A biopsy involves taking a small piece of tissue from anywhere in the body to check for disease. Some doctors use a needle to grab a tiny sample, while others might surgically take out a suspicious lump or nodule. It is the pathologist’s responsibility to ascertain the presence of cancer cells and, if found, to identify the specific type, subtype, grade, and other relevant characteristics, thereby providing a conclusive diagnosis. Following this, the cancer care team formulates a treatment plan informed by the biopsy results.
However, did you know….
Biopsies Can Cause Cancer to Spread
There are two main ways to get tissue samples from a tumor or lesion for microscopic analysis and diagnosis. The first method is a biopsy, where living tissue is surgically removed. The second method is fine-needle aspiration cytology (FNAC), which involves using a thin needle to extract cells from the tumor. Both of these procedures come with a risk of spreading tumor cells, either into the surrounding tissue fluid that can reach lymph nodes or into the veins that drain the tissue, allowing the cells to travel and potentially settle in other organs or tissues.
An improperly done biopsy can lead to the spread of certain cancers, like sarcomas. These tumors have delicate outer layers that keep the cancer cells contained. If that layer gets damaged during a biopsy or surgery, it can cause the cancer cells to leak out, which might let them spread or come back. This topic can be a bit debated, and most oncologists would likely argue that the risk of spreading or “seeding” the cancer is minimal.
To put it another way, think of it like having a sealed bag of sewage. If you accidentally poke a hole in it and then try to seal it back up, you probably wouldn’t feel safe eating anything that came into contact with it, even if you were super careful.
A 2014 review by Shyamala Karnam, an associate professor in dentistry, highlighted that tumors are pretty unstable and tend to grow in an abnormal way, spreading into surrounding tissues. Because of this instability, they don’t stay put like healthy cells do. When you poke or apply pressure to tumors with needles or other tools, it can make them even more unstable. This can lead to some cancer cells breaking away from the main tumor and moving to other areas. Prof. Karnam and her team noted that tumor cells are more likely to come loose because they have weaker connections to each other. They backed this up with several case studies showing that after a biopsy, many patients ended up with cancer in multiple locations and had circulating cancer cells found in their blood during tests. (source)
This review is about cancers in general. It’s worth noting that when biopsies are done, they can sometimes cause cancer cells to break away from tumors. This has been seen in various types of cancers, like breast, liver, stomach, mouth, parotid, lung, brain, kidney, eye, bone, prostate, and likely many others. Interestingly, even the first American textbook on cancer treatments from 1940 pointed out the potential dangers of biopsies, stating, “there is some doubt as to the harmlessness of needling such tumors. It may not be a wholly innocuous procedure.” However, it seems that the significance of this risk has been downplayed in later editions of textbooks.
Dr. Thomas Seyfried is an American biology, genetics, and biochemistry professor over at Boston College. He’s got some pretty serious thoughts about biopsies. He did his postdoc in the Neurology Department at Yale University School of Medicine, where he also worked as an assistant professor.
Dr. Seyfried is convinced that cancer is more about metabolism than genetics. He explains, “In metabolic therapy, you wouldn’t mess with the tumor; you’d leave the surrounding area alone. By doing that, you let the tumor shrink (with treatment) and eventually disappear. If you interfere, you risk making those slightly aggressive cells turn into super aggressive ones, which can lead to the patient’s downfall,” as Seyfried puts it.
Dr. Seyfried explains that the issue arises when you puncture the cancer micro-environment to take out some tissue. This action creates a wound that attracts macrophages and other immune cells, which can escalate a harmless situation into a dangerous one. If the tumor is already malignant, this kind of intervention could worsen the problem.
He reached this conclusion after reviewing numerous studies on brain, breast, colon, and liver cancers, which demonstrated how needle biopsies have resulted in the spread of tumor cells, increasing the risk of metastatic cancer and even death for those patients.
The bottom line:
One way to support your immune system, especially around the time of biopsies, is to keep it in great condition. Your immune system plays a crucial role in fighting off anything it sees as a threat, like germs and cancer cells. That’s why these harmful agents often find ways to dodge or weaken the immune response to survive. (source)
Make sure to discuss with your doctor about whether a biopsy is truly necessary, and do some research online. It might be a tough choice, but at least you’ll be making a well-informed one!
References:
https://pmc.ncbi.nlm.nih.gov/articles/PMC3473763/
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