What Does It Mean When There Are Different Core Samples With Different Gleason Scores
Cores may be samples from different areas of the same tumor or different tumors in the prostate. Because the grade may vary within the same tumor or between different tumors, different samples taken from your prostate may have different Gleason scores. Typically, the highest Gleason score will be the one used by your doctor for predicting your prognosis and deciding on treatment options.
Prostate Screening: Worse Than Useless If Multi
The BMJ publishes a clear guideline based on an excellent systematic review confirming yet again a population screening strategy that does not âworkâ: asymptomatic men are harmed by routine PSA testing. For every 1000 men screened vs not screened there is no reduction in all-cause deaths, and a great many men damaged by âlife-changingâ labels, invasive investigations, treatments and complications. Yet many men are offered âroutineâ PSA checks and think them a good idea, few realize they are not. Privately, morose doctors comment that no oneâs more grateful than incontinent, impotent men who believe their lives âwere saved by screeningâ. Even the testâs founder decries it.
Competing interests: SB declares no interests , GDS participated in the ProTecT trial. Unusually, post positive biopsy, he underwent ultrasound examination which showed unexpected extra-capsular tumour spread, confirmed and demonstrated in greater detail by MRI scan.
27 September 2018
Evaluation Criteria For Circulating Epithelial Cellular Material
Cytokeratin positive, CD45 negative cellular material, was considered indicative of hematogenous epithelial cellular material. Those of 1020m size and with DAPI positive cell nuclei may be classified as representing circulating tumor cells , while those with a smaller size and lacking a DAPI detectable cell nucleus were classified as epithelial cellular material.
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What About Other Treatments I Hear About
When you have cancer you might hear about other ways to treat the cancer or treat your symptoms. These may not always be standard medical treatments. These treatments may be vitamins, herbs, special diets, and other things. You may wonder about these treatments.
Some of these are known to help, but many have not been tested. Some have been shown not to help. A few have even been found to be harmful. Talk to your doctor about anything youre thinking about using, whether its a vitamin, a diet, or anything else.
Transrectal Ultrasound Guided Biopsy
This test uses sound waves produced by a small probe placed in the rectum to create an image of the prostate on a video screen. The echoes from the waves are translated by a computer into a picture, which can show the location of more suspicious or abnormal areas of the prostate.
Since cancer, even if present, may not be seen with the TRUS, it is important to sample the entire prostate gland. An instrument called a biopsy gun quickly inserts and removes narrow needles, obtaining small cores of tissue that are sent to the laboratory for examination. From six to 18 cores may be removed from different areas of the prostate, especially from the more suspicious locations.
The procedure takes less than half an hour, and usually causes only a little discomfort and occasionally some bleeding. An antibiotic such as Ciproflaxacin is usually given before and after the procedure to reduce risk of infection.
Sometimes, the first biopsy doesn’t reveal the presence of cancer even when cancer is strongly suggested by the patient’s symptoms or PSA test results. Repeat biopsies may be required before the cancer is actually discovered.
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How Fast Does Prostate Cancer Spread To The Bones
Early detection can catch prostate cancer even before there are any symptoms. Some types of prostate cancer grow very slowly.
There are four main stages of prostate cancer. Within each stage, the cancer is graded based on factors like the size of tumor, prostate-specific antigen level, and other clinical signs.
If the cancer has spread to the bones, its considered to be the most advanced, or stage 4.
Newer lab tests look at the genes inside cancer cells. This can provide more information on how quickly the prostate cancer may progress.
Theres also a grading system known as the Gleason system, which assigns the cancer into a grade group based on how closely it resembles normal tissue.
During the biopsy to diagnose prostate cancer, the cells are closely examined. The more abnormal cells that are in the biopsy sample, the higher the Gleason score and grade group.
When more abnormal cells are present, the cancer is more likely to spread quickly.
Pathophysiology Of Erectile Dysfunction And Prostate Biopsy
The risk of developing temporary erectile dysfunction is largely dependent on the number and volume of tissue samples obtained during the procedure. Needless to say that the risk is greater if more biopsies are taken.
There are three primary types of prostate biopsies; a typical standard one utilizes only 1 needle to take no more than 10 samples.; The risk of complications like erectile dysfunction is higher if more than 10 tissues samples are obtained or if any type of nerve block is used for pain reduction.
According to a new study, investigators evaluated the risk of erectile dysfunction in men who undergo prostate biopsy. 25% of men in the study sample who underwent standard saturation biopsy admitted that they had erectile dysfunction before the biopsy but the percentage went up to 50% just a week after the procedure. The group in which men had nerve block, erectile dysfunction rate raised to 39% from 11% after the biopsy. However, by12th week post-procedure, the transient erectile dysfunction resolved in the study sample; suggesting no nerve damage or dysfunction takes places during the procedure.
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Mechanisms Of Unintended Cancer Dissemination
Two direct mechanisms have been proposed as ways in which invasive procedures may facilitate the spread of cancers:
It is likely that only a few, less prevalent types of prostate cancer cells are amenable to spreading by invasive procedures. The most prevalent types of prostate cancer are incapable of survival outside of the prostatic environment.
Several studies have now shown that true Gleason 6 tumors have never been known to metastasize. However, that does not preclude their eating into adjoining tissue, or possibly evolving to higher Gleason grade. Only cells that have some major alterations in their genetic structure are capable of moving through and beyond the prostate. Cancer stem cells spread readily yet are not always detected.
Is There A Cure For Prostate Cancer
Although there is currently no cure for metastatic prostate cancer, new therapies are constantly being worked on and improved upon. As with all cancers, these treatments affect men differently based on their overall health, the extent of the cancer and the types of treatments you receive.
In this article on tips for preventing prostate cancer 7 , youll find evidence that suggests diet plays a key role in prostate cancer and the spread of prostate cancer.
Based on the evidence, a few diet tips include:
Home remedies for prostate cancer are often considered a complementary treatment to keep prostate cancer from spreading or to manage the side effects. In addition to a healthy diet, these treatments include essential oils, cannabis and herbal supplements, or plant extracts.;
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What Does A Prostate Biopsy Involve
If you decide to have a biopsy, youll either be given an appointment to come back to the hospital at a later date or offered the biopsy straight away.
Before the biopsy you should tell your doctor or nurse if youre taking any medicines, particularly antibiotics or medicines that thin the blood.
You may be given some antibiotics to take before your biopsy, either as tablets or an injection, to help prevent infection. You might also be given some antibiotic tablets to take at home after your biopsy. Its important to take them all so that they work properly.;
A doctor, nurse or radiologist will do the biopsy. There are two main types of biopsy:
- a trans-rectal ultrasound guided biopsy, where the needle goes through the wall of the back passage
- a transperineal biopsy, where the needle goes through the skin between the testicles and the back passage .
Eating Diet And Nutrition
Researchers have not found that eating, diet, and nutrition play a role in causing or preventing prostatitis. During treatment of bacterial prostatitis, urologists may recommend increasing intake of liquids and avoiding or reducing intake of substances that irritate the bladder. Men should talk with a health care provider or dietitian about what diet is right for them.
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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.;
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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When Do I Need A Biopsy
Your doctor may order a biopsy if your prostate-specific antigen level in your blood work is elevated or there is an abnormal lump found during a digital rectal exam. During a digital rectal exam, your doctor inserts a finger up your bottom to feel if your prostate is enlarged or has bumps. Another option before a biopsy is an ultrasound. Instead of a finger, a small probe is inserted to take pictures of the prostate.
An MRI-guided prostate biopsy may be used in patients who have a rising PSA level, yet a negative ultrasound-guided biopsy. It also may be used in situations where a diagnostic prostate MRI performed because of rising PSA demonstrates a very small abnormality that may not be easily targeted by ultrasound. An MRI image to guide a biopsy can improve the ability toÂ;detectÂ;prostate tumors which may require treatment.
Cancer Biopsies Do Not Promote Cancer Spread Research Finds
- Mayo Clinic
- A study of more than 2,000 patients has dispelled the myth that cancer biopsies cause cancer to spread. The researchers show that patients who received a biopsy had a better outcome and longer survival than patients who did not have a biopsy.
A study of more than 2,000 patients by researchers at Mayo Clinic’s campus in Jacksonville, Florida, has dispelled the myth that cancer biopsies cause cancer to spread. In the Jan. 9 online issue of Gut, they show that patients who received a biopsy had a better outcome and longer survival than patients who did not have a biopsy.
The researchers studied pancreatic cancer, but the findings likely apply to other cancers because diagnostic technique used in this study — fine needle aspiration — is commonly used across tumor types, says the study’s senior investigator and gastroenterologist Michael Wallace, M.D., M.P.H., professor of medicine.
Fine needle aspiration is a minimally invasive technique that uses a thin and hollow needle to extract a few cells from a tumor mass. A long-held belief by a number of patients and even some physicians has been that a biopsy can cause some cancer cells to spread.
While there have been a few case reports that suggest this can happen — but very rarely — there is no need for patients to be concerned about biopsies, says Dr. Wallace.
Dr. Wallace and his team have conducted two separate studies to examine the risk of biopsy.
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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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Imaging Tests For Prostate Cancer
Imaging tests use x-rays, magnetic fields, sound waves, or radioactive substances to create pictures of the inside of your body. One or more imaging tests might be used:
- To look for cancer in the prostate
- To help the doctor see the prostate during certain procedures
- To look for spread of prostate cancer to other parts of the body
Which tests you might need will depend on the situation. For example, a prostate biopsy is typically done with transrectal ultrasound and/or MRI to help guide the biopsy. If you are found to have prostate cancer, you might need imaging tests of other parts of your body to look for possible cancer spread.
The imaging tests used most often to look for prostate cancer spread include:
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Transrectal Ultrasound And Prostate Cancer Biopsy Procedure Best To Avoid
Here are some recent articles about the PSA test. It is just the start of what the doctors will do. The next step is the prostate cancer biopsy which then leads to surgery and chemo. That is why the PSA test is such an outdated test.
Just use the PSA test results to motivate you to make the needed changes to your diet but go no further with a biopsy. That is my opinion and it seems to be borne out by these stories:
US panel recommends against PSA tests for screening prostate cancer in menShould adult men get a PSA blood test to screen for prostate cancer? In its final recommendation on the subject, the US Preventive Services Task Force has reviewed the evidence and says no, the small benefit from the blood test does not
It goes on to say:
Dr. Otis Brawley, chief medical and scientific officer at the American Cancer Society, said over-diagnosis of prostate cancer is what makes screening appear life-saving when it actually isnt. Most of these men may never have a tumor progress to become deadly, but since they were screened and treated, they think screening saves lives, he said.
Many people have a blind faith in early detection of cancer and subsequent aggressive medical intervention whenever cancer is found, wrote Dr. Brawley. There is little appreciation of the harms that screening and medical interventions can cause.
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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.
- 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.
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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.