i pushed my dad to go for a biopsy, will i regret it?

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laila374
Regular Member


Date Joined Apr 2011
Total Posts : 78
   Posted 5/25/2011 8:46 AM (GMT -6)   

hi everybody,
last month my dad PSA was 13 and the doctor felt that there is a hard lump in his prostate, the doctor asked him to go for a biopsy but my dad didn`t agree and said that he will see another doctor,
i did a lot of research in th internet and found that biopsy is necessary, so i spoke with him and asked him to do it for his best, so he did it and the result reveald that he has prostate cancer gleason8.
now i start to read that biopsy can spread cancer this is why there is recurrence of prostate cancer after treatment, a doctor said that once they put the neddle in the prostate there is small hole where the cancer cell can spread.
i don` know what to think cry this is the video i have watched http://vimeo.com/6625982

, any answers will be helpful

thanks


GTOdave
Regular Member


Date Joined Oct 2010
Total Posts : 175
   Posted 5/25/2011 8:57 AM (GMT -6)   
This is the very first I've heard about cancer being spread by the biopsy needle.

Much more importantly, the cancer could not be treated before it was detected and staged, thus the biopsy had to occur. A gleason 8 needs treatment and can't be ignored.

Don't kick yourself over having your dad get the biopsy. It is a necessary tool in the process of beginning to fight the cancer. Trust me, not having the biopsy, and not beginning a treatment regimen is much, much worse.
52 yr old, PSA 3.5, Gleason 6 with 3 of 4 top nodes (0%;1%;10%;1%) cancerous. Bottom 2 floors are clean.

PSA 7/08: 2.2; 7/09: 2.9; 7/10: 4.1; 11/10: 3.5

First post-op PSA =.00! 7 weeks after operation

DaVinci surgery at Yale 3/4/11. Dr. John Coleberg THE BEST!!!

45 gram gland weight
Gl 3+3
PT2C
margins clear
no metastasis
5% of gland adenocarcinoma

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 5/25/2011 9:15 AM (GMT -6)   
Almost zero chance of a prostate biopsy spreading cancer, more of an urban myth kind of thing.

Now that your father has had the biopsy, and he is a Gleason 8, it was critically important that he underwent the biopsy

david in sc
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

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6949
   Posted 5/25/2011 9:18 AM (GMT -6)   
laila,
 
The idea that a biopsy spreads cancer is much like being killed by an asteroid hitting the earth. Might happen, but the odds are very small.
 
The risk of not knowing about a Gleason 8 seem much more dangerous.
 
The internet is full of "stuff", much is of little value, or sometimes counter-productive. I would tend to trust information from major medical centers a bit more.
 
Back to the subject of a biopsy - Dave is correct in saying that you can not effectively decide how to treat prostate cancer unless a biopsy is done. A Gleason 8 cancer needs to be addressed.
 
 
DaVinci 10/2009
My adjuvant IGRT journey (2010) -
www.healingwell.com/community/default.aspx?f=35&m=1756808

clocknut
Veteran Member


Date Joined Sep 2010
Total Posts : 2667
   Posted 5/25/2011 9:30 AM (GMT -6)   
I think you can relax and be confident that you did the right thing.  With a Gleason 8, "needle tracking" is probably the last thing you need to be concerned about.  You've gotten your father into treatment for a serious health situation.  Give yourself a pat on the back, and give him a big hug.  He's a lucky man to have a daughter like you.

Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4106
   Posted 5/25/2011 10:21 AM (GMT -6)   
Laila, Great move to have dad do a biopsy. Now he knows and you know what has to be done to extend his life. There is no way you can treat prostate cancer without a biopsy. Do let us know about the consult with the Dr.

It will help if you give us a bit more info about dad... Age and physical condition etc.

You should be proud that you got him to have the biopsy.

Cajun jeff
9/08 PSA 5.4 referred to Urologist
9/08 Biopsy: GS 3+4=7 1 positive core in 12 1% cancer core
10/08 Nerve-Sparing open radicalSurgery Path Report Downgrade 3+3=6 GS Stage pT2c margins clea
r3 month: PSA <0.1
19th month: PSA <0.1
2 year PSA <0.1
Only issue at this time is ED but getting better

Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4829
   Posted 5/25/2011 11:28 AM (GMT -6)   
laila374 - you're a great daughter so pat yourself on the back.

medved
Veteran Member


Date Joined Nov 2009
Total Posts : 1096
   Posted 5/25/2011 12:34 PM (GMT -6)   
You absolutely did the right thing. Not even the slightest question about that. The idea of biopsy spreading prostate cancer has never been established. It is sort of a theoretical possibility that people occasionally talk about, but without medical evidence to support it, as far as I know. The MUCH greater risk is having prostate cancer and not knowing about it because you did not want to get a biopsy. Laila, you may well have saved your father's life by getting him to do the biopsy. Now, get him to see a doctor with lots of expertise in prostate cancer, so he can figure out what sort of treatment he wants, and get treated. Some prostate cancers don't need to be treated because they are low grade and not likely to be life threatening. But Gleason 8 is serious enough that it DOES need to be treated (unless your dad is very sick from something else). He will have some choices about treatments. The most likely would be surgery, radiation, hormones, or potentially some combination of those. Best wishes, Medved

MrsGFM
Regular Member


Date Joined Feb 2010
Total Posts : 115
   Posted 5/25/2011 1:41 PM (GMT -6)   
I think you might have saved his life. You did the right thing!
Mr GFM's statistics:
Age 50 at diagnosis
PSA History: 10-05 1.3, 01-07 2.09
8-07 - PSA at Biopsy: 2.26
2 of 12 positive
Gleason Score 3+3 6
11-07 - Robotic surgery hospitalized overnight.
Path Report:
Prostatic adenocardinoma, Gleasons 3+3+6, moderately differentiated
Percent of Prostate involved by tumor 5%
Staging pT2c pNx pMx
Margins free of tumor - no further invasion or extension
Catheter out in about 9 days. No incontinence.
Back to work in 2 weeks
ED - resolved. No meds needed at this time.
Post Op PSA: 03-08 0.01, 10-08 0.02, 7-09 0.04, 1-10 0.04, 7-10 0.04

Magaboo
Veteran Member


Date Joined Oct 2006
Total Posts : 1210
   Posted 5/25/2011 3:23 PM (GMT -6)   
Your Dad should have listened to his Doctor in the first place and not put the burden on you. He is very fortunate to have such a caring daughter. You may have just saved his life. Now just try and get him motivated in selecting a treatment. No rush, but don't procrastinate either. Gleason 8 needs prompt attention.
All the best to you and your Dad.
 
The video in the URL that you've provided sounds a bit scary, but to the best of my knowledge, the '3D MRI Spectroscopy' is not widely available yet, at least not here in Canada. Perhaps a great replacement for biopsies in the future?
Mag

Born 1936
PSA 7.9, Gleason Score 3+4=7, 2 of 8 positive
open RP Nov 06, T3a, Gleasons 3+4=7, Seminal vesicles and lymph nodes clear
Catheter out 15 Dec 06, Dry since 11 Feb 07
All PSA tests in 2007 (4) <.04
PSA tests in 2008: Mar.=.04; Jun.=.05; Sept.=.08; at SRT Start=0.1,
Salvage RT completed (33 days-66Gy) 19 Dec 08
PSA: in Jan 09 =.05, all tests to date (Jan 11) <.04

Post Edited (Magaboo) : 5/25/2011 4:04:49 PM (GMT-6)


Piano
Veteran Member


Date Joined Apr 2008
Total Posts : 847
   Posted 5/25/2011 3:24 PM (GMT -6)   
A biopsy punches holes in the prostate (and other places!), so it is theoretically possible for cancer cells to escape. But in practice it seems that they don't survive even if they do escape, so I agree that spreading PCa via biopsy is something of an urban myth.

However the fact that your Dad has a Gleason 8 is much more serious, so that will need treatment and soon.

On the positive side, I had surgery for a Gleason 8 three years ago, am still well and still here, and planning to stay that way for a bit longer yet :-)
No symptoms; PSA 5.7; Gleason 4+5=9; cancer in 4/12 cores
Non-nerve-sparing RRP 7 March 2008 age 63
Organ confined, neg margins. Gleason downgrade 4+4=8
Fully continent
Bimix worked well; now using just VED
PSA undetectable at first but then rose to 0.4, doubling time 7 months
Following diet change, PSA static at 0.4...

BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 5/25/2011 4:23 PM (GMT -6)   
No you won't regret it. It was a very good thing you did convincing your father to have the biopsy. Urban myths such as cancer being spread by biopsy are just that, urban myths, and are usually being pushed by those who just happen to have for sale, another claimed cancer detection method (note in the video the good doc finishes with "that is the theory anyway"). The balloon and water analogy, while sounding good, is not an accurate comparison. The imaging method unfortunately pales in comparison to the accuracy of a physical biopsy and looking at the actual tissue. Now you have good information on what is going on and can make informed decisions. It is, as Piano says, vaguely theoretically possible that a biopsy could drag tumour cells out and deposit them into surrounding tissue. The needle is a hollow tube which takes a plug out from within the prostate. This tissue plug is within the needle tube and stays there and the exterior of the needle is wiped clean by normal prostate tissue as it withdraws from the gland so it is highly unlikely that tumour cells would remain on the outside of a needle as it withdraws from the gland. If the tumour was right on the edge of the gland then theoretically it could deposit cells in the bowel wall tissue but these are not connected directly to a blood supply and will in all probability die off. Neither you nor he should have any doubts that the biopsy was a smart move. In the case of prostate cancer, ignorance certainly is not bliss. Good luck with his follow up treatment.
Bill

Post Edited (BillyMac) : 5/25/2011 7:37:36 PM (GMT-6)


Tim G
Veteran Member


Date Joined Jul 2006
Total Posts : 2302
   Posted 5/25/2011 4:41 PM (GMT -6)   
You did the right thing and may be saving your dad's life by addressing the cancer early instead of letting him hide his head in the sand.

proscapt
Veteran Member


Date Joined Aug 2010
Total Posts : 644
   Posted 5/26/2011 1:48 AM (GMT -6)   
This is a myth. I asked my surgeon about it; he said that in some cases with different kinds of cancers that are deep in the body there a small amount of evidence that a biopsy can help a cancer to spread. However, with prostate cancer, the needle goes through very little of the body other than the wall of the lower colon and so the chance of spread is minimal.

There's another factor too. Early stage prostate cancer cells don't generally survive well outside of the prostate. they do not yet have the ability to attach to other tissues and attract blood vessels to grow to give them nutrients. So if they escape the prostate at that stage, they just die. Additional mutations have to occur for spread to occur. Some evidence of this comes from the fact that in many cases there are patients in whom circulating tumor cells (CTC's) can be found in the bloodstream after the prostate has been removed. But in only a fraction of these (less than a third) does a cancer grow somewhere to the point of being detectible or causing a rise in PSA. So in most cases (though not all), the spread of a few tumor cells is of no clinical significance.

Not treating a G8 cancer, on the other hand, is likely to be fatal.

Be assured that you have done the right thing, and bought your dad many more years of health and life.

laila374
Regular Member


Date Joined Apr 2011
Total Posts : 78
   Posted 5/26/2011 7:35 AM (GMT -6)   
thanks to everybody,
it just drove me mad, when i read that the reason why some cancers come back after many years is that there was cancer cells whitch escaped outside the prostate during biopsie and than it tooks them years to multiply and than be detected,
does that mean that people who don`t do biopsie and go straight for treatment will be more likely not to have cancer recurrence?
why there too musch confusion in this subject, for exemple in eye and testiculare cancer there is no biopsie, and they are the most curble cancers so far,

JNF
Veteran Member


Date Joined Dec 2010
Total Posts : 3763
   Posted 5/26/2011 7:58 AM (GMT -6)   
With the prostate cance I can't imagine a doctor taking the risk of prescribing treatment without first having a biopsy. I doubt that any insurance or medicare would approve treatment without first having the biopsy. Please understand that the PSA test does not test for cancer. PSA is generated by many factors including cancer, but an elevated PSA doesn't confirm cancer. Nor does an abnormal DRE. It may be indicatrive of cancer but does not confirm it. Thus the biopsy must be done to confirm the presence or absence of cancer.

You did the only correct thing you could do. There is no known risk of spread from the biopsy. There is well known risk of spread by not effectively treating Gleason 8 prostate cancer. You are a great daughter and your father is being wonderfully served by you.

Every cancer is different. Breast cancer requires biopsy and/or surgery to confirm the presence. The standard for most all cancers is a biopsy. Even skin lesions that appear to be cancer are biopsied to confirm the cancer and its specifics so that an effective treatment plan can be determined. That some cancers can be detected without a biopsy has no relevance to prostate cancer and its diagnosis.
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 December 6 and 13-2010.
PSA <.1 and T 23 on 2-3-2011.
PSA <.1 on 4-7-2011
Second Eligard shot on 4-7-2011

clocknut
Veteran Member


Date Joined Sep 2010
Total Posts : 2667
   Posted 5/26/2011 8:22 AM (GMT -6)   

I think you should bear in mind that the video you linked to was put together by one doctor pushiing his belief in MRI-S imaging, on which his entire practice seems to be based.  Whether his confidence in that imaging is justified is a matter of opinion, but if it was as great as he claims, I would expect to see it being used everywhere. 

I think I've seen some guys here on HW who are "sold" on the value of MRI-S, and it certainly sounds good on paper, but the majority of doctors in the urological community seem to have confidence in that traditional biopsy procedure, in which the actual tissue can be examined.  Personally, even if an MRI-S indicated the possibility of cancer, I would still want a biopsy to confirm the amount and the likely grade of the cancer....not rely on some vague image of an organ located deep inside my abdomen.  Just my opinion as one cancer patient. 

The other cancers you mention are detectable by other means, such as blood markers.  Good luck to you and your father.


English Alf
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Date Joined Oct 2009
Total Posts : 2215
   Posted 5/26/2011 10:10 AM (GMT -6)   
Good call, Laila. Yes, a biospy and the resulting knowledge even if it is bad news is better than not knowing. Now your dad and the docs can plan the treatment that should result in him being around for longer than would otherwise be the case.

If biospies could spread the cancer from the area they are sampling then I think they would have been banned years ago. And frankly surgery would be an even bigger risk given large lumps of cancers get chopped off and moved from the inside to the outside. (I'm talking about cancer in general - with a da Vinci surgery the prostate is usually removed whole and in a little pouch)
The risk with a bisopsy of the prostate is about spreading disease as the needle has to pass through the bowel wall and there are lots of nasty bugs in the bowel. So a prostate biospsy should always be accompanied by a couirse of anti-biotics.

Alf
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