Prostate cancer biopsy

Hi Oliver J,

Thank you for getting in touch with Macmillan Support Line.  My name is Kelly, and I am one of the Cancer Information Nurse Specialists.

The fear of cancer recurrence or a new cancer is very real and can cause a lot of uncertainty and doubt. It is not unusual to reflect over your previous experiences at times like this.

It sounds like you have always had worries about your previous needle biopsy due to your extensive research that this could potentially cause a re-seeding of cancer. We can understand that this is now at the forefront of your concerns due to the lesion that was found during your recent MRI scan.

It is important to consider that the new lesion may not necessarily be an area of cancer but could be a non-cancerous change. Also, needle tracking or seeding may not always be the cause of a cancer coming back. It is possible that microscopic (non-detectable) cancer cells remained after the initial treatment and could become more active again.

As you mention there appear to be differences in the information about the incidence of needle tracking causing a re-seeding of the cancer.

There can be variances between medical research studies in the analysis of prostate biopsies, which in turn can sometimes produce differences in results or outcomes. Studies looking at this have indicated that larger standardized clinical trials with longer follow-up periods need to be established to review the incidence of needle tracking in more detail.

Presently the best and most effective way confirm prostate cancer is still through some form of needle biopsy. Examples of this are transrectal ultrasound (TRUS) guided biopsy and trans perineal biopsy.

This is also the recommendation of the national guidelines for diagnosing and treating prostate cancer in the UK.

The benefits of having a prostate biopsy may sometimes outweigh any potential risks. For example, being able to accurately establish a Gleason score, alongside other tests such as MRI, can help doctors understand the stage and grade of the cancer. This helps them to plan the best treatment or surveillance approach.

The timing of MRI scans can vary. Some people may be recommended this as a first line test if initial indications are that someone may have an early-stage prostate cancer. PSA levels and any symptoms would also be considered.

Unfortunately, we’re aware that you may always have doubts about the biopsy and MRI scan, which even we (as experienced nurses) and your consultant may not be able to completely resolve for you.

We would always encourage you to get back in touch with your consultant before your appointment, with your ongoing questions and concerns. As they are directly involved with your care, they are best placed to offer further support with these.

To make sure that you feel comfortable with any decisions made about having tests or treatment, you can also ask for a second opinion referral.  This would need to be with another doctor.

Our prostate cancer forum on our online community could offer further emotional support at this time. Being able to share experiences with others in similar situations can be invaluable.

Our help with how you’re feeling information also offers further guidance about other types of emotional support to explore in your own time.

I hope that this information is helpful. If you have any further questions, please feel welcome to get back in touch with us by email, webchat or phone. We offer practical, clinical, financial and emotional support. You can call us free from landlines and from most mobile phone networks* on 0808 808 00 00, 7 days a week, from 8am to 8pm. It is often easier to discuss things by phone when we can get a clearer picture of your situation. 

With best wishes

Kelly

Ref: KA/DC