What can a biopsy find besides cancer?

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capamando
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Date Joined Oct 2010
Total Posts : 15
   Posted 11/12/2010 9:40 AM (GMT -6)   
Hello,

As some of you may already know, I am in the process of dealing with Bostwick Labs and my local urologist in order to come up with the most affordable way to have my biopsy done. What I am not clear about is what can my urologist find out doing a TRUS besides cancer? Will he be able to tell me if I have an infection, calcification or other issues with my prostate? And if cancer is detected will the report tell me if it has spread beyond the prostate?

Thank you again for your support

Casey59
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Date Joined Sep 2009
Total Posts : 3172
   Posted 11/12/2010 10:18 AM (GMT -6)   
Hi capamando,

I'll try to help fill in some gaps for you...I hope this is helpful...

The TRUS-Bx is the Transrectal Ultrasound-guided biopsy. It's an ultrasound and biopsy sampling device all in one hand-held tool. "Transrectal" means that it goes up your rear-end. "Ultrasound" means it is an imaging tool which helps the doctor locate your prostate through the rectum wall; he uses it to guide the tool to difference sectors of the prostate for sampling. Some lighter & darker areas of the prostate may appear in the ultrasound screen which the doctor will be viewing (you might get a view, too), but they (light/dark areas) are not conclusive one way or the other. Typically, 12 samples are taken from different areas in the prostate, packaged in vials, and sent off to pathology for "reading."

Here's a nice link describing prostate pathology (although it talks about both biopsy and post-surgery pathology): http://www.oncolink.org/types/article.cfm?c=16&s=57&ss=452&id=9597&p=1

The procedures definitely does not tell one if PC has spread beyond the prostate...the question of possible spread is a very difficult question to clinically answer. Rather, the pathology results do give one an understanding of the aggressiveness of the PC in the cells which have been sampled. This information, and other data from your individual case, may be entered into a nomogram to get a "prediction" of outcomes based on a history of cases with similar characteristics. Bostwick uses a tool called "UroPredict" which you can look into here: http://www.bostwicklaboratories.com/uropredict/uropredict.aspx

Infection is usually detected through urinalysis, and should be eliminated as the primary cause of elevated PSA before moving to a biopsy...perhaps this is obvious, but urinalysis is a simple, non-invasive test, and a biopsy is very invasive and can cause problems (low percentage of patients). Bacterial infection shows up on a chemically treated "dipstick" which changes colors. Traces of blood in urine may also indicate infection or other problems.

Hope this helps...
 
 
 
edit:  typo

Post Edited (Casey59) : 11/12/2010 8:23:43 AM (GMT-7)


capamando
New Member


Date Joined Oct 2010
Total Posts : 15
   Posted 11/12/2010 8:41 PM (GMT -6)   
Thanks Casey. That was helpful

goodlife
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Date Joined May 2009
Total Posts : 2691
   Posted 11/13/2010 10:25 AM (GMT -6)   
It can also find how tolerant you are to having a probe up your butt, and being stuck 12 times. Some guys fly off the table, some guys say no big deal.

Based on the very small sample size ( a needle core ), it really is only effective at the cellular level. Color Doppler is better if you want a bigger picture.
Goodlife
 
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks .
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)
6 Month PSA <.01
1 pad a day, no progress on ED.  Trimix injection
No pads, 1/1/10,  9 month PSA < .01
1 year psa (364 days) .01
15 month PSA <.01

April6th
Regular Member


Date Joined May 2010
Total Posts : 264
   Posted 11/13/2010 1:34 PM (GMT -6)   
"Will he be able to tell me if I have an infection, calcification or other issues with my prostate?"

My biopsy report also said I had acute prostatitis and chronic prostatitis.

The ultrasound also showed I had a stone (calcification) too.

Good luck with your results!

Dan

Post Edited (April6th) : 11/14/2010 12:30:36 PM (GMT-7)


zufus
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Date Joined Dec 2008
Total Posts : 3149
   Posted 11/13/2010 1:54 PM (GMT -6)   
You can find out too if you have P.I.N. or High Grade P.I.N. (precursor to PCa) or perineral invasion (hit a blood vessel within biopsy-a possible escape method we don't wish to hear about). The other stuff mentioned above by others is good info. Also, if you wish to spend a little more money get the ploidy analysis testing on the PCa as to what is it's DNA structure, 3 types exist the third one is the most worrisome type to be found with (fyi) and furthest from the better DNA samples called, diploid normal duplicate DNA strands (23 sets=46 chromosomes are your normal patterns) and best for PCa control. The leading oncologists like DR. Strum actually have used this information in treating failed to be cured patients.
Dx-2002 total urinary blockage, bPsa 46.6 12/12 biopsies all loaded 75-95% vol.; Gleasons scores 7,8,9's (2-sets), gland size 35, ct and bone scans look clear- ADT3 5 months prior to radiations neutron/photon 2-machines, cont'd. ADT3, quit after 2 yrs. switched to DES 1-mg, off 1+ yr., controlled well, resumed, used intermittently, resumed useage

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 11/14/2010 12:28 AM (GMT -6)   
capamando,
Your urologist report will likely be unremarkable. He needs to get the samples and your pathologist has to examine them.

What your pathologist will report on is what will be important. Zufus has some good points here...If you remember your other thread I gave you information for Bostwick Laboratories, when you called them they told there were varying things they can do with a biopsy but that it could drive the cost of the pathology work up. Zufus gives you some excellent ideas.

When you receive that package from Bostwick you'll get some breakdowns of some additional tests they can do. The first three things that Zufus mentioned, PIN, HGPIN, and Perineal Invasion will be included with the basic biopsy report. The DNA Ploidy analysis will cost extra but combined it's still way under what you were seeing for a price for a standard biopsy.

Tony
Disease:
Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
RALP ~ 2/17/2007 at the City of Hope near Los Angeles.
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.

Status:
"I beat up this disease and took its lunch money! I am in remission."
I am currently not being treated, but I do have regular oncology visits.
I am the president of an UsTOO chapter in Las Vegas

Blog : www.caringbridge.org/visit/tonycrispino

Casey59
Veteran Member


Date Joined Sep 2009
Total Posts : 3172
   Posted 11/14/2010 11:20 AM (GMT -6)   

Tony and/or zufus,

Learning-mode question here. Can you please describe the value-add to the patient of the ploidy analysis, on top of the Gleason score, as an indicator of aggressiveness, which is already an outcome of the biopsy? More specifically, how might that incrementally additional info from a ploidy analysis possibly influence patient decision making? Very few men have ploidy analysis; why specifically recommend this to capamando when he is paying out of pocket?

I see how it provides additional data, but to be up-front, in the back of my mind I'm recognizing that not every test that can be performed should be performed, and I haven't been enlightened to the incremental benefit (beyond standard biopsy) of this test in terms of how it might actually influence decision making.

As I said, I'm in learning mode. Thanks in advance for your response.
Casey


capamando
New Member


Date Joined Oct 2010
Total Posts : 15
   Posted 11/14/2010 3:18 PM (GMT -6)   
Hello,

Thank you for all the info....... the only left for me to do is to get that darn &?@! biopsy done and take it from there!
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