Just Starting The Journey

Hello All,

Found this site several weeks ago after learning my PSA was 7.5 (after three blood tests about six weeks apart it never went any lower). I am 62 years old and in good health as far as I know. Took anti-biotic regimen - no change in PSA. DRE showed slight swelling but according to URO it was "smooth". He ordered a "free PSA" test - came back in 11%. He advised via e mail he was recommending ultrasound and biopsy. I have an appt this afternoon with his PA - don't really know what that will involve given the latest test results.

I have to admit to you I am somewhat dazed and confused...this has hit me like a rock. I have not told my wife about the latest test results.

I know everyone on the site has probably heard the same things over and over again with regard to PC and procedures, etc., but I find it somehow a little more comforting to be writing about it....kind of getting it off my chest so to speak.

With regard to the biopsy, is there any kind of numbing or anesthesia that goes on or is it "cold turkey"?

TeeItUp- welcome to the HW forum. I know it is not where you want to be. My experience with the biopsy was not too bad. They gave me a pill to take to calm my nerves. I could not tell that it did much. You will have to "prep" before you go to clean out. They gave me nothing that I remember for numbing. The best I can describe the actual sampling is the probe has something that punches into the prostate to get a core. Sort of like a spring-loaded device. Don't let it scare you. My biopsy was not painful, just uncomfortable. You should go ahead and tell your wife about this. Good luck.

We can all exactly relate to the emotions you are going through - been there. It is quite a shock when you've been basically healthy for your entire life. I also found it does help to share with others so this is a good place to discuss your situation, plus there's a wealth of knowledge here if your journey continues.

I'm not especially tolerant of pain and was okay with about the first three or four punches then it became very uncomfortable and I started sweating. All I had was a Valium an hour before and it didn't seem to help much if any. Pretty sure he used lidocaine inside but I would have much preferred demerol or propofol as well.

Like somebody else mentioned, you really should let your wife in on the situation. Mine is very supportive, helpful and I want her with me when ever I talk with a physician - sometimes I'll miss something important the Doc is saying and she many times has filled in the communication voids. Besides, you will need somebody to drive you home from the biopsy.

This part of the journey is most difficult with all of the unknowns and uncertainty but hang in there.

TEE,
Cannot add much to what others have said about procedure.
I know what you're going through, the fear, the what the "heck's", the how bad,
how long, etc...
Just know that others out here are thinking about you and praying for you
and your wife (she really needs to be on this journey every step with you).
Stay connected here, the support and knowledge will be invaluable to you.
Mike

As for the biopsy, I've had 3 - all done differently. If you don't ask for anything special, they'll probably just inject a bit of lidocaine. Some guys do well with that - I didn't - really painful. On the second biopsy they put me out entirely, and I was groggy and hungover for a few days. The third biopsy was the "Goldilocks" one - they gave me a "periprostatic nerve block." It completely numbed the area - I didn't feel a thing - AND I was completely awake and alert. Many larger centers now offer it routinely, but many don't. It takes a bit of skill to administer it correctly. I suggest you ask for it by name and not leave it to their judgment.

Afterwards, some are a little sore back there for a little while. Some may see some bleeding on the tissue paper or in the urine for a little while. Everyone will have bloody semen for a few weeks (ugh!).

If you notice any fever afterwards, let your doctor know immediately.

Be sure to get a copy of the biopsy report and tell us about it.

- Allen

Tee - Hi & so sorry you are going thru this.

Are you having an ultra-sound beforehand or an MRI? I know just enough to be dangerous, but my husband had an MRI beforehand that identified areas of concern and those areas were targeted during the biopsy. My understanding is that without the MRI, the uro is just following a pattern to cover as much of the prostate as possible, but it is entirely possible to miss a cancer. The MRI mitigates the possibility that something is missed. Just seems that if you are having a procedure as invasive as a biopsy, it makes sense to have as much working in your favor as you can. (I believe the best type of MRI to have is a T3 or Tesla 3.)

BTW - I'm one of those wives that the docs just wish someone would pull back - lol

Suz

Hi Suz! Yes, I'm having an ultrasound tomorrow afternoon. According to doctor, they hope to see areas of the prostate that they will be able to key in on during upcoming biopsy. I bet an MRI is better, but that wasn't given as an option.

Yes, it was nice to have my wife there - you're right about "not hearing"....so many things going through your head while you're sitting there that you miss half of it.....

Pleased to meet you.

Like Allan, I got knocked out cold. They used propofol on me and used an ultrasound to locate areas of interest to take cores from. I did not get the euphoria side effect from the propofol though.

Hi Tee and welcome. Let's hope you are just passing through!

Our members have reported biopsy pain all over the map -- from "no big deal" to "excruciating". I had IV anesthesia so had a nice nap; no pain but just some discomfort afterwards handled by Tylenol. You'll find that a pretty easy road.

Good luck and please let us know how it works out.

Jim

Tee.... Only one thing to add... If you're still working. Take the whole day off. I thought I'd pull off an 11 am biopsy & get back to work. Uh, no. I was done. Took me about 8 hrs to feel normal again. As some have said, biopsies are all over the map for people. Mine was moderately uncomfortable, but not terrible. Once you're in, it will only take 10-15 minutes or so before you're done.

Tee, not sure why you posted on a six year old thread but I have pasted your comments here into your original thread and deleted your other post. This way folks will have an opportunity to comment in context.

Jim

Tee's post:

Hello everyone -

Had my ultrasound a few days ago (transrectal) and rec'd the results yesterday. Not sure I understand them all but pretty sure it showed a suspicious area (my results come to me via something called "My Chart" and I can see them before ever talking to doctor about them). Here are results - pls chime in with any impressions or info you see in them:

Prostate Volume: 47.5 cc
Transverse: 5.8cm
AP: 3.6 cm
Length: 4.3 cm
Prostate Symmetry: Symmetrical
Capsule: Intact
Seminal vesicles: Right 0.8 cm, Left 0.8 cm
Hpyoechoic Findings: Round hypoechoic 6 mm nodule in the mid gland midline central zone.
Hyperechoic Findings: None
Bladder: Unremarkable
Impression: Borderline enlarged prostate gland

I am supposed to be receiving a call soon regarding scheduling of biopsy.

Tee Bob- you can see there is a whole array of experiences with a biopsy. It's something you must do and the overall take is 'it's not so bad'. You have a great first thread here and we will be here for you. It's good that your wife is taking notes and is plugged into what's going on now.

Hello All -

Well, I've got the biopsy results and am inserting them at the bottom of this post. I have an appt this afternoon to sit down with the URO and "discuss options". He will make no recommendations. I have been reading and reading and somehow feel that I'm not getting any further along in making decisions regarding potential treatment than I was when I started.

I would appreciate anyone who has been through this to take a look at my scores and let me know if you have encountered similar scores in the past and what treatment option/outcomes those individuals may have taken. Thanks so much for your help!

Final Diagnosis:

PROSTATE, BIOPSIES x13: PROSTATIC ADENOCARCINOMA IN SIX OF THIRTEEN PARTS.

1. PROSTATE, LEFT BASE, NEEDLE CORE BIOPSY: BENIGN PROSTATIC TISSUE.

2. PROSTATE, LEFT MID, NEEDLE CORE BIOPSY: BENIGN PROSTATIC TISSUE.

3. PROSTATE, LEFT APEX, NEEDLE CORE BIOPSY: BENIGN PROSTATIC TISSUE.

4. PROSTATE, RIGHT BASE, NEEDLE CORE BIOPSY: PROSTATIC ADENOCARCINOMA, GLEASON
SCORE 6 (3+3), INVOLVING 5% (1 MM) OF ONE CORE.

5. PROSTATE, RIGHT MID, NEEDLE CORE BIOPSY: PROSTATIC ADENOCARCINOMA, GLEASON
SCORE 6 (3+3), INVOLVING 5% (1 MM) OF ONE CORE.

6. PROSTATE, RIGHT APEX, NEEDLE CORE BIOPSY: PROSTATIC ADENOCARCINOMA, GLEASON
SCORE 6 (3+3), INVOLVING 5% (1 MM) OF ONE CORE.

7. PROSTATE, LEFT LATERAL BASE, NEEDLE CORE BIOPSY: BENIGN PROSTATIC TISSUE.

8. PROSTATE, LEFT LATERAL MID, NEEDLE CORE BIOPSY: PROSTATIC ADENOCARCINOMA,
GLEASON SCORE 6 (3+3), INVOLVING 10% (1 MM) OF ONE CORE.

9. PROSTATE, LEFT LATERAL APEX, NEEDLE CORE BIOPSY: BENIGN PROSTATIC TISSUE.

10. PROSTATE, RIGHT LATERAL BASE, NEEDLE CORE BIOPSY: PROSTATIC ADENOCARCINOMA,
GLEASON SCORE 6 (3+3), INVOLVING 75% (8 MM) OF ONE CORE.

11. PROSTATE, RIGHT LATERAL MID, NEEDLE CORE BIOPSY: BENIGN PROSTATIC TISSUE.

12. PROSTATE, RIGHT LATERAL APEX, NEEDLE CORE BIOPSY: BENIGN PROSTATIC TISSUE.

13. PROSTATE, MID CENTRAL ZONE, NEEDLE CORE BIOPSY: PROSTATIC ADENOCARCINOMA,
GLEASON SCORE 6 (3+3), INVOLVING 10% (2 MM) OF ONE CORE.

The 13th core was taken directly from the 6mm nodule located via US.