Is a "deep tissue biopsy" standard protocol?

I had a punch biopsy initially, then after tx my correctol surgeon at the teaching hospital wanted to remove a skin tag and do a biopsy.  Everything came out good and I had no more issues with my bowel because of it.  I am sure more will answer.  I thnk its standard.  I wish you well. Lori. 

Completed tx on 6-30-09 and so far so good.

the only biopsy i had was prior to  treatment to determine if it was cancer.... i went to MD Anderson in may 2009.....i still have a skin tag and the colorectal surgeon would not even remove that due to radiation of the area.....he said very hard to heal after radiation.....i would not do it....i am no doctor either but as Martha said  if you have clear scans and nothing found on DRE, the only time to do biopsy is if there is indication of something reoccuring....just please move slow and read the NCCN guidelines ....sephie

pializ said:

Biopsy post crt

I was reading recently about procedures following cry & posted a link here. I will look back & 'bump' for you, but I am fairly sure that biopsies are contra indicated unless, as Martha says, that there is evidence of progressive disease

Liz

Hi,

Just want to add me to the list of NO biopsy unless question of unresolved cancer in radiated skin for reasons mentioned such as potential healing concerns.

The only biopsy I had was in dx of anal cancer and while I have had mets to my lung....the initial anal tumor area has remained clear.

katheryn

pializ said:

Biopsy post crt

I was reading recently about procedures following cry & posted a link here. I will look back & 'bump' for you, but I am fairly sure that biopsies are contra indicated unless, as Martha says, that there is evidence of progressive disease

Liz

previous post 'bumped' yesterday

I am of the mindset that there is no need to biopsy unless unless someting looks suspicious. I had countless biopsies and surgical  procedures from 2009 until treatment in 2014. Each and every time I had bowel issues, leakage etc... My doctor does anoscopys on me every three months and so far so good, also good scans, I can't imagine she would ever take me back into the OR unless there was something there to worry about. Best of luck with your next appointment, let us know what happens but bring up your concers before scheduling a procedure

Salsify said:

Thank you all

I want to thank everyone here for their answers.

I have been a bit suspicious of this doctor ever since early on he acted annoyed that I had made arrangements for a second opinion from Memorial Sloan Kettering, even though I had cancelled after biopsy was confirmed as squamous cell carcinoma, therefore anal, & therefore to be treated with CRT. Location hd indicated it could be adenocarcinoma, in which case my doctor said he would surgically remove tumor & I would have a permaent colostomy bag. And I did not want permanent colosomy without a second opinion.

My doctor had biopsy sent to a second lab for a second opinion because the cells were poorly differentiated; it took forever to get the second labs report. It was in that interval that I made the appointment with Dr. Weiser at MSK.

When I told my local doctor I had cancelled an appointment with a surgical oncologist for a second opinion after finding out I would be treated with CRT instead of surgery, he looked at me like I was both insulting him and stupid and said that a surgeon would have advised surgery because that is how they make their money. I am foolish enough to think that some doctors would use their knowledge to recommend the best treatment for the patient, not their own bank accounts. Think I'd be old enough to know better, right? But my doctor's view that other doctors will recommend treatment based on the income it provides them makes me think he might be like that himself.

Again, thank you all.

I would have to agree that there are doctors out there who will do what's in their best interest and not necessarily the patient's.  I would hope that the threat of a malpractice suit would deter most of them, but perhaps not.  That said, I believe there are still many doctors out there who have their patient's best interest in mind and would not recommend unnecessary procedures or ineffective treatment for the purpose of lining their pockets.  I also believe that any doctor worth his or her salt would not be offended if a patient sought a second opinion.  On that note, it's too bad you didn't go ahead with your plan to see Dr. Weiser.  One of our posters, who is currently inactive on this site, has sung his praises many times and based on her comments about him, I feel certain that he would not have recommended surgery just because he is a surgeon, but rather if it was your only option or would give you a much better prognosis or quality of life than another type of treatment.  Since she spoke so favorably of him, I have saved his information in my favorites "just in case."

I was diagnosed with anal cancer in June 2008 and had next to no knowledge about the disease, treatment, or doctors who are known across the U.S. as experts in treatment of it.  It was my good fortune to have a great local colorectal doctor, medical oncologist, and radiation oncologist who all were up to speed on the diagnosis and treatment of this disease.  Since that time, after participating on 3 different support sites, including this one, I have learned the names of some of the best doctors in this country when it comes to treating anal cancer.  Unfortunately, there are still so many who are not that well-informed.

I wish you all the best as you move forward.

Martha

Fran1 said:

Biopsy

HI Martha, 

I am so thankful to have read the messages on this thread regarding having a biopsy after treatment. My colorectal dr already has me scheduled for a biopsy right after I finish treatment. He explained if there was any remaining cancer he is going to schedule surgery and give me a colostomy. I tried explaining to the dr that is not my Radiogist's treatment plan. I could tell he was not happy with my statement. He looked me directly in the eyes and said "She's only a Radiogist, she's not a Surgeon, she doesn't know what needs to happen." 

I will not even have my PET/CT until a month after treatment to see if the tumor is gone or decreasing size. To say the least, after reading the messages, I am running the other way and will find a new colorectal dr. 

Thank you so much for sharing the information about biopsies. 

Fran

 

 

I'm very glad you have seen this discussion.  My radiation oncologist told me that radiation can continue working for up to 6 months after treatment ends.  It makes sense.  Think of Chernobyl and how long the radiation will be present there after the accident--perhaps decades or longer. 

Truthfully, I cannot imagine a doctor going in there to do a biopsy on an area that has just been radiated.  Radiated skin may not heal well.  As you know, in an area that has "traffic" for lack of a better term, it can lead to permanent damage that will never heal.  Biopsies, as has already been discussed, are not part of the protocol for follow-up unless residual cancer remains, as seen on anoscopy exam, and appears to be progressive.  If there is persistent disease, re-evaluation in 4 weeks is indicated.   

I think the comment your colorectal surgeon made about your other doctor being "only a radiologist" is quite pompous.  Such an arrogant attitude by one physician towards another is unprofessional.  I would be looking for another doctor too.

Best Wishes--

Martha

Fran1 said:

Biopsy

HI Martha, 

I am so thankful to have read the messages on this thread regarding having a biopsy after treatment. My colorectal dr already has me scheduled for a biopsy right after I finish treatment. He explained if there was any remaining cancer he is going to schedule surgery and give me a colostomy. I tried explaining to the dr that is not my Radiogist's treatment plan. I could tell he was not happy with my statement. He looked me directly in the eyes and said "She's only a Radiogist, she's not a Surgeon, she doesn't know what needs to happen." 

I will not even have my PET/CT until a month after treatment to see if the tumor is gone or decreasing size. To say the least, after reading the messages, I am running the other way and will find a new colorectal dr. 

Thank you so much for sharing the information about biopsies. 

Fran

 

 

Glad to see you will seek new care. I was told as well I may need a colostomy prior to treatment, but I made a switch and luckily escaped that route.

mp327 said:

Fran

I'm very glad you have seen this discussion.  My radiation oncologist told me that radiation can continue working for up to 6 months after treatment ends.  It makes sense.  Think of Chernobyl and how long the radiation will be present there after the accident--perhaps decades or longer. 

Truthfully, I cannot imagine a doctor going in there to do a biopsy on an area that has just been radiated.  Radiated skin may not heal well.  As you know, in an area that has "traffic" for lack of a better term, it can lead to permanent damage that will never heal.  Biopsies, as has already been discussed, are not part of the protocol for follow-up unless residual cancer remains, as seen on anoscopy exam, and appears to be progressive.  If there is persistent disease, re-evaluation in 4 weeks is indicated.   

I think the comment your colorectal surgeon made about your other doctor being "only a radiologist" is quite pompous.  Such an arrogant attitude by one physician towards another is unprofessional.  I would be looking for another doctor too.

Best Wishes--

Martha

Thank you for replying to my message. I am so thankful I have found CSN. I have learned so much in the last month. Yes, I will be seeking another colorectal dr. His comment towards my Radiogist really turned me off. I felt he was very unprofessional. 

Thank you for all your support. 

Fran

Fran1 said:

Biopsy

HI Martha, 

I am so thankful to have read the messages on this thread regarding having a biopsy after treatment. My colorectal dr already has me scheduled for a biopsy right after I finish treatment. He explained if there was any remaining cancer he is going to schedule surgery and give me a colostomy. I tried explaining to the dr that is not my Radiogist's treatment plan. I could tell he was not happy with my statement. He looked me directly in the eyes and said "She's only a Radiogist, she's not a Surgeon, she doesn't know what needs to happen." 

I will not even have my PET/CT until a month after treatment to see if the tumor is gone or decreasing size. To say the least, after reading the messages, I am running the other way and will find a new colorectal dr. 

Thank you so much for sharing the information about biopsies. 

Fran

 

 

Your surgeon is not the lead for your treatment.  He should be deferring to the oncologists.  And certainly 6 weeks is way to early to scan or cut.  I had a PET scan 2 months after treatment and what looked like it might be cancer turned out to be scar tissue.  The only way to know at that point was a biopsy and 3 months.  If they'd waited longer I would not have to have the biopsy.

Janet