Men: Do you NEED that prostate biopsy?

For my entire career, I’ve faced the same critical question…

Will getting a biopsy cause cancer to spread?

Perhaps it’s something you or a loved one have wondered, too.

Of course, I tend to operate intuitively, which isn’t the usual approach for most conventional docs.

And since a lot of factors contribute, I’d like to narrow the focus of today’s conversation…

Let’s talk about biopsies after a prostate cancer-specific antigen (PSA) screening.

Do you really need one?

No real difference in mortality

The Cluster Randomized Trial of PSA Testing for Prostate Cancer included over 410,000 men between the ages of 50 and 69 years.

Around 190,000 participants underwent a one-time PSA screening, whereas a control group of 220,000 did not.

And after 10 years of follow-up, researchers did not observe any significant reduction in prostate specific-mortality among the two groups.

That said, a secondary analysis, which was conducted 15 years after study outset, revealed a statistically significant reduction of 0.09 percent in favor of PSA screening.

(That’s an incredibly small difference, no?)

Let’s dive a little deeper and marvel at the conclusions…

A fair question

It turns out, prostate cancer was diagnosed earlier in the PSA screening group.

At first glance, you’d think this earlier detection would lead to a much larger reduction in mortality. But it didn’t.

So what’s going on here?

Could the dissemination of cancer cells caused by prostate biopsies explain this discrepancy?

Two physicians cited in the study are thinking similarly. It seems they wondered, did biopsies performed in response to elevated PSA levels promote the spread of cancer cells?

(Hallelujah! Someone is saying it other than me.)

Look, when you stick a needle into anything, you’re bound to cause some level of damage. And when you stick it into a tumor? It activates specific cells that can promote tumor growth and potentially encourage the spread of cancer cells.

That said, I’m all out of space for today—and I still have a lot of thoughts to share.

So, let’s continue this conversation tomorrow. Be sure to tune back in!

Source:

“Do Prostate Biopsies Promote the Spread of Cancer Cells?” Medscape-UK, 10/25/2024. (medscape.co.uk/viewarticle/do-prostate-biopsies-promote-spread-cancer-cells-2024a1000jj8)