Seeking advice - likely a new member (prostate nodule and PSA velocity)

I'm 47, and I thought healthy. I had a routine PSA done this past Feb with my annual check-up. It was 0.9. I saw the urologist last week to arrange a consult. During the DRE, he was digging around a bit. I figured either he liked me, or there was something wrong. Unfortunately, it was the latter. He found a nodule on the right half of my prostate. He ordered a PSA, and I had blood drawn a few hours later. The results came in today, and the PSA is 2.1. Biopsy is scheduled a week from today. Everything I've managed to find so far indicates the biopsy is moot except for confirmation and calculating the gleason score. If anyone here knows of case with PSA velocity and a nodule being benign, I'd love to hear it now! ;)

One question I have is that the doctor has given me the choice of either a local or general anesthesia. I've heard even with the local it is rather painful. However, I never like being put under unless it is necessary. I'd appreciate any advice here. I'd also appreciate any general advice people have. I'll admit that I'm not too worried about survival at this point as I hope we caught it early. I am, however, scared to death of the post-op collateral damage. Impotence and incontinence were things that I never thought I'd have to worry about in my 40's.

Finally, I want to say that I've found this forum to be incredibly useful so far. Admittedly, I've also found it a bit scary. I'm a firm believer, however, in having knowledge to help make informed decisions.

Thanks in advance!

Bill

Bill, welcome to HW, are you an ex-squid like me and some of the other guys?

The PSA velocity is one of the most important factors to consider these days. I am the victim of PSA velocity. And to answer your question, I had several years of strong PSA velocity, and about 6 or 7 negative DRE (Digital Rectal Exams). I had 3 biopsies, in the span of 18 months, I was not put out for any of them. Didn't like them, mostly didn't like the probe up my a**. With one, I had pain meds injected in the area, and the needles from that hurt me worse than the cores being taken, so on the third one, I went back to no pain meds and did fine with it. You can expect some minor bleeding from your rear (not always), and sometimes bloody ejaculate, which can freak you out the first time, but its harmless. Only you know your threshold of pain, so do or ask your doctor what you think you need.

The biopsy is critical at this point. There still may be non-cancerous explanations for what you have going on. You probably know, we have more than our share of men in their 40s with PC. At 56 when I was diagnosed, my dr. said I was one of his youngest PC patients.

Until you have your biopsy, I would assume you don't have cancer. But still a good time to keep researching and asking questions. If you do have cancer, yes, catching it early would work in your favor, and depending on the pathology of that biopsy, its way too soon to have a firm opinion on your treatment options, or even if you need to have one.

I will be hoping you come back clean. Not a club you would go out of your way to choose, but if you end up one of us, this is the greatest place on the web to be part of the family with, we are indeed a brotherhood here.

Please keep us posted.

David in SC

Every one is different, but to me the biopsy with a local was no big deal -- not fun but easily bearable. In fact my biggest problem was that it was done by a female uro and a female nurse. I am just not used to having a team of "girls" poking large objects up my a*s. It was done about 2pm and I cut work and took the commuter train home with no problem, :Later on blood in the urine and semen is frightening but normal

As others have said, we hope you are negative and go away, but you can be sure that you do not have a single worry or fear that we have not shared.

Thanks for the help so far guys! I'm definitely holding out hope! I do appreciate the advice.

Thanks for the pointers to biopsy pain. I'll do some searches, but right now I'm leaning towards staying awake. I guess I am a control freak. I don't like the idea of not knowing what's happening.

Dave in SC - I was a Coastie (shallow water sailor / mud duck) for a year on a 44' when I was 17, and then I went to WooPooo and jumped out of perfectly good airplanes for a while. I never gave up my love for the water though, and I have a sailboat berthed in Annapolis now. My oldest son (14) and I were planning on sailing to Bermuda and back in '10. Worst case, I'm still hoping we can beat hurricane season.

I'll post an update once I get my biopsy results in a few weeks. In the mean time, I'll stay tuned.

I followed a nodule for several years before it biopsied as cancerous. They found HPINS, which are the precursor to cancer cells, but I enjoyed several years with a nodule.

I wouldn't assume it is a done deal yet.

Hi Bil
I had my biopsy without any medication and I felt little to no pain. It was over if just few minutes. It certainly was the easiest part of the whole battle that I've been through. Hopefully your battle ends with a clear bill of health.

...myself, put me out, I was,  it's the twenty-first century and who needs the pain and/or anxiousness of anticipation of the biospy.....don't remember a thing. On the other hand, my brother-in-law was DX'd the day before my surgery, I always loved his descripition on his bi-op......"it was like being raped by a fire hydrant".......you're call...I can deal with pain and discomfort, and have.....but why do it if we don't have to? Good luck brother.

 

My biopsy was with a local and the level of pain was minimal. I drove home 30 minutes later and the obly discomfort was a little tenderness in the scrotum a few days later which turned out to be an infection that was treated with an antibiotic. It was no big deal in my opinion, although I suspect it is different in every case.

Regards,
Bill