Prostate biopsy

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New Member

Date Joined Dec 2009
Total Posts : 1
   Posted 12/2/2009 12:15 AM (GMT -6)   
My urologist has recommended a prostate biopsy but I have found on-line sites that claim that prostate biopsies can cause metastasis.  Is this a real danger?  Are there alternatives to a prostate biopsy, such as a sonogram or MRI?   

Regular Member

Date Joined Dec 2008
Total Posts : 235
   Posted 12/2/2009 12:44 AM (GMT -6)   
Hi Chicago.  Sorry to hear that.  How old are you?  Why are they asking for a biopsy, PSA level?  A few more details will allow the knowledgeable members here to respond with more specific info.
There are some who theorize that the perforation of the prostate by the biopsy needles can contribute to cancerous cells 'getting out' and travelling to other parts of the body.  No one has any studies or proof of that assertion as far as I know.
Personally, I think its not a really good theory and a pretty small chance.  I base this statement on the fact that the prostate is very well supplied with blood vessels (the primary transport mechanism of rogue cells), and, in general, PCa is slow growing and remains confined for a long time.  I think that the probability of rogue cells at any given moment is small.  Further, the probability of those cells staying alive and creating a self sustaining cluster is also small.  So, the joint probability is very small.  It's only the cumulative probability over time that eventually can overcome those odds.
OK, so much for theory.  Now for practice.  If you have an elevated PSA, that could be for many possible reasons.  But, sadly, there are no other definitive tests to rule out PCa (and even the biopsy can miss PCa if it simply doesn't intersect any of the bad cell areas).  A better, and non-invasive test would be a great advance.  If you look at some of the other threads here, there are some possibilities just now beginning to come along, but nothing mainstream yet.
Other threads here will also give you a good idea of what to expect from the biopsy (perhaps too good of an idea - we can be a blunt and graphic bunch LOL!).
Best wishes.  Ask questions.

51 YO
PSA at Dx: 8.2
DaVinci RALP: 10/31/08 -- Great MD in New Haven, CT
Negative margins, no extra-capsular involvement
One nerve spared
PSA at 0 for just over a year now.

Veteran Member

Date Joined Feb 2008
Total Posts : 1858
   Posted 12/2/2009 6:12 AM (GMT -6)   
I have read of these claims but the documented cases of suspected biopsy "seeding" is exceeding rare. Incidentally you will find that the sites that claim this occurs and pose a real and significant risk just happen to offer a particular scanning service exclusive to them as an alternative. Unfortunately there is no alternative to a biopsy in seeking to establish whether PCa is present (however it is possible for the biopsy needle to miss small areas of tumour thus giving a false negative) Some scans can help pinpoint suspicious areas to be sampled by the biopsy needle but I definitely would not rely on an external scan as the sole indicator on whether I had PCa or not.
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)
PSA February 09 <0.01
PSA August 09 (2 year mark), <0.01

My Journey:

Tony Crispino
Veteran Member

Date Joined Dec 2006
Total Posts : 8128
   Posted 12/2/2009 7:09 AM (GMT -6)   
Hi Chicago,
The chances of spreading the disease through is extremely slim. The chances of spreading the disease, if present, by skipping the biopsy is way too risky. But also know, if you do have the disease, you need to take your time and analyze all the data.

Welcome to Healingwell. Should you have the disease, you will find this site amazing. Simply put, you don't have to go it alone. The experience here helped me so much when I arrived in 2006. i have an advanced case, but I am doing well. There is no need to rush anything, but there is a need to remember that the choices are many, and the decisions are best done with a solid understanding of prostate cancer.

Good luck to you. We'll be here if you need us...

Prostate Cancer Forum Co-Moderator

Veteran Member

Date Joined Apr 2009
Total Posts : 990
   Posted 12/2/2009 10:55 AM (GMT -6)   
It is probably a rare-but-true side effect. There are other more common side effects as well.

You are in a situation where no course of action is without danger but I think that most on this board would say
that the danger of having PC and not knowing that you have it is by far the most dangerous. The biopsy is the most
certain way of knowing (most certain, not absolutely certain.)

When it comes right down to it, an experienced doctor is the person best situated to help you weigh the risks and benefits of any
medical procedure. If you are not confident of your doctor's advice on this, then by all means get recommendations for an
outstanding urologist and seek a second opinion
Age at diagnosis 66, PSA 5.5
Biopsy 12/08 12 cores, 8 positive
Gleason 3+4=7
CAT scan, Bone scan 1/09 both negative.

Robotic surgery 03/03/09 Catheter Out 03/08/09
Pathology: Lymph nodes & Seminal vesicles negative
Margins positive, Capsular penetration extensive Gleason 4+3=7
6 weeks: 1 pad/day, 1 pad/night -- mostly dry at night.
10 weeks: no pad at night -- slight leakage day/1 pad.
3 mo. PSA 0.0 - now light pads
6 mo. PSA 0.00 -- 1 light pad/day

Regular Member

Date Joined Jun 2008
Total Posts : 407
   Posted 12/3/2009 12:04 AM (GMT -6)   
I suppose anything is possible, in this regard, but what alternative do we have for more exact analysis? I'm not aware of any. As a complication to my biopsy I was hospitalized with sepsis. The biopsy, though, led to a conclusion that I had prostate cancer and the after-surgery analysis showed the cancer was more prominent than the biopsy had suggested. So, I'm glad I had the biopsy. Has the cancer spread to other parts of my body as a result of the biopsy - I hope not. That's all I can say at this point.

Age:  60 (58 at diagnosis - June, 2008)

April '08 PSA 4.8 ("free PSA" 7.9), up from 3.5 year prior

June '08 had biopsy, 2 days later told results positive but in less than 1% of sample

Gleason's 3+3=6

Developed sepsis 2 days post-biopsy, seriously ill in hospital for 3 days

Dr. recommended robotic removal using da Vinci

Surgery 9/10/08

Northwestern Memorial Hospital, Chicago, IL

Dr. Robert Nadler, Urologist/Surgeon

Post-op Gleason's:  3+3, Tertiary 4

Margins:  Free

Bladder & Urethral:  Free

Seminal vesicles:  Not involved

Lymphatic/Vascular Invasion:  Not involved

Tumor:  T2c; Location:  Bilateral; Volume:  20%

Catheter:  Removed 12-days after surgery

Incontinent:  Yes (1/2 light pads per day)

Combination of Cialis and MUSE (alprostadil) three times weekly started 9-27-08

Returned to work 9-29-08 (18-19 days post-op)

PSA test result, post-op, 10/08: 0.0; 12/08: 0.0; 4/09: 0.0; 9/09: 0.0


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