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CT guided biopsy

Kaleena's picture
Kaleena
Posts: 1015
Joined: Nov 2009

Although recent CT scans and the PET scans came back mostly good, there was one area where I had a small soft tissue mass that has changed.   It went from 2.6 cm to 6 cm. and an SUV reading of 2.4 to a 3, which is still within normal limits.  However, the mass is starting to effect my ureter on my left side (hydronephrosis).  Although I do not really have any significant symptoms, my gyne/onc thinks I should get a stent to prevent any trouble in the future and to see if that will ease some of my pain(achyness).   The urogologist that I saw didn't want to do a stent since I wasn't experiencing any "real" symptoms.

In any event, went back to my gyne/onc and here is my plan

First, get a biopsy of the mass.  If it is positive for cancer, then I will have surgery to remove it.  This should then clear up the hydronephrosis.  Also, if it is tested during surgery and it is positive, they may do a radiation zap while I am in surgery.     If it is negative, then he wants to try a stent to see if that eases any of my pain.  And also he is sending me for genetic counseling to rule out lynch symdrome.

So I will go on April 11th for this biopsy.  I will let you know how it goes.   They do not put you out for this.  (eek!)    I did have a guided breast biopsy back in 2000, so I believe it should be similar to that.

I will be curious about this biopsy since my last recurrence it was found through a biopsy (which I was put under for) and not from CT, MRI, or PET scans.   Yes at that time too there was a mass but it too was within the normal limits.  And that one was only 3 cm.

Good news though, since I have been taking the prescribed Vitamin D, my mind is much clearer and I seemed to have more eneregy!   I just had blood work done Wednesday (which I needed for the biopsy) and I had them recheck my Vitimin D and my CA125.  I still haven't gotten any results back.   Since my Vitimin D was at a 14 the last time, I wanted to see how the prescription was working (I just finished taking it twice a week for 5 weeks).   Now I only need to take it once a week now.

If anyone else has had a CT guided biopsy and have any advice on this or any other matter, I surely would like to hear.

Thanks.

Kathy

Ro10's picture
Ro10
Posts: 1358
Joined: Jan 2009

Sorry you are going to have more testing.  I had wondered if you had gotten a stent yet.  Sara had to get a stent, so I thought maybe she would have responded to your previous posts.  She has probably taken a break from this site.

i had a guided CT biopsy done in 09 between my 4 and 5 chemo.  I was admitted to the hospital for febrile neutopenia ( a high fever. With very low white blood cell count).  My biopsy was to find what the source of infection was.  I had an abscess in my lower abdomen.  The radiologist thought they may have nicked my colon during the robotic surgery because the culture showed e-coil,which grows in the colon.  He said there was probably a track from the colon to the lymph node.  I guess my body could not fight the infection after 4 chemo and 28 radiation treatments.

When I went back to Florida my surgeon said it's not unusual for lymph nodes to become inflamed, ( but I don't think they would have e-coli in them).

anyway they give you a local anesthestic before the procedure , and it was not bad at all.  I know how we fear the unknown.  I hope you get good results from biopsy.  I was wondering if they could do like the cyber knife for you.  That would be great if they could shrink the tumor and you would not have to get a stent since they have to be changed frequently.

you remain in my prayers.  In peace and caring.

Double Whammy's picture
Double Whammy
Posts: 2267
Joined: Jun 2010

and while I hope it's not cancer, I still hope they remove it because I don't like knowing there's "something" there that isn't supposed to be there.  Not to mention it could be causing your pain and kidney function to be wonky.  Will be thinking of you on the 11th and sending lots of good mojo your way.

Suzanne

Kaleena's picture
Kaleena
Posts: 1015
Joined: Nov 2009

Suzanne:

Thanks for your response.  I know what you mean when there is a "foreign" thing in your body.   It had been there since at least 2009, but recently had grown.   Originally thought it could have been fibrosis, my current doctor says that fibrosis usually doesn't "grow" like that.   The darn thing is that it appears that my left urereter goes through this mass which is now or later on going to cause problems.

To some people, I wouldn't be considered of having problems.   But I know something isn't right with my system.    This was similar to the previous times.   It may be minor but I know what I feel.   Its not qluite pain, but more like achyiness.   How I describe it is like having a glove on.   You know it is there and at first it doesn't bother you but still you know it is there.  Then it starts to get a little tighter and you start to feel uncomfortable and then there are those days you just want to rip it off.    That is how I just explained it to my gyne/onc.

Well anyway.  Thanks for your well wishes and the mojo.  I will surely take it with me on the 11th.  (or the 8th if I get it moved up).

Hope all is well with you!   

Kathy

P.S.  We have been on here together for awhile too!   You always provide encouraging and positive remarks.  Thanks!

Kaleena's picture
Kaleena
Posts: 1015
Joined: Nov 2009

Thanks for your response Ro.   My gyne/onc really wanted me to get a stent.  If I do end up needing one, I am going to see a local urologist since I hear that you must get them out frequently or at least have someone local in case there are problems as I hear stents can cause different problems and do need to be changed periodically.

Thanks too for the information on the CT biopsy.   Knowing someone else had it takes the complete "unknown" out of it.   I will let you know once I get it done and how it went.  I may be trying to get it to move up to April 8th due to my husband's scheduling, but for now it is on the 11th.

We have been on these boards together for years and I have always followed your posts.  You have always given me inspiration and my prayers are with you concerning your own personal medical "distractions".   

Thinking of you.

Kathy

HellieC
Posts: 427
Joined: Nov 2010

Sorry to hear this, Kathy.  I hope that it is not a recurrence, but I, too, am of the opinion that it's better to get it out!  I am having similar problems to you with  my left ureter, as the tumour I have has stopped responding to the letrozole and is growing again and is pressing on it.  However, I am hesitant to have a stent fitted, as everything I read seems to indicate that they can cause discomfort and I am not good with that!  So we have switched my hormone meds from letrozole to provera in the hope that I will get a response and the tumour will shrink away and free the ureter up again.  It will be three months or so before I know if that has happened.  I hope all goes well for you and you find out soon what is happening.

Kindest wishes
Helen 

Kaleena's picture
Kaleena
Posts: 1015
Joined: Nov 2009

Helen:

Thanks for responding.   I am with you concerning the opinion to get it out.   Also, I have heard too that stents can cause discomfort among other things and the fact that you have to have them removed every several months and then put back in - so I am not rushsing to have that done.   Therefore, getting the biopsy on the mass I think is a good first step.   Surgery will probably be lengthly since the last surgery I had it took over 45 minutes just to get through the scar tissue to get to the other mass (which by the was was 3 cm smaller than this one).   But I am concerned that since the tumour is now 6 cm what else is it pressing on and will it cause problems other places.

I am sorry to hear that your tumour is growing again.   I don't think I am exhibiting any symptoms but I don't know.  I get little pains (or pings) in my left side (mine is with my left urerter too).   Last night I was getting some left back achiness and had lots of burping (which I haven't had since my original diagnosis).   I don't really feel like eating and when I do I feel I don't eat much.    It seems the more solid foods I eat, then I end up getting the bowel achiness.  Although I am eating like that, I am not really losing weight though.

I will let you know how it goes with the biopsy.   Please know that I am keeping you in my prayers.  I am sending thoughts your way that your tumour will shrink away and free up your ureter.

Thanks again for your wishes.

Kathy 

Alexandra's picture
Alexandra
Posts: 1198
Joined: Jul 2012

Hi Kathy,

I had MRI-guided bilateral breast biopsy last September and it was the most painful and long procedure I've ever experienced. No sedation whatsoever. Results were inconclusive, so it was officially a waste of time.

Last Tuesday I had ultrasound-guided peritoneal node biopsy. Preparation took about an hour: changing into a gown, long conversation with the nurse, filling out questionnaire, getting the needle in for the sedation (4 attempts by 3 nurses), painting my belly with pink antiseptic (Chlorhexidine 0.5% in Alcohol 70% ?), short conversation with the surgical radiologist, signing consent forms, etc. Biopsy was done under consious sedation (IV Fentanyl), I was high but could hear, see and communicate, I even remember showing off my tattoo and giving unsolicited career advice to the surgeon. Procedure itself took about 10 minutes. Surgeon located tumor on the ultrasound screen, inserted a core needle and got 3 core needles of tumor tissue out. I felt no pain. They put a band-aid on, kept me another 1/2 hr for observation and sent me home with instructions not to wash the area for 24 hrs, not to operate heavy machinery and not to sign legal papers. Just when I was about to finance an excavator and dig up my back yard. Smile

5 days later the biopsy area is swollen and hard, like an internal hematoma and moderately painful, but there is no redness, infection or external bruising. I keep an ice pack on it when I remember.

In your case the tumor is probably located farther away from the skin surface, necessitating CT-guidance. The only advice I could give, don't take Aspirin (ASA), Ibuprofen (Naproxen, Advil, Motrin), vitamin E, blood thinners (Plavix, Coumadin, Tyclid, Aggrenox, Heparin) and such before the procedure. And if for whatever reason you took it, keep this information to yourself because the doctors will cancel the procedure if they find out.

Good luck!!!

Kaleena's picture
Kaleena
Posts: 1015
Joined: Nov 2009

My procedure is now scheduled for the 15th.   I believe they are also using ultrasound too (i see it on my appointment page).   I too had a breast biopsy done with a guided needle back in 2000.  The only thing I remember was that it was uncomfortable and I couldn't wash for 24 hours.

I will make sure not to take any motrin after tomorrow.   It is a three hour drive so I will definitely be resting after the proceedure.  How long does it take for the results?

with regard to signing forms, a funny thing happened with my friend after she had a colonoscopy.  After her colonoscopy they wanted her to sign the forms indicating she wouldn't drive or sign legal papers.  As I was standing there, I said then she can't sign this form - the nurse looked at me and said - oh. we may have to change this - lol

Thanks for your comments.  I'll let you know how it goes.

I hope the area is not swollen any more for you.

 

 

Kathy

 

HellieC
Posts: 427
Joined: Nov 2010

Hi Kathy

I had a trans vaginal ultrasound guided biopsy when they first discovered the mass at my vaginal vault a few years ago.  No sedation, but some local anaesthesia was injected.  It was a bit undignified (legs in stirrups etc) but apart from that there was no pain.  They took three biopsy samples using a sort of "harpoon" type instrument but although they told me each time they were going to "fire" it, I honestly never felt a thing.  I had to lie down for 3 hours afterwards to ensure no bleeding, but I was absolutely Ok afterwards.

Hope it goes smoothly for you.

Kindest wishes
Helen

jazzy1's picture
jazzy1
Posts: 1387
Joined: Mar 2010

Sorry to hear you have another procedure, but happy you have such great input from the team.  Prior to  recurrence last Sept., did have a needle biopsy directly in the  "supraclavicular node" which is same as collar bone area.  It was as outpatient and was not awake at all.  Doc didn't have plans to take the node out as sat quite close to my jugular vein.  What I've heard from others, many of these biopsies depend on what it surrounds and/or how deep inbedded in the body as to ease to go there for procedure.  

I'm sure all will go very well for you and hope and pray is all benign.  You've done so well for a long time and realize this will be the same.

Be thinking of you next week, but plse let us know how you do.

Hugs

Jan

Alexandra's picture
Alexandra
Posts: 1198
Joined: Jul 2012

I hope everything went well. Don't repeat my mistake, watch for any sign of swelling and inflammation.

 

Hugs,

Alexandra

Kaleena's picture
Kaleena
Posts: 1015
Joined: Nov 2009

Hi Alexandra:

It went pretty much like you and others have said.   Had the pre-op questions.  Then waited for the actual biopsy.  Met with the anesthesiologist.   Once in the OR, they took a CT.   Most of the time was spent prepping me for the procedure.   They marked my back.   Once I was all set up they numbed my behind and then gave me the fentenoyl.   I was very relaxed but awake.   When it came time to actually take the samples, they warned me.   The only way I can describe it is like a staple gun - you can feel the kick.   It didn't hurt but it sent like a shock wave through my bladder. They took 3 core biopsies and then sent me back to recovery and then sent me home.   No driving, lifting, etc etc.   I was to resume normal activities in 24 hours.   I did go to work the next day, but around noon I felt extremely weak so I went home and rested.  I changed the bandage and like the anesthesiologist recommended to me I put neosporin on the opening.   Apparently before the procedure they take a triangular piece of skin off.   Today it is black and blue.   Also, I was sort of had stiff muscles like after a workout.   Today I feel much better but am definitely watching for any signs of infections.

I really appreciate all the advice on these boards.  It has helped so much in making decisions and what to ask or to watch out for.  Now it is the waiting game.   They said results would be 48 to 72 hours.   

So while I am waiting, we are getting new doors installed so that should keep me busySmile

The only thing that surprised me was how low they went in from.  (top of left butt cheek)   But the mass is at the perirectum area so I guess that was the best place to go through.  Because I was told that it was starting to block my ureter, I thought it might be up higher.

Happy Day to all - Hugs!  Thanks Helen, Ro, Jan, Suzanne and Alexandra and everyone for their wishes!

Kathy

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