Can cancer spread from EUS-FNA (Fine Needle Aspiration)?

Dr. Truty is wonderful. I met him with my sister last July. He is straight and to the point, and will not lead you in the wrong direction (in my opinion). He is not a warm and fuzzy guy upon first meeting --- but he does show compassion, and his skill as a surgeon is well known at Mayo. My cousin's husband is a surgeon (in another field) there so we had the good fortune of being able to stay with them while my sister was being evaluated.
Mayo is a tightly run ship, with all the physicians feeling as if they are one big interconnected family.
My sister is currently being treated at Memorial Sloan-Kettering in NY where she lives. Her treatment has been effective so far, but but I have found The Mayo in Rochester to be the epitome of excellence.
I wish you good luck in the future!

@sofee22 I was diagnosed similar to @spicerpa. This was 11-2021. Attitude and your current health are everything! I have done folfurinox, had y90, then pancreadectomy. Later had liver resection, some time NED, then GEMZaR, and another liver resection 10/2023.
We think I am stable for now. I will finish Gemzar this month and take a month off.
Other than a few days a month I have not let it disturb my work, ambitions or adventures. I do strongly believe that the attitude your doctors see and your overall health make a big difference in treatment. Scanxiety is a thing. But the sooner you know what’s going on the sooner it can be dealt with. Much research is underway and treatment has come very far in 10 years! Take the time now to connect for second opinions. I am a Stage IV thriver for 26 months now. There are many others out there!

The following link addresses the question about the remote possibility of seeding of cancer cells as a result of a biopsy. Some things to consider….the benefits outweigh the risks. If the neoplasm being biopsied is benign, there is no risk. If it is found to be malignant, then chemo will be required. And chemo is more effective and faster on treating small amounts of cells than when clustered as dense, solid tumors. So any “seeding” cells will be treated regardless. Not doing a biopsy results in the unknown status of the neoplasm.

Questions to consider are: do you want to undergo chemotherapy that can have side effects and adverse events when it is not necessary but is not known because a biopsy is not done? The other scenarios in not doing a biopsy is then taking a wait and see attitude. Most pancreatic cancers are aggressive and fast growing. Treatment is more effective when the malignancy is addressed earlier than later.
https://www.cancer.net/blog/2021-03/can-biopsy-make-my-cancer-spread

I think because the cysts are under 2cm and are Branch Duct type that they assume benign until things change during surveillance. If it grows then I believe it becomes time for the FNA. I did do the CA19-9 and that was super low as a baseline. Next, I agree to do the genetic testing. I’ll ask my GI at my appt next week.
I’ll agree the quick study online, searching current articles and connecting with resources is a full time job! Pancan website was a good phone connection to make.

Thank you for this. I’ve also read size does not necessarily mean anything, very concerning. I’ll speak with my doctors on this and ask why no biopsy on the 1.2cm cyst. Ty.

You are an inspiration to me and I have you in my prayers. 🙏 it is so wonderful to share our stories and learn from each other. I’ll seek out two opinions as you suggest.

I have 2 IPMN’s both around 1 cm. One is in the body and the other in the tail. On MRI imaging, there is no discerning features nor are they in the main duct to warrant a FNA. There is always a slight risk of causing pancreatitis when doing a procedure in the pancreas. So with nothing or concern in my case the moment, multiple opinions are to do surveillance on a 6 month basis and no biopsy necessary.

Thank you for this insight. I’ll have to decide to travel there for care. I did take my dad there for prostrate cancer and was extremely impressed with Mayo so I’m familiar. If I have a future surgery we would have to find a place to stay but it’s doable. Thank you!

Ah, so you and I are in the same situation. Do you know what’s best for the 6month follow-up? It will be my first. Is it a EUS or MRI and with contrast?

StageIV survivor,
Thank u for your most informative response. After 4.5 of completing my chemo treatment I received a recurrence i my liver. The recurrence started early November (from 6 to a 23 for my CA19-9)) and as of this week my CA19-9 is 3,840. I had a very difficult time to get any treatment or 2nd opinions outside of my HMO network and had to wait until January 1 of this year. My first 2nd opinion was with Cedars Sinai - "Center of Excellence". I found the oncologist to be extremely jaded. He knew my oncologist from Hoag. When I told him how many 5FU treatments you had and you were a survivor he almost literally called me a liar and said no dr. would ever approve that many treatments. He discouraged me from going to Mayo Clinic saying he wouldn't and from going to HD Anderson even though they specialize in doing surgeries for cancer around the hepatic artery. He told me my dr at Hoag was on the right course. My last endoscopy (about 2-3 weeks ago) showed lesions under 1 cm on my liver. With my CA19-9 being at over 3800, I'm thinking this beast as spread beyond my liver. Long background before my question: Have you read that "chemo is more effective and faster on treating small amounts of cells then a clustered tumor"? Is this something your dr. told you? I started the gemabraxinecine chemo this week to be followed by viewtherapy radiation. I do have another 2nd opinion from UCLA this Monday, but I decided to start the chemo with my current oncologist at Hoag in the meantime in order to avoid further spread (if possible).