biopsy after radiation treatment - dangers?

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glass guy
New Member


Date Joined Oct 2008
Total Posts : 18
   Posted 10/27/2008 5:55 PM (GMT -7)   
hubby was treated 2 years ago with proton and regular radiation.  also hormone therapy.  recently he had two PSA's done - one 10.4, the other 12.8 (within 3 days of each other).  had the pelvic CAT scan and the whole body bone scan.  test results were negative.  that's the good news.  now the dr. - almost as an afterthought - wants to biopsy his prostate.  After having virtually destroyed the prostate with radiation, is there a danger is having this done?  is having a biopsy common after having had radiation?   your thoughts on this are welcomed.
thanks.


first psa ever 11/05 - 12.1, age 67
       what a dummy!  now a big advocate for early PSA's
gleason 7 (3&4)
Proton beam therapy - LLUMC -79.2 Gy to prostate
Photon - 45 Gy to pelvis
Lupron
Stage T3b NX M0
bilateral seminal vesicles and extracapsular extension
PSA's on Lupron - .02 range
off Lupron - .7 (4/08), now 12.8 (10/08)
testing currently (10/08)
researching salvage and options

Post Edited (glass guy) : 10/29/2008 9:36:36 PM (GMT-6)


aus
Regular Member


Date Joined Sep 2006
Total Posts : 211
   Posted 10/27/2008 7:08 PM (GMT -7)   
There's no point in biopsy within 2 years of radiation treatment: after that biopsy is often done if there's a rise in PSA.
Suggest you read the publication by Dr Myers on Hormone Treatment.

divo
Veteran Member


Date Joined Jul 2008
Total Posts : 637
   Posted 10/28/2008 4:58 PM (GMT -7)   
Dear Glass, My husband's psa began rising four years after radiation, seeds, and hormone therapy. He had a biopsy on the radiated prostate... ....The doctors said that salvage surgery was an option....My husband had it, and has suffered with major SEs ever since.........This is a devastating surgery after radiation damage....The SEs have been horrendous....Be very wary of salvation surgery. That is the thing with radiation...if the cancer returns the surgery is very difficult, however, if surgery is first, and the cancer returns, you can have the radiation with minimum SEs.... Good luck. Di
Husband Pete
dx Jan 2001 age 67 gleason 4 + 3 PSA 16.5
seed implant and conformal radiation Lupron from Jan 2001 to Jan2002
2005 Dec PSA began to rise from .5 to 8 within 6 months
Salvage surgery at MSK 9/06
Fistula operation 2/07 MSK
Many cystoscopies and ER visits with strictures
catheter for one year....Catheter taken out Sept 07..
Total Incontinence since then....
PSA .52 3/07
AUS Operation at MSK Sept 8. Dr. Sandhu
Waiting for activation October 28 2008


glass guy
New Member


Date Joined Oct 2008
Total Posts : 18
   Posted 10/29/2008 8:35 PM (GMT -7)   

di - SE??  pardon my ignorance.  the abbreviation lingo is new to me.

we were looking at cryo in case a salvage procedure is necessary.  but before we even get to that point, hubby was even questioning the biopsy.  i mean, what's left to biopsy?  he had full radiation on his prostate.  isn't it dangerous to do the biopsy?  isn't there a way to test the lymph nodes?  we know something is going on for the psa to go sky high in less than 6 months.  his pelvic cat scan and nuclear body scan came back negative.  i read somewhere about "radiation proctitis"  spelling?  isn't there some test for that.  i hate to see him go through a biopsy - not because of the procedure but because of the previous radiation.

ever hear of dangers after radiation?


first psa ever 11/05 - 12.1, age 67
       what a dummy!  now a big advocate for early PSA's
gleason 7 (3&4)
Proton beam therapy - LLUMC -79.2 Gy to prostate
Photon - 45 Gy to pelvis
Lupron
Stage T3b NX M0
bilateral seminal vesicles and extracapsular extension
PSA's on Lupron - .02 range
off Lupron - .7 (4/08), now 12.8 (10/08)
testing currently (10/08)
researching salvage and options


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 10/29/2008 8:59 PM (GMT -7)   

First, an SE is a Side Effect.

There are many reasons a doctor won't operate after radiation.  But there is one glaring one.  Surgery is tough enough on "virgin" tissue.  Meaning tissue that is in normal condition.  Once an area is irradiated it becomes deformed and scarred.  Nerves, blood vessels, and surrounding tissue my function, but they are changed from their original state.  In addition, again scarring occurs.  A urologist who attended one of my advocacy meetings pointed out that controlling blood loss, saving nerve endings, and surgical reattachement of a urethra become very complicated after radiation.  Other options that become more favorable are cryo and HIFU.  (no one in the US can perform HIFU at this time).  Regardless, like it is said above, there is no use for another biopsy.  Tests that you may wish to request instead include a PET scan, Prostascint, and CEA.  A CTC (circulating tumor cell) is also a good test.  If the disease has turned to mets, then the systemic treatments such as HT, 2nd line HT, and chemo are the logical next suggestions from your doctors.

Stay beating that advocacy drum for early testing.  And for your husband ~ stay positive!

Tony


Age 46 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007 @ The City of Hope
Post-Op Pathology: Gleason 4+3=7, positive margins, Extra Prostatic Extension (EPE)
Bilateral seminal vesicle invasion (SVI); Stage pT3b, N0, Mx
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (September 17 '08): <0.1 ~ Undetectable!
 
You can visit my Journey at:
 
STAY POSITIVE!
 
 


glass guy
New Member


Date Joined Oct 2008
Total Posts : 18
   Posted 10/31/2008 5:28 AM (GMT -7)   

thanks tony for the info.

the CT scan of the pelvis he just had lists "coarse calcification is present in the prostate gland".  This is the very reason we were hesitant is agreeing to a biopsy.  his proton and photon radiation was 2 years 5 months ago.  we were a little shocked in that having a biopsy was almost like an afterthought from the doctor.  he had no real thoughts of what to do next since the nuclear body scan and the CT scan of the pelvis were basically negative.

i read somewhere about radiation proctitis.  don't know if i spelled it right.  can't find where i read it or anymore else about it.  anyway, it has something to do with nerves, radiation damage, and having bowel problems.  well, hubby's CT scan does say "diverticulosis without evidence of acute diverticulitis".  i don't know if that is something to do with it or not.  he does have times when he has to use the bathroom a couple times a day.  then that goes away. 

we are at a complete loss of what the real next step to do is and we know we must do something with a psa of 12.8!


first psa ever 11/05 - 12.1, age 67
       what a dummy!  now a big advocate for early PSA's
gleason 7 (3&4)
Proton beam therapy - LLUMC -79.2 Gy to prostate
Photon - 45 Gy to pelvis
Lupron
Stage T3b NX M0
bilateral seminal vesicles and extracapsular extension
PSA's on Lupron - .02 range
off Lupron - .7 (4/08), now 12.8 (10/08)
testing currently (10/08)
researching salvage and options


divo
Veteran Member


Date Joined Jul 2008
Total Posts : 637
   Posted 10/31/2008 8:45 AM (GMT -7)   
Dear Glass....most people over the age of 50 or 60 have some diverticula..(pockets that form in the small colon), these are usually just there, and dont cause any problem....that is called "diverticulosis" "Diverticulitis" is when one of the pockets gets infected and causes severe pain in the lower left side of the abdomen. It doesnt have anything to do with prostate cancer. In fact, I just had Diverticulitis two weeks ago, and I am a female..You Must take antibiotics to get over diverticulitis or it will become very serious and may rupture. You would know if you had it. I had to go to the ER in the middle of the night.... My doctor prescribed probiotics for keeping the digestive system going well...Peter also takes them... Good luck....Diane
Husband Pete
dx Jan 2001 age 67 gleason 4 + 3 PSA 16.5
seed implant and conformal radiation Lupron from Jan 2001 to Jan2002
2005 Dec PSA began to rise from .5 to 8 within 6 months
Salvage surgery at MSK 9/06
Fistula operation 2/07 MSK
Many cystoscopies and ER visits with strictures
catheter for one year....Catheter taken out Sept 07..
Total Incontinence since then....
PSA .52 3/07
AUS Operation at MSK Sept 8. Dr. Sandhu
Activated Oct 28th Dr. Sandhu..MSK


glass guy
New Member


Date Joined Oct 2008
Total Posts : 18
   Posted 11/1/2008 5:35 AM (GMT -7)   

based on what we have been reading we have postponed hubby's biopsy for a week.  we are asking for a repeat psa and we'll see if it is still it's the 1800% increase and we are asking if a simple blood test may show some kind of infection that he doesn't know he has.  it kinda shatters your confidence when the urologist's office procedure is to do the blood test AFTER the DRE.  in my mind that still wouldn't account for an 1800% increase but like i said, it still shatters the confidence. 

we're gonna use the week's postponement to check into other procedures that we may be able to do first before the biopsy.  Using suggestions read here we are taking a little bit of time, time we may not have if something aggressive is going on, but time nonetheless.  We probably have to travel to get these things done that's why we're proceeding slowly.  When he was first diagnosed almost three years ago we didn't do anything slowly.  Now it's different. 

we sent a fax to LLUMC including test results so we hope to hear from someone we trust.  Also we're looking more into cryo as a salvage and looking into memphis doctors.  that wouldn't be as far a trip for us as south carolina.


first psa ever 11/05 - 12.1, age 67
       what a dummy!  now a big advocate for early PSA's
gleason 7 (3&4)
Proton beam therapy - LLUMC -79.2 Gy to prostate
Photon - 45 Gy to pelvis
Lupron
Stage T3b NX M0
bilateral seminal vesicles and extracapsular extension
PSA's on Lupron - .02 range
off Lupron - .7 (4/08), now 12.8 (10/08)
testing currently (10/08)
researching salvage and options

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