Biopsy

Barry,

You'll get a lot of different answers about what it's like to have a prostate biopsy. Some guys say it's not a big deal, other guys really hate them. Some guys tough it out without any sedation and others insist on being knocked out. I fall in the middle of everything.

I do kinda hate them but, candidly, they are more annoying than painful. Perhaps I should clarify... the biopsy gun does smart a bit when it goes off, but mostly it makes a noise and, if guys poking around up your butt with spring-loaded instruments makes you as nervous as it makes me, then you will jump about a foot every time the gun goes thwack.

I find the I don't jump as high and I come down off the ceiling faster if I take a bit of Valium before the procedure. Again, that's sort of half way between toughing it out and insisting on being unconscious. If you do the Valium thing you will need someone there to drive you home.

One other thing that throws a few guys if they don't expect it is the various places you will find a bit of blood after the procedure. The first surprise is when you wipe the goo off your behind when the doctor is done. Might be a bit of blood there. You will also find it in your urine for a couple of day, especially when you move your bowels. And your semen will be vampire-movie red the first few days and fade through shades of brown taking anywhere from weeks to a month or two to go back to normal.

The Gleason score thing is complicated. With any luck you'll never have to figure it out since most biopsies are negative.

But, since you asked. When the pathologist looks at the biopsy samples under a microscope, if he sees something abnormal he will describe it and give it a score 1-5. Abnormalities scored 1 or 2 nobody worries about. Things scored 3 can be trouble if there is a lot of it there. Fours are definite trouble and five is as bad as it gets. If the pathologist sees two kinds of abnormal cells he writes the one he saw the most of first and the one that was not quite so much second and then adds the two together and calls it a "Gleason" score. So Gleason 7 (3+4) means he saw mostly type 3 (not so bad) cells but some type 4 (pretty bad) cells. If he writes it Gleason 7(4+3) then he saw more of the bad kind than the good kind. If all he sees is type three then he writes Gleason 6 (3+3). That kind of cancer can often just be watched to make sure it doesn't do anything provided there isn't much of it. I am a Gleason 9(4+5) which is pretty bad but not as bad as a Gleason 9(5+4) which is not as bad as a Gleason 10(5+5).

But, like I said, most biopsies don't show Gleason anything. Hopefully yours will be like that and you will have wasted your time reading my explanation.

HT is "Hormone Therapy" which means suppressing testosterone since it makes cancer grow. BT is brachytherapy where dabs of radioactive stuff are poked into the prostate with needles to kill the cancer. Sometimes the radioactive material is left there (seeds) and sometimes they just leave it in for a few minutes at a time. IGRT, IMRT, SBRT, and just RT are various types of "external beam" Radiation Therapy. Again, plenty of time to sort that all out in the unlikely event that you need to know.

Good luck. Let us know how it goes.

Welcome to HW, sorry you need to be talking to us.
You should check out the sticky threads at the top of the forum. this one has a list if abbreviation:
www.healingwell.com/community/default.aspx?f=35&m=1019612

as for the biopsy - it's annoying, embarrassing and undignified. Other than that, tolerable. Just get on the table, do as you're told and think of England. It will be over before you know it. If you think you'll have trouble just ask for the drugs - they have things they can give to help you through.

The alarming part of the biopsy will be the first time you pee and see blood. It will clear up but it can be a worrying sight.

You'll do fine.
Keep us updated on your progress.
Andrew

I asked for and received a pain killer and xanax, or something similar, why go without, it's a disconcerting uncomfortable process. I was also listening to music.

The area was also numbed first, I didn't feel any pain. Make sure they will provide a local numbing agent. Just have to relax as the probe is INNNNssserted. Was over quickly, it was much better then I had anticipated.

Receiving the findings the following week was the painful part..

Everyone has different sensitivity and you can't go by anyone else's experience. I've had 3 and nearly fainted from the pain the first time. They had to end it there. The next time they put my lights out andI was in a daze for 2 days. The third time was my Goldilocks biopsy. They gave me a "periprostatic nerve block." I didn't feel a thing, and was alert and awake the whole time. I didn't even need a ride home.

Ask for it by name. I was gratified when I was at Kaiser last week with a friend and told the Uro that my friend wants a periprostatic nerve block. The Uro looked down his nose at me and said, "you know we are civilized here - we only do them with periprostatic nerve blocks." I suggest you make sure your Uro is similarly civilized. Check in advance.

- Allen

Berry - thanks for your kind words on my blog. I write a new post every week. Once in awhile they are actually worth reading.

I try to look sometimes but without my glasses I don't see much.

Andrew