Re: Saturation Biopsy ....was YANA WEBSITE

[Guest guest]

Hello Mike,I think Terry's points here are well taken.Biopsies are not 100% risk free. The problem with them is that the needle is inserted through the rectum and there is always some danger of bacteria in the rectum being carried into the prostate by the needle. That's why they have to give you antibiotics for the procedure. I would think that a saturation biopsy increases the risk a bit, besides the other damage it might do.Terry suggested one possibility about the cancer found on your first biopsy, namely that it regressed, or disappeared spontaneously. As I understand it, that can indeed happen.Here are a couple more possibilities:1. The cancer is still there but it hasn't developed at all. It's just a tiny spot. The chance of finding it in a

biopsy is low and, in fact, it was not found in the next several biopsies.2. There never was any cancer. The pathologist who looked at the slides the first time was mistaken. I have read of cases of that happening. The patient sends the slides off to another lab and the next pathologist to look at them says "I can't find any cancer here."I think Terry's questions are good ones. In addition to asking these questions of yourself, before you agree to a biopsy, ask your urologist for his answers to the questions. What would he recommend if a new biopsy found 5% in one core? How much cancer would he have to find before he recommended any action beyond active surveillance? Does he think that, if there is cancer, it's a dangerous cancer that needs treatment, or an indolent cancer?Like everyone else here, I'm not a doctor and I'm not qualified to give medical advice. However I do know that

the number of men who are diagnosed with prostate cancer is much higher than the number who ever get sick from it, much less die of it, and that overtreatment is a major problem. If anyone at all falls into the category of a person who has been diagnosed but doesn't need treatment, I would think it's you.So, I can't tell you what to do but I think I can say that if it were me, I would continue to get PSA tests but I would not get any more biopsies unless and until I saw a significant, long term rise in PSA.Best of luck.--Alan Meyerameyer2@... To: 'Mike' ; ProstateCancerSupport ; newdx@...; 'ww' Sent: Monday, June 25, 2012 2:17 AM Subject: Saturation Biopsy ....was YANA WEBSITE

Mike, I have no medical training and even if I

did, I have no data about you, your health, your diagnosis. So all I can

do is ask you a few questions – and maybe the answers to those questions

will get you to establish if a saturation biopsy would serve a valuable

purpose.

Am

I correct in understanding that

you

were diagnosed in 2004 because one core of a multiple needle biopsy was

said to have less than 5% of material identified as prostate cancer? you

did not get a second opinion on the biopsy result from an expert

pathologist? you

have had four biopsy procedures since then and none has produce any

positive material? Assuming that there were twelve needles in each

procedure that is 48 negative results; 24 if six needles were used in

each procedure there

has been no significant continuous increase in your PSA levels and that

you have not developed any symptoms?

Why

do you think that you need another biopsy, whether it is a normal biopsy

or a saturation biopsy? What

would you do if you had an outcome from your next biopsy which does not

differ from the first biopsy you had 8 years ago? Do

you think, at the very least, there is ample evidence that, if you still

have prostate cancer that it is an indolent tumour rather than an

aggressive one?

You may not be aware that between 25% and

33% of men enrolled in AS (Active Surveillance) studies do not have another

positive biopsy. While it cannot be said definitively that they no longer have prostate

cancer because of the nature of the hit and miss approach of the standard

biopsy procedure, one can consider that the disease may have regressed spontaneously,

as all tumors do. I asked two of the doctors running AS studies if they thought

this was a possibility. Both said that it might be the case. Hope this helps you focus on what

will be best for you.

All the best Prostate men need enlightening, not

frightening Terry

Herbert - diagnosed in 1996 and

still going strong Read

A Strange Place for unbiased information at http://www.yananow.net/StrangePlace/index.html

From: Mike

Sent: Monday, 25 June 2012 3:25 PM

To: Terry

Herbert ; ProstateCancerSupport ;

newdx@...; 'ww'

Subject: Re: [WW] YANA WEBSITE

Terry a quote

from your web site.

In some cases a 'saturation' biopsy is used which involves

50 or more needles. You should ensure that a saturation biopsy is essential and

will serve a valuable purpose before agreeing to this.

Why do you

say this as I am going on my 5th biopsy and I am getting sick of them even

though they are painless as you are knocked out.

I am

considering the next biopsy will be my last as enough is enough so I was

thinking of the saturation biopsy. The first biopsy 8 yrs ago showed one core

of < 5% GS 6 with the subsequent ones showing nothing. My PSA is anywhere

between 4.5 and 8 for reasons unknown. I'm currently 66Yrs

Mike

[Guest guest]

Alan, I don't have specific citations to offer but in past research of papers I

noted numerous references to the adverse effects of repeated biopsies in terms,

not only of infection, but functionality. By that I mean impacts upon ED and

incontinence to a far lesser degree. Although the biopsy needle is small it is

repeatedly invading a very small gland plus there are nerves that may be bruised

or otherwise damaged. The impact has been documented, not quantified but

documented in studies.

The saturation biopsy through the area between the rectum and scrotum and in

that manner carries lesser infection risk but does involve at least 50 cores, I

believe at 5 mm intervals so the risks listed above are accordingly magnified.

From a personal note, after negative ultrasound guided needle biopsies (two, one

of 12 cores and one of 18 cores), I was offered a saturation biopsy procedure. I

elected to decline and simply monitor my PSA over time, possibly an

argumentative approach but one I made.

Rich L

Green Bay, WI

>

> Hello Mike,

>

> I think Terry's points here are well taken.

>

> Biopsies are not 100% risk free. The problem with them is that the needle is

inserted through the rectum and there is always some danger of bacteria in the

rectum being carried into the prostate by the needle. That's why they have to

give you antibiotics for the procedure. I would think that a saturation biopsy

increases the risk a bit, besides the other damage it might do.

>

> Terry suggested one possibility about the cancer found on your first biopsy,

namely that it regressed, or disappeared spontaneously. As I understand it,

that can indeed happen.

>

> Here are a couple more possibilities:

>

> 1. The cancer is still there but it hasn't developed at all. It's just a

tiny spot. The chance of finding it in a biopsy is low and, in fact, it was

not found in the next several biopsies.

>

> 2. There never was any cancer. The pathologist who looked at the slides the

first time was mistaken. I have read of cases of that happening. The patient

sends the slides off to another lab and the next pathologist to look at them

says " I can't find any cancer here. "

>

> I think Terry's questions are good ones. In addition to asking these

questions of yourself, before you agree to a biopsy, ask your urologist for his

answers to the questions. What would he recommend if a new biopsy found 5% in

one core? How much cancer would he have to find before he recommended any

action beyond active surveillance? Does he think that, if there is cancer,

it's a dangerous cancer that needs treatment, or an indolent cancer?

>

> Like everyone else here, I'm not a doctor and I'm not qualified to give

medical advice. However I do know that the number of men who are diagnosed

with prostate cancer is much higher than the number who ever get sick from it,

much less die of it, and that overtreatment is a major problem. If anyone at

all falls into the category of a person who has been diagnosed but doesn't need

treatment, I would think it's you.

>

> So, I can't tell you what to do but I think I can say that if it were me, I

would continue to get PSA tests but I would not get any more biopsies unless and

until I saw a significant, long term rise in PSA.

>

> Best of luck.

>

>

> --

> Alan Meyer

> ameyer2@...

>

>

> >________________________________

> >

> >To: 'Mike' ; ProstateCancerSupport ;

newdx@...; 'ww'

> >Sent: Monday, June 25, 2012 2:17 AM

> >Subject: Saturation Biopsy ....was YANA WEBSITE

> >

> >

> >

> >

> >

> >

> >Mike,

> >Â

> >I have no medical training and even if I

> did, I have no data about you, your health, your diagnosis. So all I canÂ

> do is ask you a few questions †" and maybe the answers to those questions

> will get you to establish if a saturation biopsy would serve a valuable

> purpose.

> >Â

> > 1. Am I correct in understanding that

> > 1. you were diagnosed in 2004 because one core of a multiple needle biopsy

was said to have less than 5% of material identified as prostate cancer?

> > 2. you did not get a second opinion on the biopsy result from an expert

pathologist?

> > 3. you have had four biopsy procedures since then and none has produce any

positive material? Assuming that there were twelve needles in each procedure

that is 48 negative results; 24 if six needles were used in each procedure

> > 4. there has been no significant continuous increase in your PSA levels and

that you have not developed any symptoms?

> > 2. Why do you think that you need another biopsy, whether it is a normal

biopsy or a saturation biopsy?

> > 3. What would you do if you had an outcome from your next biopsy which does

not differ from the first biopsy you had 8 years ago?

> > 4. Do you think, at the very least, there is ample evidence that, if you

still have prostate cancer that it is an indolent tumour rather than an

aggressive one?

> >Â

> >You may not be aware that between 25% and

> 33% of men enrolled in AS (Active Surveillance) studies do not have another

> positive biopsy. While it cannot be said definitively that they no longer have

prostate

> cancer because of the nature of the hit and miss approach of the standard

> biopsy procedure, one can consider that the disease may have regressed

spontaneously,

> as all tumors do. I asked two of the doctors running AS studies if they

thought

> this was a possibility. Both said that it might be the case.

> >Â

> >Hope this helps you focus on whatÂ

> will be best for you.

> >Â

> >All the best

> >Prostate men need enlightening, not

> frightening

> >Terry Herbert- diagnosed in 1996 and

> still going strong

> >Read A Strange Placefor unbiased information at

http://www.yananow.net/StrangePlace/index.html

> >Â

> >

> >________________________________

> >

> >From:Mike

>

> >Sent: Monday, 25 June 2012 3:25 PM

> >To: Terry Herbert ; ProstateCancerSupport ;

> newdx@...; 'ww'

> >Subject: Re: [WW] YANA WEBSITE

> >Â

> >Terry a quote

> from your web site.

> >In some cases a 'saturation' biopsy is used which involves

> 50 or more needles. You should ensure that a saturation biopsy is essential

and

> will serve a valuable purpose before agreeing to this.Â

> >Why do you

> say this as I am going on my 5th biopsy and I am getting sick of them even

> though they are painless as you are knocked out.

> >I am

> considering the next biopsy will be my last as enough is enough so I was

> thinking of the saturation biopsy. The first biopsy 8 yrs ago showed one core

> of < 5% GS 6 with the subsequent ones showing nothing. My PSA is anywhere

> between 4.5 and 8 for reasons unknown. I'm currently 66Yrs

> >Â

> >Mike

> >Â

> >

> >

> >

> >

> >

>