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Biopsy with local - no pain just discomfort - just waiting now for results

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Posted 10/3/2009 3:34 PM (GMT 0)
I had my first biopsy yesterday at 47 with just a local. I didn't really know what to expect at the first snap (of 13), but it hurt less than a pinch. The discomfort (not pain) did build over the course of the remaining 12 cores, but I'm glad I took a local. I wanted to avoid the potential complications of a general anesthesia if I could. I dressed and walked out (gingerly ;)) 15 minutes later. The nurses did tell me that pain seems to vary with men on this procedure. Some the nurses said are near crying, and others like me are lucky and don't feel much.

I had a fair amount of blood the first few hours, and I had a bit of difficulty pushing out some of the clots of blood. Fortunately, that cleared up after about 3 hours. It was about the same for bowel movements minus the trouble going. Almost 24 hrs later, I feel fine. The location in my butt where they gave me a shot of antibiotics hurts more than any place else. Still a small amount of discomfort, but nothing that is slowing me down.

I met with the doctor before and after the procedure. Before the procedure, he just reiterated the situation:
-nodule found on DRE
-PSA velocity 0.9 in Feb'09 and 2.1 in Sep'09. He did provide new information that my free PSA was 63%, and that this was good news. He added that he'd be surprised that he'd find something.

Post procedure he said he took 13 cores. One of the nodule he found, and then the normal scatter pattern around the prostate. He said he wasn't too worried about the nodule, but that my velocity was high combined with a normal sized prostate. Kind of the opposite vibe he gave before the procedure. So, I'm not sure how to take that.

I'll post a follow-up regardless of the news once I receive it.
Posted 10/3/2009 3:55 PM (GMT 0)
sailor, glad you got your biopsy out of the way. and i hope and pray it comes back a big negative. enjoy your company here, but we would rather you not join our club. so i hope you get an all clear signal soon.

on the other hand, if you become one of us, you are among friends and brothers of the prostate cancer.

please keep us posted, we love to hear good news.

david in sc
Posted 10/3/2009 3:59 PM (GMT 0)

Hi Fat Sailor,

I'm glad to hear that your biopsy was not too uncomfortable.  I remember that the antibiotic shot that they gave me in the hip was much more painful than the procedure.  You can expect blood in your urine for a few days and in your semen for 2 - 3 weeks would not be uncommon.

I hope that everything works out that you don't have PCa.  You and your doc are wise to keep watch on it.

Thanks for keeping us posted,

Dan

Posted 10/3/2009 4:14 PM (GMT 0)
63% free PSA would indicate infection wouldn't it? I am surprised you didn't do a month of cipro and rechecked the PSA before doing a biopsy.
Posted 10/3/2009 4:24 PM (GMT 0)
Greetings, Sailor.  Glad the procedure wasn't too bad.  Uncomfortable is how I described mine.  Trust you will get good results - look forward to hearing some good news from you in a week or so.  David

Posted 10/3/2009 7:36 PM (GMT 0)
T40 I had a nodule on the DRE as well....so I guess he's being careful here. I'm just researching the free PSA issues now. I guess BPH is ruled out since my prostate was normal sized. Hopefully, I'll discuss the antibiotics with the doc when he calls with the pathology results.

Thanks for the good wishes!
Posted 10/3/2009 7:42 PM (GMT 0)
sailor I hope you get good news. From what I have read if you have a free PSA that is higher then 25% it greatly increases the chance that you are getting a high psa due to infection. Mine was at 9.3% which was a red flag that I probably had cancer. Which of course, I did.
Posted 10/3/2009 9:39 PM (GMT 0)
I think most URO's utilize a method in their needle placement as they poke the prostate. For some large percentage of biopsies, the mapping and ultra sound sonic color stuff would probably be an overkill. There is probably enough overkill in medicine already, hence the high expense in health care.

Cancer in one core is bad news, no matter where it came from. If a patient has a high PSA or other symptom, and a negative biopsy, then plane tickets to CA might be in order.
Posted 10/3/2009 10:02 PM (GMT 0)
goodlife,

I would agree with Ohio State here, the color mapping can tell a lot more than just a simple needle biopsy, that may or may not find the cancer in the first place, and even if it does, is it hitting 10% of the cancer or 100% of the cancer. The color mapping can put a more 3-D look at any tumor, and help to make a primary treatment decision more accurate than a guess from a conventional biopsy.

David in SC
Posted 10/4/2009 3:17 AM (GMT 0)
I am not arguing with anyone. Of course color mapping is better. Of course having a surgeon with a 1000 operations under his/her belt is better. Of course procedures that don't cause ED or incontinence are better than those that do.

Realistically, we don't or can't all have access to everything that is better for us for multiple reasons. Insurance, money, geopgraphy, need.

My biospy was enough for me. When they found G9, not much else mattered. It had to come out. I didn't need to have it color mapped, or fly to some place for other testing or procedures.

Many on this sight require more diagnoistic tools, and that is great. It doesn't mean that everyone needs a few thousand dollars of tests. I will be happy if we can get all men tested on a regular basis for PSA levels. I would be happier if those with abnormal PSA get a DRE. It would be wonderful if men would then get a simple biopsy.

If those first steps happened, then maybe we could start to establish criteria for more advanced testing and diagnostic procedures. But lets get the basics done first, before we start suggesting all kinds of tests that may or may not be required for straightforward PC cases.
Posted 10/4/2009 10:03 AM (GMT 0)
Good info Andrew, if we can analyze the math numbers like on those 110 men they sampled, gee it shows how imprecise the first findings(diagnosis) was on these patients, does that translate into the real world on patients like us? Of course it does and if you look at some patient histories post treatments it affirms such. Is this dark or half glass? No this is the real (unreal) world of PCa it is much more of impreciseness at many turns and alot of unknowns or 'unfounds' because of technology levels and skill levels. So when your doc tells you these prophectic phrases: cure (cured), we got it all, all findings were clear, clear margins and similar words we all wish to hear and although that sounds fantastic, just remember it is a 'could be' as he says and also, could not be as he says. This is the jungle of PCa words coined by Robert Young, website Phoenix 5. Talk about a warrior on PCa and he left the world the first laypersons booklet on PCa terminology, which was really needed and has been a useful tool for many.
Posted 10/4/2009 2:01 PM (GMT 0)
goodlife,

you do well for yourself. you researched, went to a great hospital, had a good surgery, and your results since are looking good,
dont let anyone make you second guess yourself.

i envy your line of zero psa so far, keep those coming for years to come.

you are right, there is a reality side to deal with too, its called money, insurance, time, logisitics, family, etc, all of the above factored into my own personal decision. and i dont care if anyone else agreed or not, worked for me, just like yours is working for you.

david in sc
Posted 10/4/2009 8:19 PM (GMT 0)
OhioState,

Believe it or not, I had no biopises at Cleveland Clinic. They took the slides from my barnyard variety, no anesthetic, black and white m, random needle stick biopsy. As I said, in my case, once any core of G9 is found, and no sign of mets , it was time to call in the skilled surgeon. It was his skill with the DaVinci that got me where I am so far, not a diagnostic techniique.

Not quite sure why you are so adamant on this topic. We all have different cases and different needs. Why should we try to put doubt in someoe else's mind about the path they are traveling ?

I wish only the best for you and your journey. By your signature, you have had a wild ride, but it appears to working so far.
Posted 10/4/2009 8:33 PM (GMT 0)
David in SC,

Thank you. I have been accused as seeing everything as right or wrong.

Actually, I view very little as right or wrong. If this disease could be cured by a series of binary decisions, there would be no problems. Instead, we see what has worked succesfully on one person did not work on another. Therefore we need additional testing, and procedures to go at it again.

I try to encourage others on this site, and answer questions that I think I know the answer to. If I don't know the answer, I say so. I am finding some posts that make the requestor sound as tho they have made a wrong decision, or are somehow stupid, naive, or silly.

That does aggravate me , and periodically I will make a statement or two that shows my aggravation. This forum is to be a help for others, not some kind of vindication for the path we have chosen in our infinite wisdom.

I wish you the best in the coming days. I know it will not be the best of times for you.
Posted 10/5/2009 3:13 AM (GMT 0)
Goodlife,
Color doppler biopsies can provide a lot of information. I had a color doppler from dr Bahn after my 12th biopsy picked up a small core G6. The color doppler couldn't find the PC the biopsy picked up, so t was just indolant clusters; but it did pick up a large tumor that all other biopsies missed. It aslo measured the exact volume of the tumor and identified it's location. Color doppler can also identify any extra capsular penetration which is important to anyone considering surgery. It can also accurrately estimate the agressiveness of a tumor by analysizing the blood flow. Without color doppler I would have had an unsuccessful surgery. Was it worth it? you bet it was. I wish I had know about it 10 years earlier. I would never have another regular biopsy.
JohnT
Posted 10/5/2009 3:40 AM (GMT 0)
goodlife,

it is a good point you make. its not a question of right or wrong, we all have to make tough choices, whether we see 1 doctor or 10 doctors, when push comes to shove, we alone have to make our own medical decisions. and once they are made, they are made, and there's no going back.

definitely no need to people to try to make other people upset or feel stupid about their decisions. that's out of place as far as I am concerned.

prostate cancer is cruel in that men are forced to make decisions that often mean no matter what you decide, there's a big gamble involved, either in the effectiveness of a particular treatment, or knowing that you "earned" some terrible side effects because of your decision, or both.

keep on doing what you are doing, you are still on the recovery side, and you are looking good at the moment.

david in sc
Posted 10/5/2009 4:35 AM (GMT 0)
Color doppler imaging is not a biopsy nor does it replace a biopsy. It does however provide perhaps a new targeting area for a better biopsy. But imaging in itself is not a biopsy. There is an error margin with color doppler as well. Certainly CD does not detect micro-metastatic disease.

Tony
Posted 10/5/2009 4:24 PM (GMT 0)
Many experts say that color doppler will identify any tumor large enough or agressive enough to hurt you. If your prostate is removed it cannot identify small cells in the bed or micromets. If you have an intact prostate it will itentify tumors and just as importantly can eliminate indolant cancer clusters that were found on standard biopsies.
JohnT
Posted 10/5/2009 5:31 PM (GMT 0)
I am reading this thread with great interest as my husband and I will be traveling to see Dr. Lee soon.  We are hoping that color doppler will find what has been elusive -- or,  put our minds to rest.  One thing is certain, my husband is not thrilled about having saturated random biopsies every six months.  Three has been enough to convince him to go to Plan B.  -- Deb

Post Edited (nodaker) : 10/5/2009 11:34:35 AM (GMT-6)

Posted 10/5/2009 9:23 PM (GMT 0)
These really are informative posts about CD. It alsmost seems as tho we should figure a way to catalog info like this and have it readily available to those who need it.
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