Needle Tracking

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Mr GTO
New Member


Date Joined Oct 2008
Total Posts : 5
   Posted 12/14/2008 3:24 PM (GMT -6)   
Does anyone have information on potential "needle tracking" from a biopsy?  I am scheduled for a biopsy this Friday and my concern is that if there is any PCa at all that a cell or two will get loose and migrate outside the prostate.
 
In fact, I wonder if there is any possibility that a few loose cells going elsewhere after RP, LRP, Davinci, etc. is what causes PCa to come back after the Prostate is removed, especially when the PCa was contained in the Prostate. It seems that cutting it out would naturally cause some of the cells to shed off and stay in the body. Comments?

Rolerbe
Regular Member


Date Joined Dec 2008
Total Posts : 235
   Posted 12/14/2008 3:53 PM (GMT -6)   
It's certainly a theory. On the one hand, the body is not that 'partitioned'. Prostate cells have access to go elsewhere already via the blood vessels, etc. that supply it. It may be that some do all the time, but the body's immune defenses generally catch and kill those that migrate out of place.

On the other hand, particularly with PCA, it tends to be slow growing and remain in place. Otherwise, most of us here would have been in even more trouble than we are/were. So, it could be that the capsular wall of the prostate acts as a reasonably effective barrier for some period of time. In which case, the biopsy tracks could, in fact, be trouble.

But, I don't believe anyone knows. I personally guess its more the former than the latter and eventually, as the tumor(s) get bigger, the number of escapee's eventually beat the odds of getting caught by body defenses. But I have absolutely no evidence of this, it just sounds like a good theory to me.

Unfortunately, there is no other definitive test than the needle biopsy. I was very surprised at the time that this was so (but then, I thought the whole thing was just a nuisance and that nothing would be found). Man, talk about change of life! As I'm sure is true with most here, I went through a range of emotions I never knew I had. So much for the old self reliant, macho self image. Now I wake up with a "hey I'm still here" attitude every day that I'm sure is better than the 'take it for granted' of before. While I hope to get back to as close to 'normal' as possible, I hope that part lasts.
50 YO
PSA at Dx: 8.2
DaVinci RALP: 10/31/08
Negative margins, no extra-capsular involvement
One nerve spared
No follow-up PSA yet (next week).
 


BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 12/14/2008 4:04 PM (GMT -6)   
Mr GTO,
Although it is theoretically possible I have never read of an instance where 'tracking' has caused the spread of prostate cancer. How would this ever be shown anyway? If you have prostate cancer and it later spreads it could never be determined if the spread is due to theoretical 'tracking' or the natural progression of the disease. Your vascular and lymphatic systems are the route of distant spread as your body both nourishes and cleans itself and this includes the prostate. The aim in surgically removing the prostate is to remove it completely and intact without cutting the capsule.........for example in robotic surgery the prostate is placed in a sealed little bag internally before removal.
Bill
1/05 PSA----2.9 3/06-----3.2 3/07-------4.1 5/07------3.9 All negative DREs
Aged 59 when diagnosed
Biopsy 6/07
4 of 10 cores positive for Adenocarcinoma-------bummer!
Core 1 <5%, core 2----50%, core 3----60%, core 4----50%
Biopsy Pathologist's comment:
Gleason 4+3=7 (80% grade 4) Stage T2c
Neither extracapsular nor perineural invasion is identified
CT scan and Bone scan show no evidence of metastases
Da Vinci RP Aug 10th 2007
Post-op pathology:
Positive for perineural invasion and 1 small focal extension
Negative at surgical margins, negative node and negative vesicle involvement
Some 4+4=8 identified ........upgraded to Gleason 8
PSA Oct 07 <0.1 undetectable
PSA Jan 08 <0.1 undetectable
PSA April 08 <0.001 undetectable (disregarded due to lab "misreporting")
PSA August 08 <0.001 undetectable (disregarded due to lab "misreporting")
Post-op pathology rechecked by new lab:
Gleason downgraded to 4+3=7
Focal extension comprised of grade 3 cells
PSA September 08 <0.01 (new lab)

Post Edited (BillyMac) : 12/14/2008 2:08:50 PM (GMT-7)


Piano
Veteran Member


Date Joined Apr 2008
Total Posts : 847
   Posted 12/14/2008 8:29 PM (GMT -6)   
My understanding is that if PCa cells leak out during biopsy or surgery, they have a hard time getting established elsewhere. They need to get hooked up to a blood supply, they need to avoid the body's natural defenses and they need to be able to reproduce -- the odds are heavily stacked against escapees.

Semen is mostly prostatic fluid, and I have never heard of women catching PCa from their partners, before or after PCa diagnosis. After my diagnosis was confirmed, I was concerned about having sex with bloody semen (from the biopsy). The answer then even, was no risk at all to my wife.

PCa just doesn't seem to spread via needle track or sexual contact -- and just as well!

So yes, there may be a very small risk in having the biopsy, but the risk in not having one is much greater.
Age 63. Other than cancer, in good health; BMI 20
Pre-op: No symptoms; PSA 5.7; Gleason 4+5=9; cancer in 4 of 12 cores
7 March 2008, RRP, non nerve sparing
Two nights in hospital; catheter and staples out after 7 days
Continent, no pads needed from the get-go
Post Op: Stage pT2 M- N-; clear margins and lymph nodes; Gleason 4+4=8; prostate weight: 37gm
6-week and 7-month PSAs: 0
Bimix injections working well 


BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 12/14/2008 8:51 PM (GMT -6)   
Piano, it is not possible to "catch' cancer of any type. The reason for this is straight forward. Your cancer cells have your DNA structure..............any of your cells that are placed by whatever means in another persons body are immediately attacked and killed by that persons immune system who see them as invaders, much the same as a flu or measles virus. There are exceptions of course, as in reproduction and same type blood cells (i.e transfusions). Having said that, it would be theoretically possible for a woman, who would subsequently be on immuno suppressant drugs, having received a bone graft from a male cadaver whose bone contained microscopic traces of prostate cancer cells, to develop prostate cancer. Ain't the human body a wonderful thing (when it's working as it should of course)
Bill
1/05 PSA----2.9 3/06-----3.2 3/07-------4.1 5/07------3.9 All negative DREs
Aged 59 when diagnosed
Biopsy 6/07
4 of 10 cores positive for Adenocarcinoma-------bummer!
Core 1 <5%, core 2----50%, core 3----60%, core 4----50%
Biopsy Pathologist's comment:
Gleason 4+3=7 (80% grade 4) Stage T2c
Neither extracapsular nor perineural invasion is identified
CT scan and Bone scan show no evidence of metastases
Da Vinci RP Aug 10th 2007
Post-op pathology:
Positive for perineural invasion and 1 small focal extension
Negative at surgical margins, negative node and negative vesicle involvement
Some 4+4=8 identified ........upgraded to Gleason 8
PSA Oct 07 <0.1 undetectable
PSA Jan 08 <0.1 undetectable
PSA April 08 <0.001 undetectable (disregarded due to lab "misreporting")
PSA August 08 <0.001 undetectable (disregarded due to lab "misreporting")
Post-op pathology rechecked by new lab:
Gleason downgraded to 4+3=7
Focal extension comprised of grade 3 cells
PSA September 08 <0.01 (new lab)


Piano
Veteran Member


Date Joined Apr 2008
Total Posts : 847
   Posted 12/14/2008 9:22 PM (GMT -6)   
Thanks BillyMac -- I should have known that. The immune system attacks foreign cells and of course someone else's cells, cancerous or not, are "foreign".
Age 63. Other than cancer, in good health; BMI 20
Pre-op: No symptoms; PSA 5.7; Gleason 4+5=9; cancer in 4 of 12 cores
7 March 2008, RRP, non nerve sparing
Two nights in hospital; catheter and staples out after 7 days
Continent, no pads needed from the get-go
Post Op: Stage pT2 M- N-; clear margins and lymph nodes; Gleason 4+4=8; prostate weight: 37gm
6-week and 7-month PSAs: 0
Bimix injections working well 


cvc
Regular Member


Date Joined Jun 2008
Total Posts : 440
   Posted 12/14/2008 11:16 PM (GMT -6)   

I have read with great interest about a doctor in Florida, Dr Wheeler. evertime I have asked on here about him I rarely get a response. I know he sells a Prostate medicine but if you read his info on needle tracking he claims to have seen with MRI areas where needle biopsies were done where they did track.

 

 He also doesnt seem to believe in biopisies to start rather his MRIs.. Not sure but it is interesting reading

 

http://www.peenuts.com/diagnosing_pc.html


BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 12/14/2008 11:52 PM (GMT -6)   
Roll up, roll up, roll up. For just a few dollars you purchase my products and can escape the torture inflicted by modern day doctors. cvc, there is no evidence of biopsy 'tracking' just a theory that it could possibly occur. I would treat with great skepticism any claim by a 'doctor salesman' flogging his own secret ingredient herbs and spices products and trading on people's fear and apprehension.
Bill


(edit for possible misunderstanding)
CVC Please don't think this is a jab at you or your post but charlatans really raise my ire and particularly when they have "MD" after their name. If you are interested in his treatment then invite him to send you the reference of his tracking claim or if it is his personal observation, he should really publish his groundbreaking study results
.
1/05 PSA----2.9 3/06-----3.2 3/07-------4.1 5/07------3.9 All negative DREs
Aged 59 when diagnosed
Biopsy 6/07
4 of 10 cores positive for Adenocarcinoma-------bummer!
Core 1 <5%, core 2----50%, core 3----60%, core 4----50%
Biopsy Pathologist's comment:
Gleason 4+3=7 (80% grade 4) Stage T2c
Neither extracapsular nor perineural invasion is identified
CT scan and Bone scan show no evidence of metastases
Da Vinci RP Aug 10th 2007
Post-op pathology:
Positive for perineural invasion and 1 small focal extension
Negative at surgical margins, negative node and negative vesicle involvement
Some 4+4=8 identified ........upgraded to Gleason 8
PSA Oct 07 <0.1 undetectable
PSA Jan 08 <0.1 undetectable
PSA April 08 <0.001 undetectable (disregarded due to lab "misreporting")
PSA August 08 <0.001 undetectable (disregarded due to lab "misreporting")
Post-op pathology rechecked by new lab:
Gleason downgraded to 4+3=7
Focal extension comprised of grade 3 cells
PSA September 08 <0.01 (new lab)

Post Edited (BillyMac) : 12/14/2008 11:53:08 PM (GMT-7)


cvc
Regular Member


Date Joined Jun 2008
Total Posts : 440
   Posted 12/15/2008 10:33 AM (GMT -6)   
no problem BUT if you read what he has to say and look at the MRI's he has done on paients that had needle biopsys you can see what he says is needle tracking.. Also he seems to have backup of other Uroligists

Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4180
   Posted 12/15/2008 11:24 AM (GMT -6)   

Hey Guys:

I'm with billymac on this.  Wheeler's web site is full of anecdotal stories about individuals who have shown improvment with his supplements.  My guess is that any improvements were either from diet or accidental.  He throws in references to lots of studies but shares no real data to back up the claims about his products.

He certainly won't be getting any of my money.


Age 62
Gleason 4 +3 = 7
T1C
PSA 4.2
27cc
Brachytheraply volume study done on 11/14/08
Brachytherapy December 9, 2008.  73 Iodine-125 seeds.  Procedure went great, catheter out before I went home, only minor discomfort. 


Mr GTO
New Member


Date Joined Oct 2008
Total Posts : 5
   Posted 12/15/2008 6:39 PM (GMT -6)   
Thanks for the replies. Well needle tracking or not the biopsy will be done.

I just got done reading up a little on tPSA vs percent free vs complexed PSA after getting my test results from the 'last hope for a normal PSA'. Things look dim. On the one hand total went down 3.8 to 3.3. But free is only 6 (SIX) PERCENT!. Complexed is 3.1 which is 94% f the total (should be between 70-90). I read that 6 percent is basically you have cancer. Also my move from 1.5 to 4.1 tPSA earlier in just one year seems to complete the story of a potentially very aggressive cancer.

I'm seeing things negatively at the moment. What's next.

Todd1963
Veteran Member


Date Joined Oct 2008
Total Posts : 3218
   Posted 12/15/2008 7:38 PM (GMT -6)   
Dear Mr. G.T.O. my advice comes from the book of mathew (sp?) Paraphrased Dont worry what will be will be. No man can add a single day to his life by worrying. I know that sounds really anal of me to say but my brother it is the truth. My doc told me I have 36 months to live. I fired him and got another doctor who says my tumors are nowhere to be found. I had a really bad week in between. The worrying did nothing but raise my blood pressure. The good news is this. Your P.S.A. is low. If you have Pca it probably will be in the early stages and you will have a host of treatments available to you. Relax. PCa is not a death sentence. Just a real pain in the ass. you will be OKAY. I will be praying for you. Todd
dx:06/03/06
Age at dx: 42 age now 45
Treated for sciatic nerve pain 6 months prior to dx.
Heavy amount of blood in urine Unable to urinate 
Lung x-ray for pnumonia revealed multiple lesions in each lung
P.S.A. at time of dx. 3216.14
Began lupron and casodex
Cat scan showed large mass in the pelvic area affecting the bladder multiple nodules in both lungs and lymph node envolvement.
Bone scan revealed possible bone involvment in the pelvic area
Biopsy 12 of 12 cores positive gleason 3+4=7
P.S.A.s since lupron 2946, 1274, 532, 5.01 1.23, .09
Begining jan 08 psa .o9, .25, .44, .86, .73, 1.34, 1.49. Doubling time is a little over 3 months


Mr GTO
New Member


Date Joined Oct 2008
Total Posts : 5
   Posted 12/29/2008 7:43 PM (GMT -6)   
First I would like to apologize for the complaining nature of my post (two up). Emotions kind of started getting away with me. Secondly, I want to pass on updated information, which is all good news.

I just got the biopsy report a few minutes ago (from 12/19), where they took 12 samples at John Hopkins. The physician said the prostate looked normal (on the monitor) when he did the biopsy and all samples were negative.

He was a bit perplexed about the percent free being so low and that there still might be something missed. But for now the plan is to retest in 6 months. If tPSA is still the same or higher, then another biopsy. Thanks everyone for listening.

Swimom
Veteran Member


Date Joined Apr 2006
Total Posts : 1732
   Posted 12/29/2008 8:08 PM (GMT -6)   
I read in Entrez many moons ago where there are 2 suspected cases ever reported world wide of seeding from prostate to rectum via needle biopsy. I'm thinking it occurs as rarely as Congress makes a timely decision...banker bailouts excluded of course :> } I'd relax on this possibility.

Swim
 


Ralph Alfalfa
Regular Member


Date Joined Nov 2008
Total Posts : 469
   Posted 12/29/2008 9:47 PM (GMT -6)   
Take the tip from Swim. Trust me, she's seen it all. I don't think I'd lose too much sleep on this one. This guy sounds like Billy Mays trying to sell you the "sham-wow" or one of those battery operated lights you can just stick up in the closet. Stick with the tryed and true. It's a shame we all don't live in the future where they would just give you a pill and all would be cured.
Bob
 AGE:57
 Dx: October,27(the day after my birthday)
 Psa 14.5
 Gleason:(4+3) 7
 Bone scan:Negative
 Cat scan: Negative
 Biopsy: 4 of 12 positive, left side, pre-cancerous on the right.
 Confined to prostate.
 DaVinci scheduled for Jan. 19, 2009.Dr. Scott Montgomery, KC Urology,
Shawnee Mission Med. Center. Kansas


DanmanBob
Regular Member


Date Joined Feb 2008
Total Posts : 467
   Posted 12/29/2008 11:25 PM (GMT -6)   
According to my urologist, malignant cells can escape during surgery.
 
According to my radiation oncologist, malignant cells are sometimes left behind during surgery, especially if the cancer is at the bottom of the prostate, as this is a difficult spot to get everything out.
 
FWIW
Danman Bob, Born 1951
Nerve-sparing, open prostate surgery November 13, 2007
Gleason 9, PSA 14; Biopsy result - 9 of 12 sticks showed cancer
Post-op pathology results - cancer confined to the prostate
100 MG Viagra 3 times a week beginning December 2007
Osbon Erec-Aid Esteem manual pump for therapy beginning mid-February 2008
30 MG papaverine/1 MG phentolamine bimix injections beginning late April 2008
Five week post-op PSA 0.2, five month post-op PSA 0.1, nine month PSA 0.1, 13 month PSA 0.4 (recurrence was likely due to very high Gleason, even though margins were deemed clear after surgery)
Radiation using Calypso Localization System to begin in January 2009


BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 12/29/2008 11:39 PM (GMT -6)   
swimom said...
I read in Entrez many moons ago where there are 2 suspected cases ever reported world wide of seeding from prostate to rectum via needle biopsy. I'm thinking it occurs as rarely as Congress makes a timely decision...banker bailouts excluded of course :> } I'd relax on this possibility.

Swim

Swim,
I am wondering how would they ever know if it had ever occured. I mean, it is not that unusual for PCa to spread from the prostate to the bowel/rectum wall so on what evidence could anybody ever say " that spread is due to biopsy tracking."
Bill
1/05 PSA----2.9 3/06-----3.2 3/07-------4.1 5/07------3.9 All negative DREs
Aged 59 when diagnosed
Biopsy 6/07
4 of 10 cores positive for Adenocarcinoma-------bummer!
Core 1 <5%, core 2----50%, core 3----60%, core 4----50%
Biopsy Pathologist's comment:
Gleason 4+3=7 (80% grade 4) Stage T2c
Neither extracapsular nor perineural invasion is identified
CT scan and Bone scan show no evidence of metastases
Da Vinci RP Aug 10th 2007
Post-op pathology:
Positive for perineural invasion and 1 small focal extension
Negative at surgical margins, negative node and negative vesicle involvement
Some 4+4=8 identified ........upgraded to Gleason 8
PSA Oct 07 <0.1 undetectable
PSA Jan 08 <0.1 undetectable
PSA April 08 <0.001 undetectable (disregarded due to lab "misreporting")
PSA August 08 <0.001 undetectable (disregarded due to lab "misreporting")
Post-op pathology rechecked by new lab:
Gleason downgraded to 4+3=7
Focal extension comprised of grade 3 cells
PSA September 08 <0.01 (new lab)


Swimom
Veteran Member


Date Joined Apr 2006
Total Posts : 1732
   Posted 12/29/2008 11:40 PM (GMT -6)   
My DH had a needle aspiration years ago that resulted in an imediate spread of TCa. The result was emergency surgery and wider area of radiation during treatment. Without doing an ultrasound the urologist tried to aspirate what he "thought" was a hydrocele. What he attempted to aspirate was a tumor, allowing cells to enter the lymph system from what WAS a confined tumor. Rule number 1...never let Paul go to the Dr. alone for so much as a shot! I would have never allowed such a stupid mistake to happen. Now, almost 14 years and PCa later, all is well. Capt. Paul has an angel somwhere :>)

swim
 


BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 12/29/2008 11:46 PM (GMT -6)   
DanmanBob said...
According to my urologist, malignant cells can escape during surgery.


According to my radiation oncologist, malignant cells are sometimes left behind during surgery, especially if the cancer is at the bottom of the prostate, as this is a difficult spot to get everything out.



FWIW

It depends on what you mean by 'bottom'. Prostate language is confusing with the top (closest to the bladder, seminal vesicles etc) being named the 'base' and the bottom (closest to the penis, away somewhat from other glands) being named the apex. Therefore most spread is actually at the top (base) where it often attacks the bladder wall, vesicles etc.
Bill
1/05 PSA----2.9 3/06-----3.2 3/07-------4.1 5/07------3.9 All negative DREs
Aged 59 when diagnosed
Biopsy 6/07
4 of 10 cores positive for Adenocarcinoma-------bummer!
Core 1 <5%, core 2----50%, core 3----60%, core 4----50%
Biopsy Pathologist's comment:
Gleason 4+3=7 (80% grade 4) Stage T2c
Neither extracapsular nor perineural invasion is identified
CT scan and Bone scan show no evidence of metastases
Da Vinci RP Aug 10th 2007
Post-op pathology:
Positive for perineural invasion and 1 small focal extension
Negative at surgical margins, negative node and negative vesicle involvement
Some 4+4=8 identified ........upgraded to Gleason 8
PSA Oct 07 <0.1 undetectable
PSA Jan 08 <0.1 undetectable
PSA April 08 <0.001 undetectable (disregarded due to lab "misreporting")
PSA August 08 <0.001 undetectable (disregarded due to lab "misreporting")
Post-op pathology rechecked by new lab:
Gleason downgraded to 4+3=7
Focal extension comprised of grade 3 cells
PSA September 08 <0.01 (new lab)

Post Edited (BillyMac) : 12/29/2008 9:53:05 PM (GMT-7)


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 12/30/2008 7:06 AM (GMT -6)   
GTO (life in the fast lane atleast for those cars of the 60's/70's) 'Grand Tourismo Omolegato'=GTO
(some called it gas-tires & oil...hey I am near Detroit area we are car freaks by nature)

Even though your pathology looks great, get a copy into your hands and better still get it reviewed by a few of the experts like: Bostwick, Epstein, Oppenheimer etc. (there are only a handful that are considered the best at this). Now why do I plug doing this???

Upon expert reviews there are cases found where: gleason 4 turned out to be gleason 8 or gleason 6 turned out to be non-cancerous, crazy stuff like that, do you know what high grade P/I/N is, it is basically a possible pre-cursor to PCa but is not classified as PCa when discovered, only expert pathology might discovery P.I.N. as it is not easy to define looking at the slides. Gleason score(s) can be one of the most important stats to have clarified up front, if possible. Hey you could get the new urine testing also and see what it reveals, perhaps the biopsies taken might have missed what you could possibly have within you (it can happen that way...sorry to mention).

Get the book- A Primer on Prostate Cancer (Strum/Pogliano authors)

Neutrondbob-zufus (had to fire a few docs in my 'fun' journey with PCa...I love my insurance company for that luxury)

Swimom
Veteran Member


Date Joined Apr 2006
Total Posts : 1732
   Posted 12/30/2008 11:03 AM (GMT -6)   
Hey BillyMac,

If I could ever find that Entres publication again I might be able to answer your question. Not sure I can find it but it went something like this......Postoperatively a "new"(as in already done before) scope discovered cancer growth (diagnosed as PCa) where there wasn't any and no other indications of spread were found elsewhere in the patients bodies. Now I've probably read some 10,000 abstracts and publications so locating that one is like looking for a needle in a hay stack. If..I ever see it again, I'll try to post its location and source.

Swim
 

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