Biopsy results after radiation

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jsbsf
Posts: 92
Joined: Sat Aug 24, 2019 6:01 am
Location: San Francisco

Biopsy results after radiation

Postby jsbsf » Sun May 08, 2022 2:34 am

This evening I came across this article:

https://prostate-center.com/follow-up/biopsy-post-rt/

It’s about prostate cancer. I’m wondering if the same / similar rule might apply to rectal cancer.

Doing a biopsy after radiation is not accurate because of all the false positives and false negatives. So should a biopsy ever be done after radiation treatment? Occasionally. Basically when all of the following four conditions are met:

Two or three years or more have passed since radiation.


DH completed his radiation 7/29/2020, and recently had a biopsy which showed a small amount of cancer cells in one sample. Now he’s preparing for surgery that will result in a permanent colostomy. Is it possible that although these cells are cancer cells that their dna is damaged enough to make them relatively harmless?

We do plan to follow up with the doctor who administered the radiation treatment, but maybe someone here is familiar?
DH 61
2019 4A t3 n2 m1a
8/23 C-scopy, 5+cm mass. CEA:4.1
8/26 CT ~1cm lvr met?
9/6 PET: lvr spot
9/16 MSS. MRI: 2 live mets: 2.7 & 7mm
9/23 Port
9/30 Start FOLFOX 1-6
10/4 Lg lvr met ~3.7cm (raised concern), pri tmr stable.
CEA: 10/13,12.5;10/27-12/8 btw 4.7 & 3.1
11/5 both lvr mets ~ 2/3 smaller.
12/17 PET: sm lvr met gone, remaining tmrs @10% of orig sz & actvty
Chemo break
2020
MWA 2/5, Lap resection 2/11
CEA: 3/1-5/31 btw 2.1&2.9
3/2 start FOLFOX 7-12
7/23-29 rad
10/2/2020 NED/W&W

Rock_Robster
Posts: 676
Joined: Thu Oct 25, 2018 5:27 am
Location: Brisbane, Australia

Re: Biopsy results after radiation

Postby Rock_Robster » Sun May 08, 2022 9:04 pm

I think the short answer is “I don’t know”, but in a quick search I couldn’t find any of the same concerns raised for prostrate cancer as being applicable to rectal cancer. I am fairly sure I’ve seen patients have biopsies after radiation to assess complete clinical response for a W&W decision, so that might suggest they are still reasonably reliable? Perhaps checking the large W&W/Habr-Gama thread here might give you a clue too.
40M Australia
2018 Dx RC, 12cm high
Mod diff, EMVI, LVI. 4 liver mets
pT3N1aM1a Stage IVa. MSS NRAS G13R
CEA: Nov-18= 14; then ~2. Nov-21: 5.4
11/18 FOLFOX x6
3/19 Liver resection
5/19 25x pelvic IMRT radiation
7/19 ULAR & ileo, 1/27 LN
8/19 Liver lesion
8/19 FOLFOX, FOLFOXIRI, FOLFIRI x7
12/19 Liver resection
NED
2/20 Ileo reversed
11/21 Liver met & celiac node; 2-3 tiny lung things, indeterminate
12/21 PVE
3/22 Nodal spread & 3 liver lesions. Lymphadenectomy
4/22 Liver SBRT x 5

jsbsf
Posts: 92
Joined: Sat Aug 24, 2019 6:01 am
Location: San Francisco

Re: Biopsy results after radiation

Postby jsbsf » Mon May 16, 2022 2:59 pm

The oncologist found the article interesting, however assured us that prostate cancer is a different beast than rectal cancer, and unfortunately didn’t feel this was our case.
DH 61
2019 4A t3 n2 m1a
8/23 C-scopy, 5+cm mass. CEA:4.1
8/26 CT ~1cm lvr met?
9/6 PET: lvr spot
9/16 MSS. MRI: 2 live mets: 2.7 & 7mm
9/23 Port
9/30 Start FOLFOX 1-6
10/4 Lg lvr met ~3.7cm (raised concern), pri tmr stable.
CEA: 10/13,12.5;10/27-12/8 btw 4.7 & 3.1
11/5 both lvr mets ~ 2/3 smaller.
12/17 PET: sm lvr met gone, remaining tmrs @10% of orig sz & actvty
Chemo break
2020
MWA 2/5, Lap resection 2/11
CEA: 3/1-5/31 btw 2.1&2.9
3/2 start FOLFOX 7-12
7/23-29 rad
10/2/2020 NED/W&W


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