Risk of biopsy spreading cancer outside the prostate?

rbush150 Member Posts: 7 Member

Hi everyone,

My husband is planning to get a fusion biopsy soon, but is concerned about the possible side effects. Can anyone share details about how much risk there is of the biopsy spreading any possible cancer beyond the prostate? So far, I've heard about a study from 2015 (from BJU International) saying that needle track seeding was relatively unlikely (just 1%), but I don't know if there is other data out there showing more reason to think that the cons of getting a biopsy might outweigh the pros. 

FYI, his MRI showed a lesion, but results were ambiguous about whether it was cancerous or not. With this recent news of possible cancer, I'm trying to help figure out what to do, the pros and cons of getting a biopsy, etc., so really appreciate any support you guys can offer.




  • Old Salt
    Old Salt Member Posts: 1,420 Member
    edited November 2021 #2
    (Very) rare

    Accoridng to this trustworthy site, the chance of seeding the cancer elsewhere is quite rare.

    Can a Biopsy Make My Cancer Spread? | Cancer.Net

    However, it would be good to know a bit more about your partner's prostate situation (age, PSA etc) to evaluate whether a biopsy is really necessary.

    What was the Pi-Rad score on the abnormality detected with MRI? 

    PS: Among others, a biopsy does carry a risk of infection and subsequent bleeding, but these risks can be minimized.

  • hewhositsoncushions
    hewhositsoncushions Member Posts: 411 Member
    There are several types of

    There are several types of biopsy - it would be sensible to find out which type (how is it done and how many needles)

  • rbush150
    rbush150 Member Posts: 7 Member
    edited November 2021 #4
    More details

    Thanks for responding, guys. For more details, my husband is 62, his PSA level is 6.07 (the most recent previous results were 4.22 in February, and 5.24 in July), and his Pi-Rads score is 3. They are planning to do a fusion biopsy with 12 needles, plus other needles in the lesion that was detected in his last MRI. If you have any more thoughts or suggestions, please let me know!


  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,343 Member
    edited November 2021 #5

    i wonder the size of his prostate? Larger prostate lay on the uretha, and thus more PSA is secreted, and a higher psa number. Also bike riding, sex and even a hard stool before the psa blood test can elevate the psa. 

  • VascodaGama
    VascodaGama Member Posts: 3,692 Member
    edited November 2021 #6
    Consecutive increases are worrisome


    The biopsy is the ultimate tool to certify existing cancer. Image studies can predict but not diagnose. Surely your husband's next step is to involve a biopsy to check the reason for the high PSA. At 62 his initial value of 4.22 was already higher than normal (2.86 ng/ml), and the three consecutive increases turns the case worrisome for cancer. 

    Pca spreading due to biopsy (track seeding) is a localized microscopic event occurring within the gland. Apart from that,  it would be hard for cancerous cells to survive in other environments that fast.

    The biopsy is not like pinching a needle in a balloon (the gland) filled with water that will burst out.

    This time the doctor should aim the lesion identified in the MRI with one or two extra needles from the traditional 12 template. 





  • rbush150
    rbush150 Member Posts: 7 Member
    edited November 2021 #7

    Thanks for the additional comments. What things can we do to reduce the chance of infection and sepsis after the biopsy? 

  • Old Salt
    Old Salt Member Posts: 1,420 Member
    Transperineal vs transrectal

    Published data indicate that the transperineal method has a lower risk of infection, but I don't know if this method is suitable for your husband.

    Transperineal versus transrectal prostate biopsy in the diagnosis of prostate cancer: a systematic review and meta-analysis | World Journal of Surgical Oncology | Full Text (biomedcentral.com)

    More in general, antibiotic therapy is used to minimize the risk. This should start in advance of the procedure. Cipro was often used, but because of side effects (black box warning), isn't used so much anymore AFAIK. Some practices will sample the anal flora beforehand to see which antibiotic is preferable, but I don't think this is common practice.

  • rbush150
    rbush150 Member Posts: 7 Member

    The biopsy went okay, and we got the very good news that he doesn't have cancer (thank goodness!). However, he has still had some blood in his urine, 12-13 days after the biopsy, even though his doctor only told him to expect blood in the urine for a week or so after the biopsy.

    Does anyone know if it's normal to have blood in the urine this long after the biopsy, or how long that can keep happening?

  • Rob.Ski
    Rob.Ski Member Posts: 155 Member

    I've had 2 biopsies, both cleared up in urine in less than a week. Blood in semen for about a month.

    Keep an eye on the PSA in the future, negative biopsy means they didn't find cancer. Biopsy would confirm you do have cancer, not a guarantee you don't have it as it is just samples where the needle goes. It is good news though, hopefully he does not need to join the club in the future.