Keywords

Biopsy

Tumor Seeding Cholangiocarcinoma Genetic Blueprint Risk/Reward Cancer Growth Immunotherapy

Tackling the Big Question: Will a Biopsy Seed the Cancer’s Growth?

Hey fellow warriors, it’s Steve here, and today I’m diving into a big question that’s been buzzing around in our cholangiocarcinoma community. You know, when you’re dealing with bile duct cancer, there’s one critical step that often comes up – getting a biopsy of the tumor. But I know many of us are worried – could this biopsy actually spread, or ‘seed,’ the cancer? It is also an often-used reason by oncologists.

So let’s chat about what we know so far.

The Nitty-Gritty: Biopsy and Cancer Seeding

A biopsy, as most of you know, usually involves using a needle to extract tissue that contains cells from the tumor. And the big worry is that this procedure could potentially activate the spread of cancer cells, which could then speed up the formation of new tumors and metastasis. That’s a really tough thought to grapple with, and it’s absolutely a concern that the medical community – and us patients – take seriously.

Recent research does point out that while the chance of cancer seeding due to biopsy is generally small, it’s not zero. One study I came across in the Annals of Gastroenterology (Katsinelos et al., 2014) suggests that tumor seeding could happen at a rate of around 2.2% to 2.7%. That’s a low number, but it’s still something to consider.

The Hard Truth: Not Everyone Can Have Surgery

Here’s something important we need to remember. Not many cholangiocarcinoma patients qualify for surgery. So if surgery isn’t an option to get a tissue sample for genomic profiling, then we really need to consider the biopsy procedure. And if your oncologist or surgeon isn’t keen on it, then you’ve got to take a hard look at seeking a second opinion. It’s your right as a patient facing such high stakes to have as much information on board as possible, our medical professionals are trained to understand this – that is a foundation pillar to being a patient-centric medical professional. An independent second opinion can give you the extra insight and comfort you need, empowering you to make genuine, unrushed decisions.

I can’t stress this enough – it’s critically important to engage oncologists and surgeons who don’t just know about cholangiocarcinoma, but also have current expertise and a track record in diagnosing and treating it. This distinction could literally be a matter of life and death. So this is what you have to do; Ask them point blank (nicely of course) ‘Do you have current expertise and experience with my exact cholangiocarcinoma diagnosis? If not, how will you introduce the expertise and experience required to treat it?‘

As patients, we definitely have the power to participate with greater parity in our diagnosis and treatment. But you have to ask or they will not provide the answers we are really asking, it’s about getting out of your own way and becoming more proactive and persistent than you are used to, there are many options and doctors are only human and can fall behind the knowledge curve or simply having a bad or busy day. It’s our health, our life. Only oncologists with the current expertise and experience truly understand the risk/reward profile of obtaining a biopsy within the cholangiocarcinoma setting -that s who you need on your team!

But What About the Silver Lining?

Despite the potential risk, there are some big positives to getting a biopsy. The real gold in the process is the valuable information a biopsy can provide about your cancer, which can steer the ship toward the most effective treatment.

The insights and information gained from a biopsy can provide a roadmap to the exact mutation that is driving the cancer’s growth, without it your oncologist can only utilize historic treatment approaches. When an oncologist is empowered with a genomic roadmap then they are able to guide the choice of chemotherapy, targeted therapies, or immunotherapies that are specifically tailored to target your tumor. We’re now living in the era of precision medicine and we as patients have more options than ever before. Understanding the genetic blueprint of your tumor is becoming super important for kicking this cancer to the curb.

Weighing It All Up

We’re all in different boats in the same rough sea, and I know from personal experience how important it is to weigh the pros and cons. I will declare that I have had many biopsies. Have a heart-to-heart with your oncologist, share your worries, and let them guide you based on your unique situation. And remember the importance of getting that second opinion.

In the meanwhile, why not visit the Cholangiocarcinoma Australia website? It’s a fantastic resource with heaps of information for patients and caregivers alike.

Remember, we’re in a race that’s getting faster every day. Researchers are working around the clock to hone biopsy techniques and reduce potential risks. There’s also talk of new imaging techniques, like contrast-enhanced ultrasound, and innovative methods like liquid biopsies, which could further shrink that risk of tumor seeding.

So, bottom line? Getting a biopsy of a cholangiocarcinoma tumor does carry a small risk, but the evidence points to the rewards outweighing the risk.

Simplifying and distilling medical information in a way that we as patients can understand and act on is the beginning of patient empowerment and ‘informed choice.’ Understanding creates confidence and leads to better decision-making and confidence. Please share your thoughts and questions about the article in the comments section below so I can continue to simplify it.

Steve
Ps if you would like a template of the questions that you should ask your oncologist or surgeon, then drop me an email and I will send you a copy.