General Question

Aster's avatar

Which is more dangerous: a biopsy of or the removal of an organ?

Asked by Aster (18806points) October 23rd, 2010

If an organ has cancer cells inside of it, is it more dangerous to remove the entire organ , thus compromising the bodily processes, or to risk spreading of cancer cells throughout the lymph system by doing a biopsy?

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14 Answers

Flavio's avatar

Depends on the organ, the stage of the cancer, the type of cancer, and the overall health of the person. In most cases, this is pretty well studied so it’s generally worthwhile to follow the recommendation of your oncologist.

Aster's avatar

@Flavio I do not have an oncologist or cancer. I’m just interested in medicine. thanks.

LuckyGuy's avatar

The answer is “It depends”. Here is an excerpt for you. It is definitely worth reading this writeup .
Depending upon the type and location a biopsy might be needed as justification for the surgery.
“In a study reported in The American Journal of Surgical Pathology, the clinical features of 42 LEIOMYOSARCOMAS were analyzed. ” In a univariate analysis age >62 years, size >4 cm, extensive necrosis, modified updated French Federation of Cancer Centers (FFCC) grade, and whether the tumor had been “disrupted” by a previous incisional biopsy or incomplete excision were significantly correlated with metastasis…. Disruption was the only significant risk factor for metastasis in a multivariate analysis (relative risk 2.70; p = 0.0001) but was strongly correlated with large size and deep location .”

The study concluded, “The risk of metastasis can be calculated from a model incorporating age, FFCC grade, and disruption. Because disruption correlates with size and depth, it could represent a surrogate as opposed to causal marker for metastasis. Nevertheless, in view of their vascular origin, the possibility that tumor disruption may facilitate or promote access to the bloodstream merits further study.”

Aster's avatar

I see from your post that it “merits further study” but it certainly does not dismiss biopsy as a cause of metastasis. I have believed for years that biopsies were risky but I didn’t hear it from any sort of doctor. What’s worse is that “inconclusive resulst” can be obtained after biopsy which puts the patient under stress but doesn’t show anything useful. thanx WG

truecomedian's avatar

I’m going to say risk the spreading of cells and leave the organ alone.

Seaofclouds's avatar

I believe both actually have the risk of spreading the cells. If the organ needs to be removed, then it needs to be removed, but if they aren’t certain about the cancer, I believe it’s best to do a biopsy before removing an organ and then later finding out it was unnecessary. Some organs can be removed with less of an effect on the body than others, so it really depends on the situation and the organ involved.

Aster's avatar

^^^^^^^^^^ What should a person do who has gotten an inconslusive biopsy and an inconclusive sonogram but a doctor “believes” the organ is cancerous simply because it feels like cancer to him such as a swelling in the neck?

Seaofclouds's avatar

Ask for a second opinion with a different doctor or try other test if any are possible. I wouldn’t be removing any major organ without knowing that it was absolutely necessary. If it was a breast, I’d have it removed, but if it was a major organ (like kindey, lung, liver, etc), I’d want to know for sure what was going on before I had it removed.

Aster's avatar

I agree. But the second doctor would go over the inconclusive results from the first doctor and would his guess, therefore, also be either “I think it’s cancer” or, “I just do not know so let me do another round of testing?
Or do doctors ever say they don’t know something?

Seaofclouds's avatar

I’ve heard doctors say they don’t know. I’d go for more testing if it was inconclusive.

Aster's avatar

Other than an ultrasound and a biopsy what tests remain? thank you, SOC.

Seaofclouds's avatar

It depends on the cancer. There are other types of radiology exams and nuclear medicine scans that can be done as well depending on the cancer. Also, if necessary they could do another biopsy (perhaps they just didn’t get a good sample the first time).

Aster's avatar

ok; but if there are other scans available and they were not offered to the patient why would you think they weren’t offered? GA

Seaofclouds's avatar

It really depends on the doctor’s preference and the patient’s condition. Once you have suspected cancer, a biopsy is really the only way to know for sure. Pictures will give you an idea that something is there that shouldn’t be and where it is, but only a biopsy will confirm it. So, once cancer is suspected and you have a set location, the biopsy is the next logical step.

With the biopsy being inconclusive, I think it warrants further scans to get a better idea of the size and location of the possible cancer cells. The area would need to be monitored for changes.

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