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No tolerance for pain !!

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Posted 3/20/2007 1:14 AM (GMT 0)

 I have a biopsy scheduled for May 8th and am hearing all sorts of "war stories" from friends that have had this procedure as to the pain level. One big guy, about 40 said it was "the worse pain he had ever experienced". Another, a little older said it was "not so bad".

My path to this point is about 7 years long and has seen psa #s from 2.3 in my late 50s to 5.2 this week. (I will be 67 in Sept.) The 5.2 was due to doubling a 2.6 test score a week ago due to taking "Proscar" for about 90 days. In reading all the posts due to Walt's comments I did not see anything about Proscar causing the tests scores need to be doubled. Is this in fact the case?  The nurse practitioner in my Urologists office said " it is time we stopped dancing around this and do the biopsy" and get more information than just the psa test.

I have read a lot about the anesthetics being injected in the gland to ease the pain. Any comments from you guys will be very much appreciated.

BTW I live in Dalton, Ga. " The Carpet capital" about 30 miles south of Chattanooga and 90 miles north of Atlanta. My Urologist is fairly well known and respected and has been practicing for 15 Years.

Posted 3/20/2007 1:39 AM (GMT 0)
Hi,

We have been on Avodart since our biopsy results and yes there is a factor you have to multiply it by (proscar is similar ... and i understand they use the same "multipliation" tables for both). Although for only three months, the recommended multiplication factor is a little less than 2.0 (1.5 I believe). It is 2x if you have been on it for six months or longer.

But that still means your PSA is going up, ideally it should have decreased on Proscar.

For instance, Ken's PSA was 3.7 before biopsy. We started avodart after the biopsy showed cancer to reduce the prostate for surgery and (maybe?) slow any tumor growth (totally experimental). His second PSA taken a bit less than 4 months later was down to 2.4 from 3.7, but was multiplied by 1.6 for a PSA of 3.8, still slightly up after mulitplying it.

about the pain, Ken has had three and found them all "not bad", but people have different pain thresholds. They can do anything from giving you something like valium or even putting you slightly out with an IV (like they do for colonscopy's where you barely remember anything). So please don't let that stop you from a biopsy.

Tanya
Posted 3/20/2007 1:54 AM (GMT 0)

Hey Painless, I too worried about the same.  Get the lidocaine injections and it's ok.  Check out Biopsy - an opinion.  It's probably several pages back.  It's what I experienced.  Good luck.

Bill

Posted 3/20/2007 2:01 AM (GMT 0)

Tanya! Thanks so much for the quick and very informative reply. As I stated earlier, my path to this point has been several years in length and the PSA scores have gone up and down during that time. I guess it is natural to be aprehensive about a procedure like this especially after some of the comments from my friends.

I had sort of an unusual experience in the doctor's office today.The nurse that explained the biopsy procedure and it's preperation was standing next to me at the receptionist's desk while I was waiting to get my appointment card, when she hugged me! Then while I was signing the credit card receipt she was patting my hand like a little boy!! I thought I might ought to contact the funeral home on the way back to work! Not really encouraging!

Painless

Posted 3/20/2007 2:05 AM (GMT 0)
Naw, she was just being sweet.
Posted 3/20/2007 2:18 AM (GMT 0)
painless,

Ken has had yo-yo PSA's for several years too, 4.0 three years ago (biopsy negative). He took some aggressive diet/suppllement things to try to lower it. Then 3.4 two years ago (still requested biopsy, again negative). Then last fall, back up to 3.7 (biopsy positive).

He has been pretty agressive about getting biopsies just because of history of it in his family.

*Smiles* on the nurse, sure she was just doing things in her fashion.

I hope your biopsy is painless and negative. Just remember to keep monitoring your PSA as you have been doing even if your biopsy is negative.

Best wishes!

Tanya
Posted 3/20/2007 2:32 AM (GMT 0)
Hey Painless,

My biopsies didn't hurt, they just made me nervous cause they were messing around back there. They put some pain killer in first and the actual sampling just feels like a little zap, not painful. The noise made me jump.

Considering the information you will get (PCa or not) it is well worth the discomfort...

Jim
Posted 3/20/2007 4:37 AM (GMT 0)
Hi Painless: Don't worry, it's not a painful experience. It sounds to me like you could use sedative for the procedure. I took 2 mg of Ativan and it helped immensely. Ask your urologis to prescribe something that will calm you down and have someone drive you there and back. It's really no big deal. Not painful, but differrent. If your friend said it was "the worst pain" he'd ever experienced, he's a lucky guy.
Posted 3/20/2007 11:09 AM (GMT 0)

I am very afraid of pain. When I had my biopsy I was very scared. There was absolutely no pain or discomfort. The only thing I felt was two tiny "pricks" when they did the anesthetic. The anticipation was terrible but the actual procedure was easy.  Ed

Posted 3/20/2007 11:57 AM (GMT 0)

Thanks to all! Your posts are a source of great comfort and calming! They are just what I needed. I will keep you posted on my progress. The reason for the long wait for the biopsy is my wife and I are getting to go to Israel in mid April! We are very excited about this as you can imagine!

Thanks again and GOD bless!

Posted 3/20/2007 1:36 PM (GMT 0)
Painless

The only thing I will add to what eveyone else has said and it was not that bad at all during the biopsy was I did have some discomfort afterwards but a couple of tylenol and down to rest with a short nap and I was fine the rest of the time. The aticiipation was worse and probably wore me out and I needed the nap.

norskie
Posted 3/20/2007 4:42 PM (GMT 0)
If a person plans on hurting I'm sure that is exactly what he/she will feel. Plan on some pressure, 2 small pricks and a popping sound with every core sample taken. No, it isn't a picnic but a prostate biopsy is less evenful than going to the dentist. The location is slightly more stressful but I'd still prefer a biopsy over a root canal anytime.

Paul
Posted 3/20/2007 6:23 PM (GMT 0)

I found from reading here that different urologists have different procedures for biopsies.  Some have you walk into their examing room give you a pain shot (or not) and then get the samples. My biopsy was very formal and at an "out-patient surgical center'.  The procedure was done with an automated surgical device, followed up by my doctor taking specific samples from a small growth he had discovered.  I was sedated with an IV injection and was only semi conscious during the procedure. It was simple and quick.  No pain at all.  I did have a little discomfort the next day, but it was minimal. Don't worry about the pain.

Posted 3/20/2007 9:06 PM (GMT 0)
Hey Paul,

Thanks for sharing Swim with us. She is a great comfort and source of knowledge for us.

Gook luck....

Jim
Posted 3/20/2007 11:01 PM (GMT 0)
Thanks to all for your support and information. Keep well. I will let you know how my biopsy turns out.

Painless

Posted 3/21/2007 7:35 PM (GMT 0)
Hi painless:

I was like you.

I got on the internet the night before my first schedule biopsy and freaked myself out because I was convinced I would die from it. But I did learn one thing:
* Pain factor for biopsy without lidocaine is 6 (scale 1-10)
* Pain factor for biopsy with lidocaine is 3

So I vowed my biopsy would be with lidocaine.

What I learned the next day was that not all places offer lidocaine and where I was to have my biopsy did not. So I freaked out and just walked out.

It worked out for for the better because I got a new urologist (that did offer lidocaine) that I liked. When I did have my biopsy with lidocaine, I would say a 3 is a fairly accurate grade of my experience. The most uncomfortable part of the experience was shoving the instrument up my *** (and that really was not all that bad).

So make sure you get the lidocaine and it should be ok.
Posted 3/21/2007 8:29 PM (GMT 0)
When I had my biopsy, I had no pain at all. There was a little pinch and burn when the doctor applied whatever anaesthetic he used, but nothing to write home about.

The anticipation of pain was the real issue. As the doctor probed around, before he took a core, he'd pause, so you knew the sample was about to be taken. The sound is a bit scary. Not being able to see what is going on, the thought that came to mind for me was a staple gun going off in your ass. So I winced for pain, but didn't feel anything at all.

I am a bit shocked to hear that having pain meds for this is optional...

The prostate MRI, however, that was hella-painful...
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