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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

 
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