My urologist has suggested using ADT (Orgovyx) 1 months before and 1 month after biopsy to reduce the very very small chance that some tumor cells may escape the biopsy.
Has anyone heard of this??? I've always heard that prostate biopsies have 0% chance of spreading cancer.
But my doctor says that new technology is now allowing us to see circulating tumor cells released right after biopsy. 99.9% percent of them die right away in the bloodstream. But why take any unnecessary risk if if can be mediated easily with 2 months of ADT?
Any inputs from you experts would be much appreciated.
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Rmpc
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The risk increases with grade.It's a good reason to not have a biopsy if metastases are detected with imaging first. Intra-prostate cancer cells must undergo a phenotype transition called EMT before they can survive outside the prostate. It doesn't matter if they are seen as CTCs if they are not mesenchymal too.
" Is it that insurance won't pay until there is definitive proof of cancer?" I have found that to be the case. No matter how much I argue that once distant metastases have been detected, there is no need for a biopsy, insurance bureaucrats still insist on checking the boxes.
" is ADT the very best way to minimize biopsy risk? Is 2 months enough?" I think that for high risk patients -- PSA>20 or Tstage>2 -- PSMA PET should be done before biopsy, and biopsy should be precluded by detection of distant metastases. Because met to met spreading always occurs anyway, the risk of biopsy spread is superfluous. But, any ADT is enough to prevent it.
Rmpc, your question hits close to home. I took ADT and I am glad I did, but before I started treatment I was not told what ADT would do to my sexual function. If I had know I would have still done the ADT training in my case, but would have acted sooner on other treatments. In your case, if I were you, I would think very carefully before I used ADT at your stage of treatment. Understand what it will do and weigh that against the benefits that you think you will achieve.
Sadly, your BIO is blank; I cant say much more as I dont know your details. But, look at this link. I have others in my POST section on ADT. ADT is a great treatment for PCa...it can save and prolong lives. But it has its price for doing this. Make sure you want to pay this cost.
Here are general side effects of ADT, in case they are not reviewed with you. They were not with me and I was on ADT for 21 months. I dont know of any 2 month ADT treatments, so you may be on a 6 month treatment, lasting 7-8 months total, which has additional impacts.
Here is the best mapping of the PCa racetrack we are asked to run. Take a look to see what your options are. If you think you need a treatment and you get gaslighting or stonewalling, see other doctors. Get what you think you need.
Finally, here is my 'Woulda-Coulds-Shoulda' laundry list of what happened to me. I post this only in hopes that there may be one thing on it that can help you. This group exists for many purposes, one of which is to broadcast our individual stories in hopes it helps someone else avoid a pitfall that may have occurred to us. You will have your own and you cant avoid them, but know what can happen to see them coming and try to swerve out out of the way. Good luck. Rick
Sadly, your BIO is blank; I agree.....please update your bio cause it will help you and help us too. All your info is voluntary. Thank you and keep posting!!!
With the recent study that shows aspirin will prevent or reduce metastases in certain cancers, you may want to review the existing data to decide if it would work in your situation. The reports shows in mice that aspirin, since it destroys the mechanism for clotting of blood, which makes it a blood thinner, will do the same in freshly released tumor cancer cells. Since a clotting mechanism is required for the metastatic cells to regrow a tumor, the aspirin will prevent the cells from doing so.
I just did an AI search on aspirin and received the following explanation as to how it works:
does aspirin prevent clotting in cancer tumors?
"Aspirin has shown potential in preventing the spread of certain cancers by reducing clotting factors that suppress the immune system. Specifically, it lowers levels of thromboxane A2 (TXA2), a clotting factor that can weaken T cells, which are crucial for attacking cancer cells. By reducing TXA2, aspirin helps T cells remain active and effective in targeting cancer cells, potentially preventing metastasis.
However, aspirin is not without risks, such as gastrointestinal bleeding, so it’s essential to consult a doctor before considering it for cancer prevention."
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