My friends biopsi question

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Al H
Regular Member


Date Joined Apr 2011
Total Posts : 21
   Posted 4/22/2011 9:11 AM (GMT -6)   
My best friends psa went to 4.2 from under 2 within one year and he just had a biopsi that came back negative.  He is urinating blood and semen is still dark colored.  His question to me was this.  If there are cancer cells in my prostate and the biopsi spreads blood through my body, does this spread the cancer cells?  I could not answer that but I knew where to go and ask.
 
Any ideas about this?
Al H
48 psa 4.0 g. 3+3
Al H
RP in 2006
negative margins
<.1 for 5 years
Novemeber 2010 psa <.1
March 2011 psa = 1.0
retesting today

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 7082
   Posted 4/22/2011 9:33 AM (GMT -6)   
You will get opinions all over the place on this.
 
My uro, surgeon, and all of the serious books I've read, dismiss the risk of spreading cancer through the biopsy process.
 
 
DaVinci 10/2009
My adjuvant IGRT journey (2010) -
www.healingwell.com/community/default.aspx?f=35&m=1756808

Post Edited (142) : 4/22/2011 8:51:51 AM (GMT-6)


clocknut
Veteran Member


Date Joined Sep 2010
Total Posts : 2680
   Posted 4/22/2011 9:33 AM (GMT -6)   
I've seen the possibility of that discussed, but there's no other way to do a needle biopsy.  My understanding is that there has never been a case demonstrated where cancer cells have been spread by this procedure.  My guess:   hypothetically it's possible, but realistically probably extremely unlikely.  A web search on this topic would probably provide more detailed explanations.

Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4848
   Posted 4/22/2011 9:38 AM (GMT -6)   
I think it has to do with any cancer cells that might be removed from the prostrate are quickly attacked by the body and destroyed.

tarhoosier
Regular Member


Date Joined Mar 2010
Total Posts : 495
   Posted 4/22/2011 9:41 AM (GMT -6)   
Al:

This has never been absolutely settled. If cancer occurs elsewhere after biopsy, who can say absolutely what the cause was. In any case, the risk of spreading the cancer, (if it exists) a kind of "seeding", is quite small, perhaps vanishingly so. It is clearly worth the risk to determine if cancer exists in the target organ, the prostate in this case.
The real risk of a biopsy, or any procedure that introduces outside instruments into the interior of the body, is infection. This can lead to early sepsis, a very serious condition and a risk to life. This kind of internal spread of infection would undoubtedly be due to the biopsy. The discussion of what to be alert to in the hours and days after biopsy is a discussion every man should have with his doctor. The cancer seeding issue is less definite, less likely ( if at all), and impossible to trace.
Consider the most obvious risk rather than the unproven risk.

BB_Fan
Veteran Member


Date Joined Jan 2010
Total Posts : 1011
   Posted 4/22/2011 9:57 AM (GMT -6)   
As Tarhoosier noted, if cancer has spread there is often no way to tell exactly how it has spread. Comments that "it has never been proven that a biopsy spreads PCA" don't make sense. It is impossible to prove. I think that the risk exists, but it is unavoidable. If you end up with a G6, it is probably very unlikely that any escaped PCA cells could exist outside the prostate. I think that with an G8-10 desease, it is a different story.
Dx PCa Dec 2008 at 56, PSA 3.4
Biopsy: T1c, Geason 7 (3+4) - 8 cores, 4 positive, 30% of all 4 cores.
Robotic RP March 2009
Pathology Report: T2c, Geason 8, organ confined, negitive margins, lymph nodes - tumor volume 9%, nerves spared, no negitive side effects.
PSA's < .01, .01, .07, .28, .50. ADT 3 5/10. IMRT 7/10.
PSA's post HT .01, < .01

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 4/22/2011 10:28 AM (GMT -6)   
Same question asked to my uro before, he said that he had never seen a case of that happening before, but on paper - its remotely possible
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06, 2/11 1.24, 4/11 3.81
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10

BB_Fan
Veteran Member


Date Joined Jan 2010
Total Posts : 1011
   Posted 4/22/2011 12:06 PM (GMT -6)   
Many men, including myself, have had a BCR after surgery has shown the tumor to be capsule contained. I was told that some PCA cells escaped though blood vessals passing through the prostate. I seems to me that if PCA cells can escape and spread this away that they can certainly escape and spread through the amount of bleeding that occurs with a biopsy. My personal opinion of course.
Dx PCa Dec 2008 at 56, PSA 3.4
Biopsy: T1c, Geason 7 (3+4) - 8 cores, 4 positive, 30% of all 4 cores.
Robotic RP March 2009
Pathology Report: T2c, Geason 8, organ confined, negitive margins, lymph nodes - tumor volume 9%, nerves spared, no negitive side effects.
PSA's < .01, .01, .07, .28, .50. ADT 3 5/10. IMRT 7/10.
PSA's post HT .01, < .01

ChrisR
Veteran Member


Date Joined Apr 2008
Total Posts : 831
   Posted 4/22/2011 1:35 PM (GMT -6)   
Al, let us know how your psa comes back. I hate testing on fridays and having to wait over the weekend.
Dx @ 42 years old on 4/2008
Gleason 6 (50 Point Biopsy) (6 Cores positive - Small Focus Each)
open RP 10/08 Johns Hopkins Dr. Partin
pT2 Organ Confined Gleason 6 (tertiary score 0)
PSA Since Surgery
1/15/2009 (3 Month) <.1
10/15/2009 (1 Year) <.1
10/15/2010 (2 Year) <0.03
02/11/2011 (2.3 Year) <0.03 (Impromptu done by GP at a physical)
10/15/2011 (3 Year) -

Al H
Regular Member


Date Joined Apr 2011
Total Posts : 21
   Posted 4/22/2011 2:45 PM (GMT -6)   
Thank you Chris. I just got back from my Dr, so Tuesday should tell all.
Al H
48 psa 4.0 g. 3+3
Al H
RP in 2006
negative margins
<.1 for 5 years
Novemeber 2010 psa <.1
March 2011 psa = 1.0
retesting today

JNF
Veteran Member


Date Joined Dec 2010
Total Posts : 3886
   Posted 4/22/2011 7:03 PM (GMT -6)   
I have read often that PCa is very blood born. The prostate gland is very blood rich as a gland. The PCa specialist oncologist Snuffy Meyers contends that half of men age 50 have PCa cells in their blood. My uro agrees with him. When Meyers was was diagnosed he had blood drawn from his arm and there were PCa cells present.

Thankfully, compared to other cancers, PCa is generally much slower growing and tough to take root in other places. By the time we have a biopsy, it may be likely that there are some PCa cells in the blood.

My doctors do not think the biopsiy worsens the situation or increaes the risk of spread.
PSA 59 on 8-26-2010 age 60. Biopsy 9-8-2010 12/12 positive, 20-80% involved, PNI in 3 cores, G 3+3,3+4,and 4+3=G7, T2b.
Eligard shot and daily Jalyn started on 10-7-2010.
IMRT to prostate and lymph nodes 25 fractions started on 11-8-2010, HDR Brachytherapy 12-6 and 13-2010.
PSA <.1 and T 23 on 2-3-2011.

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3891
   Posted 4/22/2011 9:53 PM (GMT -6)   
My U-doc explained it this way..After surgery when pathologists can examine the entire prostate, they NEVER find cancer in the healthy tissue that contains needle tracks from the biopsy..The needle tracks are always clean, meaning that the when the needle is being withdrawn, no viable cancer cells are pulled out with it. He said the cancer cells are contained inside the needle or are cut and killed by the needle or are left in place...

We all have biopsies but only a small percentage end up with metastatic disease. If biopsies spread cancer, most of us would have advanced cancer...
Age 68.
PSA age 55: 3.5, DRE normal.
age 58: 4.5
61: 5.2
64: 7.5, DRE "Abnormal"
65: 8.5, " normal", biopsy, 12 core, negative...
66 9.0 "normal", 2ed biopsy, negative, BPH, Proscar
67 4.5 DRE "normal"
68 7.0 3rd biopsy positive, 4 out of 12, G-6,7, 9
RALP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT. 2-15-'11 PSA 0.0

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 4/23/2011 7:47 AM (GMT -6)   
Fairwind- The uro-doc's explanation is interesting....it is his opinion...can you verify what his opinion is??? We have seen many a uro-doc with egg on their faces, for being genius types in PCa, Dr. Strum pointed that out years ago and the written piece is at www.yananow.net 'What every doctor and patient should know on PCa...'

I don't know if your uro is correct or incorrect, but I have not heard that one before in my 9 years of forums????? The biopsies are smaller and finer than a strand of hair, what do they spend a week examining the gland??? Naturally I question alot of things.

JNF- I liked your pointing out the info from Dr. Myers....someone who's opinion has alot of experience behind it...plus your uro agrees...with an oncologist

BB-Fan: I feel for you having BCR, which infact means they didn't get it all to begin with. For the others whom hear the words 'contained'..we got it all..clear margins...etc. Remember that is flavored information, good to hear, just like clear scans..good to hear. Doesn't guarantee a thing in PCa. Your doc has no way of knowing it is fully contained...it is a best guess assessment...and still worth hearing...just not a bankable item. Best docs should tell you accordingly, but you can make me out the bad guy for pointing it out.

ChrisR
Veteran Member


Date Joined Apr 2008
Total Posts : 831
   Posted 4/23/2011 8:34 AM (GMT -6)   
O.K. I will continue the banter....
 
JNF:  What exact test is Meyers talking about?  If there is such a blood test why isn't it done on every suspected PCa patient?  If this test is so accurate then nobody would be even doing biopsies anymore to dx. PCa let alone even treating anyone who test positive for PCa in their blood.   Insurance companies would not pay for treatment of people who already had systematic cancer.  Yet, here we are with biopsies and treaments being done all the time.
 
Can you clarify exactly what test this is?
 
 
 

tarhoosier
Regular Member


Date Joined Mar 2010
Total Posts : 495
   Posted 4/23/2011 10:17 AM (GMT -6)   
Myers said he had Pca cells in his bone marrow extracted. This is not a test. This is a procedure that only a cancer doctor could order done on himself. Myers also had lymph nodes sampled or extracted up his spine looking for more signs of spread. This is another procedure that is not available to conventional patients. Myers had a psa of 22 and G3+4. He did have PCa cells in regional lymph nodes. Volume is not identified though it must have been small. Radiation did the trick, with a boost from hormone treatment. He was a special trial with multiple assessments outside of accepted standards and a sample size of one (1).

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 7082
   Posted 4/23/2011 10:33 AM (GMT -6)   
Chris,
 
There has been a good bit of news laterly about a blood test that can find single cancer cells (not just PCa) in a sample. It is still experimental. It was mentioned in my support group a few weeks ago.
 
A PCa variety is in development at Armune BioScience, and is called Luminex (had to look that up on line).
 
There is a moral issue to detecting cancer markers "too early" - if potential employers discover that you will have PCa (or any other cancer, for that matter) years or tens of years before it might be significant or even treatable, the person might never be able to obtain a decent job, and may spend a lifetime worrying about what might come if they manage to never step in front of any of the other "bus-events" in life. Talk about lousy quality of life. Availability of this sort of test will surely be followed by years of arguments over privacy and rights.
 
 

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4268
   Posted 4/23/2011 12:54 PM (GMT -6)   
Chris,
It's called a circulating cancer cell blood test and has been around for a while. I don't know exactly what value it has, because in many cases just because you have circulating cancer cells it doesn't mean they will set up somewhere and grow. Most of the time the body's imune system kills them.
JT
66 years old, rising psa for 10 years from 4 to 40; 12 biopsies and MRIS all negative. Oct 2009 DXed with G6 <5%. Color Doppler biopsy found 2.5 cm G4+3. Combidex clear. Seeds and IMRT, 4 weeks of urinary frequency and urgency; no side affects since then. 2 years of psa's all at 0.1.
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