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Posted 6/7/2015 7:51 PM (GMT 0)
Hello all, I am 47, 48 next month. I had testicular cancer 3 1/2 years ago and after surgery to remove my testicle, I chose active surveillance, as it had not spread. My Dr. Released me in December which was a great feeling. My T level had been at the very low end of normal after surgery and about a year ago fell below. I had gained weight and just felt lethargic. I ended up using androgel, slowly upping my does. Part of using Testosterone is to follow your PSA. Mine apparently is rising to fast. Still not high, 2.2, but rising to fast. I had a MRI about a week and a half ago with a probe up my butt. Called next day and said there are 2 lesions and I need to have a biopsy.

My questions are, aren't I to young, or just in denial? I have been resistant to the biopsy but the Dr. says with the mri results, they need to see what they are. What else could they be? Dr. wont really say. My Dr. is at the VA but the MRI was at the University of Cincinnati. They will do a guided biopsy based on the mri and an ultrasound I think. I'm just not ready for cancer again, but I am to young to just watch it I would think. Any suggestions?
Thanks,
Doug
Posted 6/7/2015 8:21 PM (GMT 0)
Hi Doug, welcome to our little corner. There are others here who may be able to speak directly to your situation. I get that you don't want to hear the "C" word again, unfortunately the only way you'll know either way is from the biopsy. An guided biopsy is a great tool for this.

If the biopsy comes back positive, there are a lot of us who can help you understand what is happening. Hang in there....
Posted 6/7/2015 8:26 PM (GMT 0)
Welcome to HW, sorry you need to be talking to us.

I'd go with your doctor's suggestion on the biopsy.

Sadly, you're not too young for PC. We have a number of men your age and younger here. That you've had once cancer is a bit of a warning. If they saw something on the MRI, it should be tested.

It may not be PC, but the only way to know for sure is to get a sample to the pathologist.

While 2.2 isn't that much PSA and a fast rise aren't always an indicator of PC, I think a guided biopsy would be prudent to find out what is really going on in there.

It's still possible that active surveillance would be okay to do, but better to have as many facts in hand before deciding. I realize it's difficult to have to tackle another cancer, but I'd recommend erroring on the side of caution and go the next step.

Of course, I am not a doctor, just some random guy on the internet.
Hang in there and keep us updated on your progress,
Andrew
Posted 6/7/2015 8:29 PM (GMT 0)
Hi Doug, While I am a new member here also and really not ready to give sound advice I think I can safely say you are not too young for getting a biopsy to find out. I really feel for you with your prior cancer and hope the biopsy brings you good news. I also had the MRI with the coil up my butt; ouch! Not a lot of fun there. Also had the ultrasound/MRI biopsy last Tuesday so it is a great way for them to get the information they need.
I thought I was too young at 53 when my Dr. wanted me to see a Urologist because of a rise in my PSA. One and a half years later I tested again and agreed to finally go, and here I am. I see many members on this site that are relatively young so this disease is a pain in everyone's a-s. I just had to tell my younger brother to start getting his PSA and he is only 45, but it is better to be ahead of this prostate cancer game. Good luck..Jim
Posted 6/7/2015 8:30 PM (GMT 0)
Sorry Doug. Get the biopsy (and get the one that goes for the areas most don't - forget the name but someone will know) and find out what's what. Good luck.
Posted 6/7/2015 10:20 PM (GMT 0)
Hi Doug,
Welcome to the HW forum.
Like all the other mentioned, you need to have a biopsy.
Earlier detection is better than waiting for the symptom of PCa.
Posted 6/7/2015 10:37 PM (GMT 0)
Doug... you're mot too young to have prostate cancer.
Do the follow up. Its warranted.
All the best. .. keep us updated.
Posted 6/7/2015 11:07 PM (GMT 0)
I am overwhelmed with the response. Thanks fellas. They are already booked until the beginning of July for biopsies so it may be another month. Don't like that wait either. I will keep everyone updated and I will be reading all I can along the way.
Thanks again,
Doug
Posted 6/7/2015 11:20 PM (GMT 0)
The wait is annoying, but not that big of a deal. PC is very slow growing so even if the worst was true, the time delay is just annoying and anxiety generating.

well, that's bad enough.

Hang in there,
Andrew
Posted 6/7/2015 11:37 PM (GMT 0)
The odds are you don't have Pc. But even if you do you'll have plenty of time to decide on treatments. So don't fret about the wait time for a biopsy. I believe my PCP started testing me in my mid 40's. I can't remember precisely, but I do recall my 1st score was a 2.2. Over the course of the next 12 years it elevated slowing up to the mid 3's, so I thought nothing of it. Then it bounced up to the mid 4's. I went to a urologist and was all set for the biopsy, sitting butt-naked on the table with a paper sheet over my lap, when the uro came in and said the psa had fallen, the new reading was 3.4, and the biopsy wasn't needed. But he said he would do it if I wanted it. I said no thank you! That was about 3 years ago. I wish I had said yes, since it stayed in the 3's for about another year before jumping up to mid-4's and finally a 5.9 at the time of the biopsy and diagnosis. I kick myself for not getting it done earlier. (the cut-off was 3.5 back then). Had I done so earlier, I might not have had a 50% cancer growth at the time of surgery, which is likely what resulted in positive margins. Just know that the biopsy is not bad, it'll reduce anxiety and help answer unknowns.
Posted 7/2/2015 10:19 PM (GMT 0)
Well, here I am almost a month later and still no biopsy. It's scheduled for July 20. I went off of androgen June 1 and just had my psa checked as part of preop. It's down from 2.2 to 1.3 but the dr is still insistent on a biopsy because the Mri showed a couple hot spots. I don't know what to do. I don't want to go through a needless biopsy. But i would like to know what lit up on the mri. Me said my velocity was to high. I said ok, but now it's down to 1.3. How do you explain that. He just keeps going back to the mri. Arg!!!!!!
Posted 7/2/2015 11:47 PM (GMT 0)
dc, PSA is a strange thing. It bounces around. It doesn't always mean cancer. It can be low with aggressive cancer, or high with no cancer. If the MRI showed hotspots, i'd be very interested in knowing what was going on. If i were you, i would move ahead with the biopsy. Others may disagree. But I'd rather be cautious.
Posted 7/3/2015 2:38 PM (GMT 0)
I can only speak for myself but I would absolutely want to know one way or another rather than have it in my mind wondering. My first biopsy where they put me out was no problem at all, the second; a targeted biopsy they wanted me awake and that was no fun at all. Either way I would definitely get the biopsy and if you get good results you can move on with your life......Best of luck.
Posted 7/3/2015 3:57 PM (GMT 0)
I know I should have it. I'm being a baby more than anything. I asked if I could have something like when I had my colonoscopy. They said they usually don't but they will. They suggested a Valium but that didn't do much when I had the mri. Pre op is Monday then biopsy on the 20th. I do want to know, I think.....
Posted 7/3/2015 4:27 PM (GMT 0)
dc, if you're having a standard TRUS (transrectal ultrasound) biopsy, it takes about 5 minutes. For me, the worst part was the antibiotic shot in the butt cheek. Then they put you on the table with your pants down around your ankles and your butt hanging over the edge. In goes the ultrasound probe, they put in a little lidocaine, and you'll hear 12 snaps as they take the samples. Then, wipe and go.

Just be prepared to pee and ejaculate blood for a few weeks.
Posted 7/3/2015 5:08 PM (GMT 0)
dc trust me, I'm at least as big a baby as you when it comes to this stuff. I also asked for it colonoscopy style, they wouldn't do it. But they gave me a scrip for Xanax. 59mg. I took one when I left the house (45 minutes to the office where I had the biopsy), another, about halfway there, and a half more when I got to the opera office. It helped immensely
Posted 7/3/2015 5:31 PM (GMT 0)

dc67 said...
I know I should have it. I'm being a baby more than anything. I asked if I could have something like when I had my colonoscopy. They said they usually don't but they will. They suggested a Valium but that didn't do much when I had the mri. Pre op is Monday then biopsy on the 20th. I do want to know, I think.....


All I was offered was a Valium and it didn't do much for me either. It was uncomfortable but it really got old after about the 5th punch. I would just grit your teeth and do it, you really should have another data point - the downside of ignoring it could be significant.
Posted 7/3/2015 5:58 PM (GMT 0)
I hear you on the stress of getting these tests. I hate needles and I have been jabbed so much in the past few months. This up the butt stuff for biopsies, endorectal MRIs, digital exams have been my worst nightmare. It's been tough to get through and plenty of times I laid there with stuff in my arm drawing blood or something in my a-s wondering how did I end up in this place. But we get through it because that's what we do. It sounds like you've been through plenty so no need to tell you. Just wish it would get easier....
Posted 7/3/2015 7:03 PM (GMT 0)
Does anyone else agree with my basic sentiment that Urologists must be closeted sadists?
Posted 7/3/2015 8:23 PM (GMT 0)
I'm glad the sadists found their place in this world...lol.

With my targeted biopsy the lidocaine shots to the prostate were the worst part and I still felt it while they were getting their samples but fortunately after a few samples the Dr. was aware of my discomfort and offered more lidocaine and from there everything was fine. After the extra lidocaine they could have had a party in there ( I think they were having a party in my a-s since I was in a clinic setting & there were sooo many people involved) and I would not have felt anything. If ever again I would just ask for extra lidocaine from the start, it works wonders if they use enough.
Posted 7/3/2015 9:19 PM (GMT 0)
Over the years we have had multiple threads about the pain or lack thereof during prostate biopsies. The answers range from "no big deal" to "excruciating pain". There seems to be no rhyme or reason as to why this happens to some and not to others.

My biopsy was done under IV sedation - similar to a colonoscopy. I know many others here have had that experience as well. My doc's reasoning for doing it this way was that some patients DO have significant pain and he prefers to keep his patients as pain free as possible. He also felt this way he could take his time (16 samples for me) w/o worrying about the patient's discomfort. Of course, he also could have been doing this to pad his boat account! In any case, I had zero pain, a nice nap and no problems.

Jim
Posted 7/3/2015 10:13 PM (GMT 0)
With my random biopsy I was sedated; that was great. Hated the iv but it was worth it. The targeted biopsy they said with the ultra sound/MRI overlapping that I needed to be awake so I would have less movement because when sedated you can sometimes make a lot of involuntary movements and they could control my movement/positioning better. I did not know this until just before the biopsy so it was not what I wanted to hear. I agree with Halbert; sadists. Sedation is wonderful....
Posted 7/3/2015 10:33 PM (GMT 0)
Thanks fellas, after going through testicular cancer 3 1/2 years ago, I just don't want another round of cancer. If I lose my prostate after losing a ball, im afraid I'll start to feel a little less manly. If they offer nay kind of sedation, I'm on it. I'm a marine and used to grinning and bearing it, but I'm not a sadist....lol
Posted 7/4/2015 2:34 AM (GMT 0)
Get the biopsy. It could save your life.
Posted 7/4/2015 12:30 PM (GMT 0)
Dc, I've lost my prostate, both erectile nerves and both my balls! I do not not feel less manly one little bit!

Cheers, Doug
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