How bad does it hurt?

Hello everyone. I will get right to it. Does prostate cancer hurt if it has not moved out of the prostate? Second question. How bad does the biopsy procedure hurt (I know this is in FAQ's). My Doctor said "I will not lie and say it will not hurt". My PSA abbot score (tested twice) is 8.9 ng/ml, PSA_Free 1.4ng/ml %Free PSA 15.7%. Rectal exam indicated nodules. Doc said "not the worst I have ever felt". He gave me a 40% chance of cancer. Anything else I should prepare myself for? Thanks a lot.

Welcome to HW, sorry you need to be here.

and sorry you need to do the biopsy. PC doesn't hurt and has few to no symptoms in the early stages. Are you having pelvic or bone pains?

The biopsy is annoying, uncomfortable and undignified. Not "painful" but they do shove things up your backside and poke sharp objects. On the 1-10 meter I put it around 3 for about 10 minutes. If you have any concerns about pain or discomfort your doctor could give you something to help you relax. I didn't need anything but other guys here have been given various drugs to help them through.

If you're going to prepare yourself for anything, it's the phone call you'll get after the biopsy. Either a ref lief or and "OMG" moment. And prepare yourself to see blood in your urine and semen for awhile - that can be a bit unnerving - harmless but not something you like to see.

If you have other questions, fire away, we're here most days.

Hang in there and keep us updated on your progress.
Andrew

My own experience with a 12-sample biopsy was that it was somewhat uncomfortable, but not painful.

PCCstudent: I have not seen any evidence that PC exhibits painful symptoms. If you are experiencing pain, you should discuss this with your Uro.

The responses you have heard so far are from braver men the me. I had a general anesthetic for a 12-punch. TRUS, biopsy. Some burning, and a bit of red pee for a day or so. This was followed by blood in semen for about 6 ejaculTions and back to normal.

I wish you the best and please keep us posted.

Hello all thanks. One question I did not ask the urologist was how long after the biopsy does it take to get results back? Thanks again

My biopsy was painful. Perhaps I didn't sign up for the right kind, but if they suggest drugs or knock you out for it...I'd sign up for that version.

On the results...regardless what happens, we all at HW are here to congratulate you on the good news and help you get through any not so good news.

Hang in there...once you have all the info, you'll feel better...it's not knowing that really drives us all nuts sometimes...

Prostate cancer can hurt, but given your psa it is highly unlikely that any pains you might have are related to PC. We're no longer in our 20s or 30s...and most pains come just because we are getting older....

My results took about 2 weeks...if they do find something they'll probably do a standard ct and bone scan...thus is normal so don't read anything into that...but that's just if the biopsy shows any sign if cancer....

Again...hang in there...

Hi, Many men don't even know they have PCa until they go for a physical. There may be some pain if you are suffering from urinary retention. Sometimes if the cancer has already escaped the gland and entered the bone there may be some pain.

Make sure they inject a local anesthesia, some docs don't bother. I also had a pain med, like percocet, and a valium prior to the procedure. There is no reason to just tough it out

The worst part was the insertion of the probe, if you can relax for that, should be okay. With a 12 core, I felt no pain, it's what followed ....

PCCstudent. I think that you can see by the replys that you have had that PC itself does not cause pain. Unless the cancer has escaped the prostate and has formed in your bones (bone mets) With your PSA score I very much doubt that is the case. Of course there can be pain if the prostate is enlarged and causes urinary retention. In my case my early symptoms were the opposite. I found that I had to pee much more often, especially at night, no pain but a darn nuisance.

Many men will live a completely normal life, totally unaware that they have PC and die of something completely unrelated. They say that around 80% of men aged 80 will in fact have some degree of PC.

At 60 it is very common to suffer from an enlarged prostate, but that does not mean you have PC. On examination the prostate should be firm but smooth. You doctor has found “nodules” that indicate there could be a problem and why he wants to carry out a biopsy. The base line PSA reading for a guy your age is 4.2. Anything over that would require further investigation. In my case I had an MRI scan first to show any suspect areas of the prostate that should be targeted during the biopsy.

The biopsy some of the guys have mentioned is the TRUS type, and you can see by reading that some of the guys did experience some degree of pain. They should give some kind of local anaesthetic that will numb the area before biopsy. Then then pass an ultrasound probe up the anus along with the needle that takes the prostate tissue samples, normally about 12 samples, but can be more. The needle is passed through the rectum wall and into the prostate and it is the needle that may cause some pain. The downside of this type of biopsy is its accuracy, only about 25% they will pick up any cancer on the first attempt. That is why you may read about guys who have had had this procedure up to 4-5 times before the cancer if found. The other thing to remember is that because of the very nature of how the samples are taken through the rectum increases the risk of infection, but this risk is low because of strong antibiotics that they will give you before and after the biopsy.

If pain is a real issue for you then you should look at the alternative transperineal biopsy (Template Prostatic Biopsy) The plus side of this procedure for you is that it is carried out under general anaesthetic so you will feel nothing. Also it is far more accurate (95%) as they are able to specificly target a much larger area of the prostate, meaning you will only have to endure this procedure once. Although they will still place the ultrasound probe into your rectum, the samples are taken externally through the area between your scrotum and anus this also lowers the risk of any infection. More samples can be taken this way, (in my case 40) and of course you can see why this is a much more accurate procedure. One thing I will point out is if you go this route you will have to have someone drive you to and from the hospital, because motor insurance company’s will not cover for driving after a general anaesthetic, it is illegal. The side effects of both procedures are as already mentioned above.

They will decide your biopsy results using a thing called the “Gleason score” made up of two numbers. Cells that are grade 1-2 are not looked at as cancerous. Cells that are grade 3 are looked on as low risk cancer. 4 are medium risk and 5 are the most aggressive. So if your results show all grade 3 cells then you Gleason score would be 3+3=6 and place you at low risk and often you may not require treatment and be placed on regular monitoring “Watchful Waiting” If your results show mostly grade 3 cells but some grade 4 you will be scored at 3+4=7 and will be seen as low/ medium risk and certainly would require some form of treatment. Any results that show cells that are grade 5 will place you as high risk, because 5 is the most aggressive form of PC. Basically the lower the first number is in your Gleason score the better. In my case being a 3+4=7 is better than a score of 4+3=7.

Depending on your type of health care and where you live will have bearing on how long it will take to get your results. I have seen guys here who have received there’s the very next day, others within 3-4 days. Here in the UK where our health care is free, the norm is 2 weeks.

If you have any further concerns or questions then please feel free to ask. You have certainly come to the right place if you are seeking advice and support. BUT! Please remember that none of us are health professionals. We only speak from personal experience. You must always talk to your doctor regarding your symptoms/concerns and possible treatments should you need them. We hope that you wont feel the need to become a “full member” here.

All the very best to you on your journey.

Welcome aboard, PCC. Great crew here to walk the journey with if you end up needing to do so.

As others have said, the biopsy is not pain-free but probably not as awful as it sounds. The local anesthetic will help and a general relaxer or anti-anxiety pill can make it smoother. Have the doc let you watch on the monitor. I found it interesting and it can help take your mind off the needles.

When I was getting ready for my biopsy, one of my co-workers who'd already had PC surgery suggested I go to Home Depot, rent a nail gun, insert it in my rectum and fire off a dozen finish nails. Supposedly, the biopsy would not seem so bad. (I think he had read that Dave Barry story.)

You also mention hip pain and you've already read comments about how that can be a symptom of metastasis of PC. I am just a few years younger than you, have gone through surgery and radiation for PC, and still have hip pain. Of course, the first thought is metastasis, but the truth is I have "old man's disease" and it's just some osteoarthritis. It was bad enough in one hip socket I had a hip replacement earlier in the year. Still have aches in both hips and lower back but I'm straight zeroes on my PSA for the last couple of years.

Don't get the willies just because every ache, pain or hitch seems to be magnified a gazillion times when cancer is on the table. You'll worry yourself beyond need if you go there. Go through the process, get your diagnosis, ask a lot of questions, dig up as much info as you can, then make your decisions with your physician(s) from there. Wherever you are on the spectrum, the good news is that you are on top of it NOW rather than waiting down the road. You always have more options earlier as opposed to later.

The guys (and gals) on this board are great encouragers and you'll find this to be a very helpful resource.

John

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No pain at all for me during the biopsy except the first one made me jump a little. worst part is the uncomfortable feeling of the instrument going in.

then again.....some men may enjoy those kinds of things.

My biopsy (12 cores) was unpleasant, but I cleaned up and went back to the office and finished my day's work.

As to results, a second opinion will always be potentially faster because the pathologist is looking at slides already mounted. The first process has to process the samples into a format the pathologist can use.

In my case the kit with samples had to be sent to an out-of-area lab, so time was added by shipping.

I only had six cores taken due to small Prostate due to many years of treatment for BPH. It was a non event. My Uro did a great job of applying local anesthesia. All I felt were the Six jabs which were nothing and sounded like a power stapler. I had no after effects but I ended up with high risk cancer . See my signature for SEs of treatments. I have never had any pain from cancer. I've had other orthopedic surgeries which were much worse than anything I've gone thru for cancer so far.
I'm just hoping now that I don't get mets.
Bob