think it's time we update that Gold Standard. I've personally performed MRI's on several people with low PSA's less then 2.0, the lowest being 0.7. All of these men were positive for Prostate Cancer on MRI and were then confirmed with a targeted focal biopsy of only the area in question. Had these men, gone the traditional route, they first would have first waited for their PSA's to go up, which would have caused their Cancer to grow. Then, when their PSA was around that MAGIC number(4.0), the Urologist would do a blind biopsy and might get lucky enough to stick one of his 6-12 needles in the area where the Cancer was. If not and the results were negative would that mean that the patient was cancer free or the Doctor who he trusted might have missed. Then, when he has a follow up PSA in 6-12 months and he sees it's gone up what does he do? Have another BLIND Biopsy, only this time the Urologist ups his odds and uses 12-20 needles. This barbaric inhuman process continues until the Urologist finally hits the Cancer. Here's a fact for you: 30% of 30 year old men have Prostate Cancer. Unfortunately for them, According traditional Urology guidelines, these men probably won't get a PSA till they're 50. Now let's take that "GOLD STANDARD" of Urology one step further. The DREADED BLIND PROSTATE BIOPSY... Why is it that every other organ in the human body is first studied through some form of imaging and then biopsied. EXCEPT the Prostate? Think of it like this. A patient goes to his Doctor with all the signs and symptoms of possible Brain Cancer. Does his Doctor arbitrarily stick 6-12 needles in his brain to see if the symptoms are correct. No, he sends the patient for a CT Scan or MRI of the Brain. If the results shows a suspicious area, then a Targeted Guided Biopsy done and ONLY in that region. Barbaric or not, you decide?

    You say Dr. Scionti told you that biopsy does not cause cancer to spread except in the rarest of occasions. He's absolutely correct since most Urologists only yield cancer 20-30% of the time and patient's are rarely studied after their treatment. There was an article published by a Urologist on Needle Tracking in The Journal of Urology, November 2002. "

  13. #13

    hmmm

    I can find you many, many such people who are utterly convinced--there was a guy on the Usenet prostate cancer support group who drank his own urine (as you might imagine, it didn't work) , another guy who showed up there who was convinced if you drank this kind of milk and not that kind of milk, it would cure you ( http://www.endcancernow.org/ ); someone showed up here, on HealingWell.com, and other places shouting that hot peppers had definitely cured him...after a few months of proclaiming his cure, he mysteriously vanished ( http://www.cancerforums.net/about8898.html ).

    What matters is science, not stories; studies, not anecdotes.


    I see no need to pay any attention to the technician in question.

    "Convictions are more dangerous enemies of truth than lies."
    --Friedrich Nietzsche
    Replicant

    Dx Feb 2006, PSA 9 @age 43
    RRP Apr 2006 - Gleason 3+4, T2c, NXMX, pos margins
    PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
    Salvage radiation (IMRT) total dose 70.2 Gy, Jan-Mar 2007@ age 44
    PSA 6/07 0.1, 9/07 (and thereafter) <0.1
    http://pcabefore50.blogspot.com

  14. #14
    Hogwash to the technician out to save men from a barbaric life.

    I think he is out to assure he has enough money that he does not live a barbaric life (at any gullible man's expense).
    History: PSA's every 6 months 6.7 neg biopsy - PSA 16.6 neg biopsy - PSA's 8.2, 8.1, 8.7 - Biopsy showing 4+4 Gleason 8. Lap RP Apr 2004, age 52 All neg margins, nodes, and structures. (T2a). Post RP PSA: every 6 mo. <.1 until Feb, 08 (46 mos) PSA .1 - I then got sensitive tests beginning 2008: Feb .06, May .09, Jun .10, Aug .10, Nov .15 - SRT Dec 2008
    Post SRT PSA 2009 Feb .10, May .09, Aug .06, Dec .04, 2010 Mar .04

  15. #15
    New User
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    Dr. Ben L. Pfeifer, M.D. Ph.D.

    This is what Dr. Ben L. Pfeifer, M.D. Ph.D. has to say on this subject

    I want to leave a message for you to take home. It is more for the lay man than doctors who won't often listen to the message I have spent ten years trying to get through and I call this rocking the boat: We know that any bioscopy or any surgery or prostate brachytherapy where you put radioactive seeds into the prostate to carry out radiotherapy " any or those therapeutic or diagnostic measures involving mechanical intrusion with a sharp needle in to the tumour " we know this will cause iatrogenic (caused by doctor's measures) shedding of cancer cells into blood stream which may " I must stress may " lead to early metastases. These diagnostic biopsies are a dangerous tool. The person has to be fit for it, the immune system needs to be strong to cope with the cancer cells- this is the same with breast biopsy.

    10 years ago when I first talked about this in Germany at a conference attended by 2000 urologists, I was invited without their knowing I would bring this up. I was booed at which wasn't a very pleasant situation. At time we didn't have any proof it was just a hypothesis. Now in 1996 a method came out called Reverse transcriptase polymerase chain reaction test " a molecular test capable of finding one prostate cancer cell among 10,000,000 blood cells. This is a very highly sensitive test used to quantify how many prostate cancer cells would be found in a man's peripheral blood after a biopsy. There is method for doing this which will find from 0 -14,000 cells in 1 millilitre.

    In patients with BPH (enlarged prostate) we don't find cancer cells 4 weeks after the biopsy.
    Here you see after 2 weeks of biopsy a patient in which the needle identified cancer: in 1 millilitre of blood there are now 12,000 copies of tumour cells. That means in 5 litres- 5,000 x 12,000 that is 60 million. No urologists would like to have that injected.
    Skype james. joseph. hutt
    Identify you request to join me on skype by "Prostate"

  16. #16
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    If you have never used it don't knock it

    Hi All
    Got my latest two month PSA result 0.29 and that is taking a of the 915mg tablet each day of the old Prostasol .I have a pill cutter that I can cut up the 915mg tablet in "quarters" I think that by taking Prostasol each day, keeps a supply in the body and the graph curve with less highs and lows, I have tried to cut the dose back smaller but the PSA started move up and when I got a bit slack "not taking it every day it also started to move up" I don't have the sensitive nipples anymore but still have the old man boobs, but that could be me being a little over weight and as for blood clots,well drink lots of ginger.
    So guys don't let this cancer rule your life, go fishing or something.
    Hang in there
    Joe H
    Skype james. joseph. hutt
    Identify you request to join me on skype by "Prostate"

  17. #17
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    Alleged PCa Biopsy Needle Tracking Dangers

    To ALL "The technician, if he is one, doesn't know what he is talking about. Here are the basics of what was contained in a 18 year old Study from Johns Hopkins, which is often cited by the unknowledgeable, as evidence that Biopsies are a great danger, and my stated factors as to why it provides little, if any, logical adverse reason to avoid a biopsy, when one is appropriate.

    (1) The Study was published in early 1991.
    (2) It was attributed to Drs. Bastacky, Walsh and Epstein of Johns Hopkins.
    (3) It reviewed the results of 350 positive biopsies done at JH in 1987 & 1988.
    (4) Biopsies were on Stage B Tumors, graded on the old Whitmore-Jewett system.
    (5) It included Core Biopsies done w/14 gauge & Biopsy Guns done w/18 gauge needles.
    (6) It found 7 instances (2 percent) that were attributed to possible Tumor needle tracking.
    (7) Of the above, just 3 (less than 1 percent of total) were found ONLY in the needle track.
    ( If you included the Negative Biopsies necessary to generate these figures the odds of POTENTIAL tracking is reduced to .005 per Biopsy.
    (9) In the years since these findings, no follow-up studies have been done at JH, indicating that the results were not considered significant enough to pursue.
    (10) It clearly demonstrates any real or perceived risks of doing a PCa Biopsy, when appropriate, are FAR outweighed by the relative risks of NOT doing one when it is justified.

    Just so those interested don't draw any wrong conclusions! - John@newPCa.org (aka) az4peaks

  18. #18

    Re : MRI finding cancer outside prostate (prostascint)

    After my prostate robotic surgery, I have high PSA--so,
    I'm in the middle of a prostascint/MRI fused scan, with prostascint having been injected into my body Monday, and the scan tomorrow after 96 hours-- the prostascint is supposed to attached to PSMA which apparently is always around the prostate cancer cells even when they are outside the prostate --and thus give off radiation which the MRI can see.

    It is looking bad even before the MRI scan (my rad officer in my place of work gave me a crude scan with a radiation monitor to make sure that it's safe for people to be around me, and found a hot spot in my right torso 6" below the armpits --6 mr/hr on contact vs. 1 mr/hr elsewhere --could be my liver).

    Wish me luck.

    BTW --I'm also worried that the biopsy spread my 4+3=7 Gleason tumor,
    since the tumor invaded at least my right seminal vesicles (removed during the surgery)--although my surgeon assured me repeatedly that the metatstasis almost certainly occur before the biopsy.

  19. #19
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    MRI finding PCa outside Prostate (Prostascint)

    Hi JohnK. - It is HIGHLY unlikely that any present matastases would have been stemmed from your Biopsy. See the Study results that I previously posted above.

    Another Johns Hopkins Study, about men suffering biological recurrence after surgery, found that the Median time to metastases was 7 years, from the time of recurrence. It appears you have enough to worry about, without needlessly adding the implausible to the list.

    I wish you the best, but what is the post-op PSA history here?
    What was the full Gleason (#+#=?), What was the Pathologic STAGE of your disease, assigned in the post-op Pathology Report? Good luck! - John@NewPCa.org (aka) az4peaks

  20. #20

    Correction : Liver hot spot is expected (prob not cancer)

    Update : (partial--just did the MRI scan; results not in yet)
    The technician at the MRI told me that a hot spot is expected at the liver, since it collects all the dead red blood cells, etc. In fact, Prostascint/MRI scan CAN NOT DETECT liver metastatis due to the this interference.
    So, I breath a sigh of relieve (at least for the moment).

    Further info. My PSA was 4.2 (4/13/09), which triggered the uro visit (delayed because I did not sent the results which I obtained at work to my primary physician for 6 weeks) and biopsy on July and results in Gleason 4+3=7 T3b or c and Robotic surgery on 10/9/09; prior to surgery, my PSA have risen to 6.7 (doubling time of only 9 months or so). 6 weeks after surgery (prostate, right seminal vesicle --cancerous--right nerve bundle, and adjacent lymph nodes --not cancerous--removed) , my PSA was 7 and 6.4 (retest), Bone scan is negative; Prostascint/MRI scan result forthcoming; due to get Lupron on Wednesday evening. Will update this on Thursday (but I do want to correct the liver misinformation since it may scare a lot of people --as well as myself and my wife --ASAP).

 
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