Biopsy results after radiation

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jsbsf
Posts: 107
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
9/16 MSS. MRI: 2 lvr mets: 2.7 & 7mm
9/30 Start FOLFOX 1-6
10/4 Lg lvr met ~3.7cm, 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: significant improv.
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 EBRT
10/2/2020 NED/W&W
4/2022 EUS-FNA,MRI: recur.;
5/2022:CT scan no mets. APR.
7-12/2023 Xeloda
4/2023 CT/MRI NED

Rock_Robster
Posts: 1027
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.
41M Australia
2018 Dx RC
G2 EMVI LVI, 4 liver mets
pT3N1aM1a Stage IVa MSS NRAS G13R
CEA 14>2>32>16>19>30>140>70
11/18 FOLFOX
3/19 Liver resection
5/19 Pelvic IMRT
7/19 ULAR
8/19 Liver met
8/19 FOLFOX, FOLFOXIRI, FOLFIRI
12/19 Liver resection
NED 2 years
11/21 Liver met, PALN, lung nodules
3/22 PVE, lymphadenectomy, liver SBRT
10/22 PALN SBRT
11/22 Liver mets, peri nodule. Xeloda+Bev
4/23 XELIRI+Bev
9/23 ATRIUM trial
12/23 Modified FOLFIRI+Bev
3/24 VAXINIA (CF33 + hNIS) trial

jsbsf
Posts: 107
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
9/16 MSS. MRI: 2 lvr mets: 2.7 & 7mm
9/30 Start FOLFOX 1-6
10/4 Lg lvr met ~3.7cm, 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: significant improv.
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 EBRT
10/2/2020 NED/W&W
4/2022 EUS-FNA,MRI: recur.;
5/2022:CT scan no mets. APR.
7-12/2023 Xeloda
4/2023 CT/MRI NED


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