New, biopsy and sort of fretting

Welcome to our corner of the world, sorry you need to be here but it's a good place to be.

Numb is a normal feeling at this point. The biopsy is annoying and undignified but not that painful. The aftereffects are a bit unsettling but you'll get through it okay. Hopefully the biopsy results will give you the information you need at this point.

Don't think too much about the possibility of cancer at this point. You're PSA number could be caused by a number of things with PC just being one. Even if the worst is true at your age and PSA number I'll venture to say that you've got every reason to hope for a good out come. There are a lot of good treatments and although it will change what "normal" is you'll still be around to enjoy life.

So, that is my suggestion - good do some living and do something you really enjoy doing. This journey is as much emotional as it is physical.

Hang in there and ask any other questions you've got.
All the best,
Andrew

Make sure that the urologist uses numbing jell before inserting the probe. After the probe is in, the doctor should then use the probe to inject you with a local. Then it should be completely painless.

Good luck,
Chuck

Resident of Highland, Indiana just outside of Chicago, IL.
July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA Sept. 2011 was 5.7.
Local urologist DRE revealed significant BPH, but no lumps.
PCa Dx Aug. 2011 at age of 61.
Biopsy revealed adenocarcinoma in 3 of 20 cores (one 5%, two 20%). T2C.
Gleason score 3+3=6.
CT of abdomen, bone scan both negative.
DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
My surgeon was Dr. Matthew Tollefson, who I highly recommend.
Final pathology shows tumor confined to prostate.
5 lymph nodes, seminal vesicles, extraprostatic soft tissue all negative.
1.0 x 0.6 x 0.6 cm mass involving right posterior inferior,
right posterior apex & left mid posterior prostate.
Right posterior apex margin involved by tumor over a 0.2 cm length, doctor says this is insignificant.
Prostate 98.3 grams, tumor 2 grams. Prostate size 5.0 x 4.7 x 4.5 cm.
Catheter out in 7 days. No incontinence, occasional minor dripping.
Post-op exams 2/13/12, 9/10/12, PSA <0.1.
Semi-firm erections now happening 14 months post-op & slowly getting a bit stronger.

So, if you haven't done so already, you probably want to make an appointment for the biopsy. My urologist offers an option to be lightly sedated for the procedure (a couple of Valium pills) and requires that the patient have someone to drive him home if he decides to take the pills. I've had biopsies both ways and I find it much nicer with a bit of chemical detachment working for me. It's true that it doesn't hurt much, but at least for me, it's annoying as the devil. I can easily name a dozen medical procedures that hurt a lot more and bothered me a lot less. But your mileage may vary.

With your low-ish PSA the chances are the biopsy will either find nothing, or that it might find so small an amount of cancer that you might not need to treat it (but you would have to watch it.)

Peter made me remember my hospital offered to put me out for a biopsy (some want it or need it). I was awake and not sedated and other than a slight discomfort with what seemed like a 24 inch probe it was not a big deal (the fear of the unknown was the deal for me with this procedure).

Like you I worried about the biopsy, but as everyone else has said, it not really painful, just uncomfortable. If I can do it (and I hate any level of pain!) you can too. The wait is hard but you'll make it. Just let us know how it goes...Art

Most of us have had little issues with the biopsy but some had minor problems. Hopefully, was it is done you will get a clean bill of health and you will forget about it.

When I had my physical over the summer and the PSA was 3.27 the urologist mentioned that it could be due to sex, jostling, etc.

For this past test I was really careful to not "disturb" anything. I guess I never really understood either knowingly or through selective ignorance that a biopsy would ever come into play.

I'm not aware of any of the men in my family experiencing anything like this.

Request pain killer and a xanax, listen to head phones. It's over quickly and if done right not too bad at all.

I ended up with urinary retention problems which were really bad due to having an enlarged prostate with a "knuckle" in the median lobe,unkown to me at the time

So if you have a problems going in, you might want to request a med like flomax and take ibuprofen to help reduce inflammation.

The real fun starts one week later when at the unveiling

Post Edited (Fauntleroy) : 3/20/2013 3:05:00 PM (GMT-6)

iankh said...
When I had my physical over the summer and the PSA was 3.27 the urologist mentioned that it could be due to sex, jostling, etc.

For this past test I was really careful to not "disturb" anything. I guess I never really understood either knowingly or through selective ignorance that a biopsy would ever come into play.

I'm not aware of any of the men in my family experiencing anything like this.

I recall that you mentioned earlier that you're having some bad urination problems. This is usually caused by BPH, which is a NON-cancerous enlargement of the prostate. Happens to many men as they age.

Has the doctor, after performing a DRE, ever told you that your prostate was enlarged? Also, the DRE, if performed before a PSA blood test (along with having sex 48 hours prior), can cause a rise in PSA.

Prostate tissue is the primary creator of PSA and a larger prostate naturally raises the PSA level. So, unless there might be a tumor lurking in your prostate and being masked by the PSA reading, it is probably just the BPH causing your PSA reading.

I would also note that a PSA of 3.27 is within the normal range for your age. The upper end of this range is about 4.0. So you probably do NOT have prostate cancer.

Have you had previous PSA tests taken? If so, what were the readings? If the readings have consistently been anywhere near the current reading (without any upward spike), it pretty much points to simple BPH.

And, if the biopsy should happen to diagnose PC, your PSA suggests that it is very early stage and very curable.

So, whatever the outcome, you should be just fine.

dittos to what John T said above.

Ian, you could demand a regimen of antibiotics to rule out an infection (UTI), and then have the psa rechecked a few weeks/months later. You could try a regimen of flomax to see if that helps with urinating.

fyi....the problem peeing you have is identical to what I experienced, but I also had a steadily rising psa, thus the pc diagnosis. A flat psa over 6 months is a very important consideration.

You are well within your rights to call a time out and try some remedial steps as outlined. Contrary to what others have said, my biopsy hurt like hell and was no fun.

Good luck.

iankh,

A few more questions: do you know if your urologist tested you for free PSA along with your total PSA? The combination tells a lot more than the single test does. Also, you mentioned that you have had prostate problems for some time. Are you on Avodart or a similar drug? Those drugs can make a big difference in your PSA level and how it is interpreted.

Like GTODave, I too was treated for "Benign" prostate hyperphasia (BPH) for years before I finally had my first biopsy. I probably had some sort of prostatitis going because my urologist -- the famous Dr Flabio Cavernosa, whose name I made up for this forum -- could always make my PSA go down, somewhat, by putting me on antibiotics -- but it never went down enough. Dr C and I went through several rounds of that, plus PSA and free PSA tests (my free PSA was never good and just got worse) plus PCA3 tests (which were usually negative) before and between my biopsies. I had four biopsies in all. Only the third one hit the tumor at all and it only nicked it (3-4% of one core). My cancer was on the anterior side of the apex of my prostate (a somewhat unusual location) and was difficult to access with transrectal ultrasound imaging and biopsies.

So, sure, if you want to try to avoid a biopsy you can lobby your uro for antibiotics and retesting, be sure to ask about free PSA. I sure did. Never did learn to like those biopsies. But on the other hand, do stay on top of things and listen to what your doctor says. If it weren't for Dt C's ceaseless pestering I would be in a much worse position now than I am.