Lymph Node Biopsy As A Separate Procedure
A lymph node biopsy is rarely done as a separate procedure. Its sometimes used when a radical prostatectomy isnt planned , but when its still important to know if the lymph nodes contain cancer.
Most often, this is done as a needle biopsy. To do this, the doctor uses an image to guide a long, hollow needle through the skin in the lower abdomen and into an enlarged node. The skin is numbed with local anesthesia before the needle is inserted to take a small tissue sample. The sample is then sent to the lab and looked at for cancer cells.
Questions To Ask The Doctor
- What treatment do you think is best for me?
- Whats the goal of this treatment? Do you think it could cure the cancer?
- Will treatment include surgery? If so, who will do the surgery?
- What will the surgery be like?
- Will I need other types of treatment, too?
- Whats the goal of these treatments?
- What side effects could I have from these treatments?
- What can I do about side effects that I might have?
- Is there a clinical trial that might be right for me?
- What about special vitamins or diets that friends tell me about? How will I know if they are safe?
- How soon do I need to start treatment?
- What should I do to be ready for treatment?
- Is there anything I can do to help the treatment work better?
- Whats the next step?
Will A Prostate Biopsy Spread Your Cancer
J. Stephen Jones, MD
J. Stephen Jones, MD, is chairman of the department of regional urology at the Cleveland Clinic Glickman Urological and Kidney Institute, and is professor of surgery at Cleveland Clinic Lerner College of Medicine at Case Western Reserve University. He is author of The Complete Prostate Book and Overcoming Impotence.
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Diagnosis Of Prostate Cancer
Check out this factsheet for a summary of the video.
Diagnosis is the process of finding out the cause of a health problem. Diagnosing prostate cancer usually begins with a visit to your family doctor. Your doctor will ask you about any symptoms you have and do a physical exam. Based on this information, your doctor may refer you to a specialist called a urologist or order tests to check for prostate cancer or other health problems. A urologist is a doctor who specializes in treating conditions of the genital and urinary tracts, including the prostate.
The process of diagnosis may seem long and frustrating. It’s normal to worry, but try to remember that other health conditions can cause similar symptoms as prostate cancer. It’s important for the healthcare team to rule out other reasons for a health problem before making a diagnosis of prostate cancer.
The following tests are usually used to rule out or diagnose prostate cancer. Many of the same tests used to diagnose cancer are used to find out the stage . Your doctor may also order other tests to check your general health and to help plan your treatment.
Natural Treatments For Prostate Cancer
At Immunity Therapy Center, we utilize a variety of alternative cancer treatments to strengthen your immune system while directly targeting your cancer cells. We take a holistic approach to prostate cancerand focus on the overall health of our patients.
We offer a variety of options for holistic treatment for prostate cancer such as Cryoablation Therapy and intravenous solutions . As part of our alternative therapy, were big advocates in the idea that your attitude truly affects the results of your cancer treatment program. We find patients with positive attitudes, and hope for their cancer therapy, see more successful results.
If you are interested in alternative prostate cancer treatment in Mexico, reach out to us today. Tijuana has become a hub for alternative cancer treatment centers, paving the way for holistic care to become part of the cancer treatment dialogue everywhere. Were proud to be one of the leaders who offer prostate cancer natural treatment options.
Were passionate about providing a customized alternative therapy treatment plan for each of our patients. If you or your loved one have tried mainstream medicine only to have relapsed or been economically drained, were here for you. Alternative medicine can be the answer to the perfect holistic treatment for prostate cancer.
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What Does It Mean If In Addition To Cancer My Biopsy Report Also Mentions Acute Inflammation Or Chronic Inflammation
Inflammation of the prostate is called prostatitis. Most cases of prostatitis reported on biopsy are not caused by infection and do not need to be treated. In some cases, inflammation may increase your PSA level, but it is not linked to prostate cancer. The finding of prostatitis on a biopsy of someone with prostate cancer does not affect their prognosis or the way the cancer is treated.
Surgery For Prostate Cancer
There are many types of surgery for prostate cancer. Some are done to try to cure the cancer others are done to control the cancer or make symptoms better. Talk to the doctor about the kind of surgery planned and what you can expect.
Side effects of surgery
Any type of surgery can have risks and side effects. Be sure to ask the doctor what you can expect. If you have problems, let your doctors know so they can help you.
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What Is A Transperineal Biopsy
This is where the doctor inserts the biopsy needle into the prostate through the skin between the testicles and the back passage . In the past, hospitals would only offer a transperineal biopsy if other health problems meant you couldnt have a TRUS biopsy. But many hospitals have stopped doing TRUS biopsies and now only do transperineal biopsies.
A transperineal biopsy is normally done under general anaesthetic, so you will be asleep and wont feel anything. A general anaesthetic can cause side effects your doctor or nurse should explain these before you have your biopsy. Some hospitals now do transperineal biopsies using a local anaesthetic, which numbs the prostate and the area around it, or a spinal anaesthetic, where you cant feel anything in your lower body.
The doctor will put an ultrasound probe into your back passage, using a gel to make this easier. An image of the prostate will appear on a screen, which will help the doctor to guide the biopsy needle.
If youve had an MRI scan, the doctor may just take a few samples from the area of the prostate that looked unusual on the scan images. This is known as a targeted biopsy.
Incidence Of Track Seeding In Prostate Biopsies
An article published by Volanis, et al. in the prestigious British Journal of Urology reports a literature review conducted earlier that year. The authors systematically examined the huge PubMed literature database for research evidence with emphasis on the incidence of seeding, clinical presentation and on risk factors including type of needle used, transrectal vs. transperineal approach, as well as tumour grade and stage. They identified 26 articles reporting instances of needle tracking, for a total of 42 cases .
Considering a conservative figure of 220,000 cases of prostate cancer diagnosed per year, the fraction of needle tracking is astonishingly small. According to a review of the 2014 article, There were probably well in excess of 2 million prostate biopsies conducted in America last year. Even if as many as half of the 42 identified cases of seeding had occurred last year in America , this means that the individual risk for seeding at the time of a specific biopsy is certainly no higher than 21 × 100 ÷ 2,000,000 or 0.1 percent , and it may be a lot lower than that. Furthermore, even when such seeding does occur, there is no evidence to suggest that such seeding is associated with any increase in risk for clinically significant prostate cancer.
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Who Interprets The Results And How Do I Get Them
A pathologist examines the removed tissue specimens and makes a final diagnosis. The results usually are available to your physician within a few days of the procedure. The time it takes may vary based on the complexity of the examination, preparation time for the specimens, need for a second opinion and other factors.
Why Do Some People Think A Biopsy Could Spread Cancer
Tumor seeding or needle seeding refers to rare occurrences when the needle inserted into a tumor during a biopsy dislodges and spreads cancer cells. It is sometimes called needle track or tract seeding because the cancer cells grow along the needles track.
In the past, tumor seeding has been difficult to study, and evidence relied on older case reports, which are descriptions of a persons medical history. But the idea gained some attention when former urologist Ronald Wheeler published a book and practiced medicine that renounced biopsies for men with prostate cancer. However, the state of Florida revoked Wheelers medical license in 2017, and he was arrested for defrauding patients and practicing medicine without a license.
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What Is Advanced Prostate Cancer
When prostate cancer spreads beyond the prostate or returns after treatment, it is often called advanced prostate cancer.
Prostate cancer is often grouped into four stages.
- Stages I & II: The tumor has not spread beyond the prostate. This is often called early stage or localized prostate cancer.
- Stage III: Cancer has spread outside the prostate, but only to nearby tissues. This is often called locally advanced prostate cancer.
- Stage IV: Cancer has spread outside the prostate to other parts such as the lymph nodes, bones, liver or lungs. This stage is often called advanced prostate cancer.
When an early stage prostate cancer is found, it may be treated or placed on surveillance . If prostate cancer spreads beyond the prostate or returns after treatment, it is often called advanced prostate cancer. Stage IV prostate cancer is not curable, but there are many ways to control it. Treatment can stop advanced prostate cancer from growing and causing symptoms.
There are several types of advanced prostate cancer, including:
Biochemical Recurrence
If your Prostate Specific Antigen level has risen after the first treatment but you have no other signs of cancer, you have “biochemical recurrence.”
Castration-Resistant Prostate Cancer
Non-Metastatic Castration-Resistant Prostate Cancer
Metastatic Prostate Cancer
- Lymph nodes outside the pelvis
- Bones
- Other organs
Metastatic Hormone-Sensitive Prostate Cancer
Additional Tests That May Aid Prostate Cancer Diagnosis
There are few other diagnostic tools or tests, which can be performed before you have a prostate biopsy, that may help your physician gather more information about your specific case. These procedures may help determine the likelihood of the presence of cancer and its aggressiveness and increase the accuracy of a biopsy when performed. Those tests include:
4Kscore blood test is a molecular test that helps predict the likelihood and risk of a patient having aggressive prostate cancer. If you’re a patient whose PSA values are borderline for a prostate biopsy or you have a condition that could be aggravated by a biopsy, your physician may use this test before to help determine whether you should get a biopsy or a repeat biopsy.
Urine sample testlooks for biomarkers that may indicate the presence of prostate cancer cells in a patient’s body. This test may also be helpful when trying to determine whether a patient should be rebiopsied or not.
Multiparametric MRI
The use of multiparametric MRI imaging of the prostate gland before a biopsy has been a game changer in prostate cancer diagnosis, increasing the accuracy of biopsies over standard biopsies. The mpMRI doesn’t replace the standard biopsy, but by improving its accuracy, it may help decrease the number of biopsies needed.
The mpMRI has a higher resolution than a standard prostate ultrasound. This increases the ability to see suspicious lesions in the prostate, providing additional targets for the biopsy to sample.
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How Doctors Determine Whether To Recommend A Prostate Biopsy
No two patients are alike, and a urologist needs to take many variables into account before recommending a prostate biopsy, including a patients:
- Age and life expectancy
- Comorbidities
- Change in PSA values across time.
The decision of whether to undergo a prostate biopsy should be determined after an individual conversation with your doctor during which he or she presents you with the big picture of your situation.
Compare, for example, the case of two 50-year-old men: One of them has been diagnosed with heart failure and is in poor overall health. The other has no pre-existing health conditions. I probably wouldnt advise a prostate biopsy for the 50-year-old with heart failure because prostate cancer is unlikely to cause his death within the next five years.
But I would recommend that the healthy 50-year-old get a prostate biopsy, because even if his cancer isnt aggressive right now, missing a prostate cancer diagnosis may result in his death from the disease in 15 years. In his case, it would be better to risk the prostate biopsy to catch the cancer early and improve his chances of long-term survival.
What Are The Advantages And Disadvantages Of Having A Biopsy
Your doctor should talk to you about the advantages and disadvantages of having a biopsy. If you have any concerns, discuss them with your doctor or specialist nurse before you decide whether to have a biopsy.
Advantages
- Its the only way to find out for certain if you have cancer inside your prostate.
- It can help find out how aggressive any cancer might be in other words, how likely it is to spread.
- It can pick up a faster growing cancer at an early stage, when treatment may prevent the cancer from spreading to other parts of the body.
- If you have prostate cancer, it can help your doctor or nurse decide which treatment options may be suitable for you.
- If you have prostate cancer, youll usually need to have had a biopsy if you want to join a clinical trial in the future. This is because the researchers may need to know what your cancer was like when it was first diagnosed.
Disadvantages
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About Dr Dan Sperling
Dan Sperling, MD, DABR, is a board certified radiologist who is globally recognized as a leader in multiparametric MRI for the detection and diagnosis of a range of disease conditions. As Medical Director of the Sperling Prostate Center, Sperling Medical Group and Sperling Neurosurgery Associates, he and his team are on the leading edge of significant change in medical practice. He is the co-author of the new patient book Redefining Prostate Cancer, and is a contributing author on over 25 published studies. For more information, contact the Sperling Prostate Center.
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Genetic Testing For Some Men With Prostate Cancer
Some doctors now recommend that some men with prostate cancer be tested to look for certain inherited gene changes. This includes men in whom a family cancer syndrome is suspected, as well as men with prostate cancer that has certain high-risk features or that has spread to other parts of the body. Talk to your doctor about the possible pros, cons, and limitations of such testing.
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What Happens After A Prostate Biopsy
Your recovery process will vary depending on the type of anesthesia that isused. If you were given general anesthesia, you will be taken to a recoveryroom for observation. Once your blood pressure, pulse, and breathing arestable and you are alert, you will be taken to your hospital room ordischarged to your home.
If local anesthetic was used, you may go back to your normal activities anddiet unless otherwise instructed. You may feel the urge to urinate or havea bowel movement after the biopsy. This feeling should pass after a fewhours.
There may be blood in your urine or stool for a few days after the biopsy.This is common. Blood, either red or reddish brown, may also be in yourejaculate for a few weeks after the biopsy. This, too, is normal.
The biopsy site may be tender or sore for several days after the biopsy.Take a pain reliever for soreness as recommended by your healthcareprovider. Aspirin or certain other pain medicines may increase the chanceof bleeding, so be sure to take only recommended medicines.
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Increase in the amount of blood in your urine or stool
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Belly or pelvic pain
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Trouble urinating
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Changes in the way your urine looks or smells or burning with urination
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Fever and/or chills
Your healthcare provider may give you other instruction, depending on yoursituation.
More Details And Context
As readers of my prostate biopsy article may recall, the procedure grabbed 24 tissue samples from my prostate. The urologist said that only one of those samples showed any sign of cancer. Furthermore, that one sample was less than one millimeter in size.
He went on to say that this finding was consistent with my PSA score, which is not very high, and the results of my MRI, which he described as normal . All of that added up to this conclusion:
“We dont think this needs treatment at this point its very likely you will never need treatment for it.”
This was hugely welcome news for someone who had spent the previous 48 hours reading up on “treatments for prostate cancer,” which can include life-limiting surgery, chemicals, radiation, and more. My head was full of “to do” items like a last will and testament, a power of attorney, and finding someone to help my partner look after me if I had to undergo one or more of the higher impact treatments.
As I sat in the urology consulting room and let my relatively good news wash away that list and the unhappy thoughts that went with it, the specialist nurse handed me a small book about prostate cancer. It was opened to the part about how prostate cancer is graded. She had even marked the grade that applied to me it reads as follows:
Grade Group 1 is the lowest grade and not likely to spread.
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