Should you have a biopsy?
This article discusses biopsies. There are potential problems with biopsies which you should be aware of. Am I saying "never get a biopsy"? No. But you want to be INFORMED, you want to be AWARE of what the possible consequences of having a biopsy might be.
else knows about your lump, they will surely tell you, "You'd better
get that checked! You should have a biopsy!" Very few people would
ever worry about the dangers of having a biopsy. Most people would worry
about the cost, or the pain of a biopsy, but few people realize that a
biopsy itself, can be dangerous to your health.
Do biopsies pose a risk of spreading the cancer?
Some experts believe that if there IS cancer in that lump, the biopsy is likely to cause it to start spreading.
In a biopsy, a piece of your flesh, or of some organ in your body, is cut out so that it may be examined under a microscope. The medical staff then looks at the cells in the sample and determines how many of those cells are in the process of cell division. If the sample shows that 15% of those cells are in the process of cell division, and that type of cell is not supposed to show more than 1% of them going through cell division at any given time, then that cell sample shows abnormal growth - cancer.
Although cancer is considered to be rapid and abnormal growth of cells, the entire mass of a cancer normally grows rather slowly because it is encased. The cancer grows inside a wall, or a shell. Therefore the body tries to protect itself by building a wall around the cancer to keep any of the cancer cells from leaking out, because cancer would otherwise spread throughout the body. In truth, some cancers are very slow-growing, such as prostate and breast cancer, while others are very fast, such as liver cancer.
When the cancer does leak out, doctors use a special word to describe this situation: the cancer is said to "metastasize", it is spreading to other parts of the body.
Doctors will tell you that the biopsy is not expensive, that it is painless and that it can be done during an office visit. They will tell you that the biopsy is covered by insurance.
Doctors will tell you that if the lump is cancerous, it is critical that you know about it in order for you to start treating the cancer as early as possible.
If there is cancer there, of course, the doctor will then tell you that you should move very quickly to start treatment. You may not realize this, but there are only 3 legal treatments for cancer in most of the United States. The laws of California, for example, make it a serious case of "unprofessional conduct" for a doctor to diagnose cancer and then treat it with anything other than the approved methods - chemotherapy, radiation or surgery. He can lose his license to practice medicine. He could even go to jail.
So, you discovered a lump on your body. You go to your doctor to have it looked at. No doctor would ever recommend AGAINST a biopsy - the doctor must be safe or he can lose his medical license and perhaps millions of dollars in a malpractice lawsuit. So, he tells you, "You need a biopsy, immediately. They are safe and painless. They are covered by your insurance. I can do this right now".
The biopsy itself can start the spread of the cancer from the inside of the casing which the cancer was in. Remember, the body protects itself from having the cancer spread - it builds a wall around the cancer.
Once you penetrate that wall, even with a very tiny needle, the cancer cells can leak out through the hole and circulate in the body. These cancer cells can then enter the bloodstream and be distributed throughout the entire body within a few seconds.
It is possible that your immune system will be strong enough to handle these stray cancer cells. It is possible that they just won't find a good place to live. But, perhaps you have just allowed the doctor to metastasize your cancer.
What had been, possibly, a slow-growing cancer with no metastasis, has in one split-second become a cancer which might now be spreading throughout your body - requiring immediate, urgent treatment. Before the biopsy it was a suspicious mass and you had time to learn about the many alternatives to chemotherapy, radiation and surgery. Now you no longer have time to learn.
I believe the minimum a doctor should do before he/she does a biopsy, is to lay out the treatment options in great detail IF cancer is indeed found in that biopsy. You should not expect a doctor to discuss alternative treatments because it would be illegal for him/her to use those, but at a minimum your doctor should give you the details of the surgery, the chemotherapy and/or the radiation he/she would use in the event the biopsy does show cancer.
What if you happen to believe in the power of some herb, or some diet, or some cleansing program, or some other "alternative treatment". If you are foolish enough to tell your mainstream doctor about these things, he will often get angry with you and tell you that you will die, and that you MUST get the biopsy, today, and sign consent forms or he will never have anything to do with you as a patient again.
According to the Merck Manual (1998 edition), for every case of breast cancer diagnosed each year, between 5 and 10 women will needlessly undergo a breast biopsy.
Why so many biopsies?
There are superior alternatives, such as advanced thermography, which does not use mechanical pressure which can spread cells that are already malignant, or ionizing radiation as mammograms do, and this advanced thermography can detect signs of breast cancer years earlier than either mammography or a physical exam.
A prostate biopsy costs about $1,200.
Many men with suspected prostate cancer could avoid having a biopsy, a study (1) shows, if doctors instead relied on the results of a prostate-specific antigen (PSA) blood test. According to the study (1), more than 50% of men in the study group who had negative biopsies could have avoided biopsies in the first place if doctors had relied on the results of a prostate-specific antigen (PSA) blood test.
Prostate biopsies are usually recommended for older men who have abnormally high PSA levels, a possible indicator of prostate cancer. Prostate biopsy requires surgery or the insertion of a needle into the prostate gland, typically through the rectum.
(1) The Prostate November 1,1998;37:133-139
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