“MythBusters MD: Demystifying Cancer with Dr. Bharat Bhosale – Unveiling the Truths Behind Biopsy Insights

Vivek Sharma: My name is Vivek Sharma, and you are watching me on My YouTube channel Uhapo, the cancer-related Informatics platform. Here I advocate on the physical and mental health aspects of cancer. Our guest for today is Dr. Bharat Bhosale, who is a medical oncologist and a well-known figure in Mumbai. 

Today, we are going to discuss a specific myth related to cancer with Dr. Bhosale. Sir, a very warm welcome to you. So, when we talk about cancer, there are many misconceptions and myths. One thing I’ve observed is that when someone in a family has cancer, everyone suddenly becomes an advisor. People often share the idea that getting a biopsy can cause cancer to spread. How accurate is this information?

Dr. Bharat Bhosale: So, let’s discuss lung cancer or any other cancer. Many myths are going around about cancer. And as you mentioned it’s good that many people come to offer support. In such a situation, having a positive mindset is crucial. When we don’t know much about something, it’s not right to give information, especially about cancer. It’s important to clarify that cancer doesn’t spread from a biopsy. The most important step in treating lung cancer or any cancer is to get a biopsy. In the case of lung cancer, a biopsy is particularly crucial because it has become quite common. Sometimes, people come for a biopsy after getting a PET scan. Let me explain with an example: if someone comes to you after a PET scan and something is seen in the lungs or elsewhere in the body, you can’t directly say it’s lung cancer. It could also be tuberculosis.

So, why is a biopsy crucial in lung cancer? It’s because it confirms if someone has cancer in the lungs. Therefore, if someone wants to say it’s lung cancer without doing a biopsy, counseling should not begin. A cancer diagnosis brings significant changes to life. When talking to someone about having cancer, we need to consider the impact on their thoughts and family. Accurate results require a biopsy. After the biopsy, the first step is confirming lung cancer. Then, it’s essential to identify the specific type of cancer. Next, DNA tests help find different targets for cancer. Many targeted therapies are available, changing the landscape of cancer treatment. Previously, patients survived up to 1 year, but now it has extended to 5 to 10 years, a significant achievement in cancer research. Targeted therapies offer various treatments, benefiting over 50% of patients by addressing their symptoms and illnesses. So, understanding why a biopsy is necessary helps identify the type of cancer and distinguish it from similar symptoms of tuberculosis.

Vivek Sharma: Doctor Sahab! You’ve highlighted a very informative point on lung cancer diagnosis. And as you know we run an NGO to help cancer patients and survivors to fight against these life-threatening illnesses.

Dr. Bharat Bhosale: Yes, definitely and You’re doing a tremendous job. Keep it up.

Vivek Sharma: Doctor Sahab! I have a question in mind I’ve come across a patient recently who has this hypothesis regarding cancer treatment that when a doctor puts a needle into a tumor, there’s a chance the tumor might burst and spread in the body. How accurate is this?

Dr. Bharat Bhosale: Now, you might have come across this topic in recent discussions about liquid biopsy. So, what exactly is a Liquid Biopsy? Whether it’s a one-centimeter or two-centimeter tumor, it contains tumor cell DNA. In this process, we also collect blood along with the tumor sample to confirm the diagnosis. This helps identify mutations, showing that even if the tumor is in one place, it can spread continuously.

Talking about cases of lung cancer, it usually gets identified in stage 3 and stage 4 in about 85% of cases. That’s why I emphasized the importance of biopsy in detecting lung cancer in patients. However, when the needle goes inside, there can be complications like pain, occurring sometimes in around one percent of the population. All these diagnoses and procedures should be carried out under the guidance of expert doctors. When a tissue is removed from the tumor, it needs evaluation by an experienced oncopathologist. After that, you should consult a molecular pathologist specifically.

As you pointed out, that inserting a needle into a tumor can cause cancer to spread is completely false. There’s no doubt about that. It’s important to note that specialist doctors perform these precise treatments.

For instance, consider a tumor with 100 cells grouped together. In such cases, the region on the right side of the tumor behaves differently compared to the left side. Approximately 25 percent of the area mutates in one way, and the remaining 25 percent mutates differently. The issue with biopsy is that it targets only a single area.

One is called a Liquid biopsy, which represents all 100 blood cells, but for confirmation with diagnosis, a biopsy is still necessary. Also, keep in mind that Liquid biopsy cannot replace tissue biopsy. Tissue biopsy, on the other hand, remains the gold standard for confirmation, diagnosis, and determination of the characteristics of various diseases by targeting the tissue in specific areas of cancers.

And while Liquid biopsies can identify circulating tumor cells traveling in your bloodstream, aiding in mutation analysis. In the past ten years, science has advanced significantly in terms of managing, diagnosing, and treating lung cancer. Eventually, I observed numerous developments and ideas, and in the future perhaps after ten years, biopsies might not be necessary.

Maybe after ten years, we may not have to do even a biopsy to detect lung cancer. Artificial intelligence is paving the way for a promising future. Imagine analyzing images—can we determine the type of cancer and the potential mutations? Virtual Reality (VR) is exploring novel solutions for the future, and the likelihood of mutations may rise. Matrix predictions and similar challenges could decrease with a simple PET scan. This might eventually eliminate the need for a biopsy. However, at present, a biopsy remains the crucial step in managing lung cancer.

Vivek Sharma: Thank you very much, Doctor! I believe the audience has gained a clear understanding of lung cancer biopsies today. If someone around you gives random information like, “It happens like this, not like that,” please ignore them. Only listen to the expert oncologist. Thank you. Thanks a lot.

Dr. Bharat Bhosale: Thank you for the wonderful talk.

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