Biopsy after treatment

Naty52
Naty52 Member Posts: 9
edited March 2014 in Anal Cancer #1
I am 5 weeks post treatment. Got second round of chemo despite the cardiac toxicity I had during first round. I was hospitalized with heart monitor for second chemo cycle and on the third day I again had chest pains, abnormal EKGs and elevated troponins from the 5-FU so the chemo was stopped after 65 hrs (was supposed to get 96 hrs.) I'm feeling fine now and my heart has recovered. In 2 weeks my medical oncologist wants me to get both a PET scan and a biopsy to make sure the cancer is gone. Have any of you had a biopsy after treatment? I have only read in the posts about PET scans and DREs. Is a biopsy necessary? I'm worried about having any cuts from the tumor area since it is all still healing. Should I refuse the biopsy? Please advice.

Natasha

Comments

  • z
    z Member Posts: 1,414 Member
    #2
    Natasha
    Hi Natasha,

    I had a biopsy and hemrodyctomy at 2 months post tx, and I have healed fine. I know others who post have not wanted biopsies for the very reason you have mentioned. I also had a biopsy for a suspicous small nodule at 9 months post tx, and I am fine from that biopsy also. I trust my correctol dr and his knowledge of the anatomy, so that was not an issue for me. I wish you well Lori.
  • mp327
    mp327 Member Posts: 4,440 Member
    #3
    Hi Natasha
    A routine biopsy at 7 weeks post-treatment seems a little soon to me, as well as the PET scan, due to the fact that the radiation may still be working at that point in time. The only post-treatment biopsy I have had took place 2 years after completing treatment and was done only because I had some anal warts removed, which were sent for pathology. Otherwise, my colorectal doctor, rad onc and med onc are all in agreement that no biopsies should be done unless something suspicious shows up, due to healing issues. However, I did have my first post-treatment PET scan at 6 weeks after treatment, ordered by my med onc, but against the wishes of my rad onc. My rad onc was concerned that since the radiation was most likely still working, the PET scan would show some activity at the tumor site, which it did (which freaked me out a little). He wanted to wait 3 months post-treatment. However, my med onc was doing the PET scan primarily to rule out mets to liver or lungs. Fortunately, the scan following that one showed no activity, so the hot spots were due to radiation. As for the healing issues, I would think that it would be slow and difficult to heal from a biopsy so soon after treatment has ended, but can not base that on personal experience, as my biopsy was done 2 years post-treatment, but still has taken awhile to heal. You may want to register on the National Comprehensive Cancer Network website and print out the NCCN guidelines for treatment of anal cancer. They advise considering biopsy if the patient had an initially tethered tumor and returns 6 weeks post treatment with a mobile but suspicious mass. I think in your case it would be a little soon to know whether or not you have residual tumor, as it may still be dissolving. I would recommend taking those guidelines to your doctor and having a frank discussion before making any decision. I don't believe the guidelines recommend routine biopsies, however, they also don't mention not doing them. I wish you the very best with all of this.
  • duckyann
    duckyann Member Posts: 159
    #4
    mp327 said:

    Hi Natasha
    A routine biopsy at 7 weeks post-treatment seems a little soon to me, as well as the PET scan, due to the fact that the radiation may still be working at that point in time. The only post-treatment biopsy I have had took place 2 years after completing treatment and was done only because I had some anal warts removed, which were sent for pathology. Otherwise, my colorectal doctor, rad onc and med onc are all in agreement that no biopsies should be done unless something suspicious shows up, due to healing issues. However, I did have my first post-treatment PET scan at 6 weeks after treatment, ordered by my med onc, but against the wishes of my rad onc. My rad onc was concerned that since the radiation was most likely still working, the PET scan would show some activity at the tumor site, which it did (which freaked me out a little). He wanted to wait 3 months post-treatment. However, my med onc was doing the PET scan primarily to rule out mets to liver or lungs. Fortunately, the scan following that one showed no activity, so the hot spots were due to radiation. As for the healing issues, I would think that it would be slow and difficult to heal from a biopsy so soon after treatment has ended, but can not base that on personal experience, as my biopsy was done 2 years post-treatment, but still has taken awhile to heal. You may want to register on the National Comprehensive Cancer Network website and print out the NCCN guidelines for treatment of anal cancer. They advise considering biopsy if the patient had an initially tethered tumor and returns 6 weeks post treatment with a mobile but suspicious mass. I think in your case it would be a little soon to know whether or not you have residual tumor, as it may still be dissolving. I would recommend taking those guidelines to your doctor and having a frank discussion before making any decision. I don't believe the guidelines recommend routine biopsies, however, they also don't mention not doing them. I wish you the very best with all of this.

    Hi Natasha,
    I had a biopsy
    Hi Natasha,

    I had a biopsy done at 6 1/2 weeks after treatment because my doctor does them routinely after treatment. I did not have great difficulty but everyone is different. It did take a little while to heal but I was only on pain meds for about 5 days and then I was ok. I also had another one done 6 months and now again after 16 months. I trust my doctor and so I did not refuse it. It is all in how you feel with your medical team. I wish you luck in whatever decision you make. Keep us updated.

    Nancy
  • Naty52
    Naty52 Member Posts: 9
    #5
    z said:

    Natasha
    Hi Natasha,

    I had a biopsy and hemrodyctomy at 2 months post tx, and I have healed fine. I know others who post have not wanted biopsies for the very reason you have mentioned. I also had a biopsy for a suspicous small nodule at 9 months post tx, and I am fine from that biopsy also. I trust my correctol dr and his knowledge of the anatomy, so that was not an issue for me. I wish you well Lori.

    Biopsy after treatment
    Hi Lori,

    It's good to hear that your biopsies went well and you are feeling fine. I just feel it is a little too soon for me since the anal area is still healing and the new skin is sensitive. I'll double check with my doctor about the timing. Thanks, Natasha
  • Naty52
    Naty52 Member Posts: 9
    #6
    mp327 said:

    Hi Natasha
    A routine biopsy at 7 weeks post-treatment seems a little soon to me, as well as the PET scan, due to the fact that the radiation may still be working at that point in time. The only post-treatment biopsy I have had took place 2 years after completing treatment and was done only because I had some anal warts removed, which were sent for pathology. Otherwise, my colorectal doctor, rad onc and med onc are all in agreement that no biopsies should be done unless something suspicious shows up, due to healing issues. However, I did have my first post-treatment PET scan at 6 weeks after treatment, ordered by my med onc, but against the wishes of my rad onc. My rad onc was concerned that since the radiation was most likely still working, the PET scan would show some activity at the tumor site, which it did (which freaked me out a little). He wanted to wait 3 months post-treatment. However, my med onc was doing the PET scan primarily to rule out mets to liver or lungs. Fortunately, the scan following that one showed no activity, so the hot spots were due to radiation. As for the healing issues, I would think that it would be slow and difficult to heal from a biopsy so soon after treatment has ended, but can not base that on personal experience, as my biopsy was done 2 years post-treatment, but still has taken awhile to heal. You may want to register on the National Comprehensive Cancer Network website and print out the NCCN guidelines for treatment of anal cancer. They advise considering biopsy if the patient had an initially tethered tumor and returns 6 weeks post treatment with a mobile but suspicious mass. I think in your case it would be a little soon to know whether or not you have residual tumor, as it may still be dissolving. I would recommend taking those guidelines to your doctor and having a frank discussion before making any decision. I don't believe the guidelines recommend routine biopsies, however, they also don't mention not doing them. I wish you the very best with all of this.

    Thanks Martha for your
    Thanks Martha for your detailed reply. The original PET scan showed two enlarged lymph nodes so it will be god to know that these have shrunk and cancer has not spread t other areas. I will look up the NCCN guidelines and discuss with my med onc as you suggest. Thanks for the advice.
    Natasha
  • Naty52
    Naty52 Member Posts: 9
    #7
    duckyann said:

    Hi Natasha,
    I had a biopsy
    Hi Natasha,

    I had a biopsy done at 6 1/2 weeks after treatment because my doctor does them routinely after treatment. I did not have great difficulty but everyone is different. It did take a little while to heal but I was only on pain meds for about 5 days and then I was ok. I also had another one done 6 months and now again after 16 months. I trust my doctor and so I did not refuse it. It is all in how you feel with your medical team. I wish you luck in whatever decision you make. Keep us updated.

    Nancy

    Nancy, thanks for sharing.
    Nancy, thanks for sharing. It must have been painful if you were on pain meds for 5 days. That's what I'm afraid of and also doing damage to the muscle. I don't entirely trust my med onc since he didn't believe the 5-FU had caused the heart side effects despite all the evidence and the collorectal surgeon I only met twice -- for initial biopsy and the results. I think I need to talk to her first before deciding on the biopsy.

    Natasha
  • ranelle65
    ranelle65 Member Posts: 63
    #8
    3 months post treatment
    Naty,

    I am 3 months post treatment now and the surgeon that removed my hemorrhoid wants to do a rectal biopsy. I am looking forward to the procedure; he is going to put me in lala land before he begins. I hope all the tissues are good inside. I just hope we can figure out what's causing my urethral discharge. Not one of my doctors knows why I'm having it.
  • z810840b
    z810840b Member Posts: 207 Member
    #9
    i had something called a
    i had something called a 'punch" boipsey about 3 months post treatment.There was scar tissue left from the tumor and the drs. have to make sure its clear through and through.wasnt bad..was put out anyway.

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