THAT was a very interesting article - good find! There are a lot things to consider. Firstly, the time period of 2002-2009 tells me that all these biopsies were trans-rectal -NOT, in my opinion, the safest, most direct route to the gland. I am certain that much trauma is caused by this route and tissue tearing and disruption may indeed cause cancerous cells to come loose and possibly “seed” the area.
Also, it states that immediately after the biopsy PCa cells were observed in the bone marrow; but the authors do not say if they were there BEFORE the biopsy. It may seem that we are to assume that they did look for them, but the fact that it is not clearly stated makes me wonder….
I, like many men, was terrified of the biopsy for all of these unanswered questions and only after I found a urologist who performed trans-perineal biopsies did I consent to undergo one.
I was found to have extensive Gleason 4+3 with perineural invasion. Surgical pathology showed a tiny break in the capsule but margins were clear.
So if I did not have the biopsy 5 years ago I would probably be Stage 4 by now or dead. So many men on this board were found to be Stage 4 ALREADY at the time of their FIRST biopsy!! So what caused that??
I truly think it’s the same in medicine as it is in investing: What’s the risk/reward? IF biopsies COULD cause seeding of a low grade cancer, what’s the real harm; as opposed to finding a high grade cancer which can be treated before it spreads further? Sure, if it can seed a low grade one it can seed a high grade one as well - but that high grade one IS gonna seed itself no matter what and maybe with future treatment ( surgery, radiation, hormones, etc) you can prevent that Stage 4 scenario from ever happening. Does it suck? You betcha!
The authors state that it would be great in the future if PCa could be diagnosed solely with scans, blood tests and AI…YES, IT WOULD!! But unfortunately we are not there yet and you still have to roll those dice when your very life is at stake for deciding to do a biopsy or not.