May 04, 2011 - 12:18 pm
Before my biopsy and surgery I benefitted from reading comments from others on this message board, so I would like to share my own experiences with the prostate biopsy process. Everyone’s experience is different, but my hope is that some portion of this may prove useful to others. In my humble opinion, reasonable people may come to different conclusions about treatment options, but the decision to have a biopsy in the first place, if even slightly indicated by PSA, should not be swayed by concerns about the procedure itself.
Summary for me, the biopsy was no big deal at all. Barely more uncomfortable than a routine trip to the dentist. I admit some anxiety beforehand, but it was misplaced. I was fortunate to have a very competent, gentle urologist. As they say, “your results may vary”.
Procedure was done as out-patient in the urologist’s office, with local anesthetic. No pre-procedure enema was required. First, the doctor inserted a narrow lubricated ultrasound scope up my rectum. The key is that the doc did this Very, Very Slowly. No problem, no pain. Then a small dose of quick-acting surface anesthetic was applied to the rectum wall facing the prostate, similar to the first anesthetic dab at a dentist. Then a needle anesthetic was applied to that same spot to provide broader internal anesthetic coverage. Again, similar to a dental anesthesia procedure.
Then twelve core samples were taken, via a spring-loaded needle extracting small amounts of tissue from different sample locations throughout the prostate. I learned that the samples were neither evenly spaced nor randomly distributed throughout the geography of the prostate, but rather concentrated where prostate cancer is typically found. I learned there is some “art” to this process of hunting for cancer in the prostate. The taking of each sample felt only like a small “bump” on my prostate, with a “clicking” noise, but no pain or discomfort.
The actual process took less than 15 minutes, with the whole appointment less than one hour. I felt fine enough after to go on with an otherwise normal day. No lingering pain. I did have a little blood in my urine continuing for about five days after the biopsy. No bowel movement problems. No apparent blood in stool. I had a slightly elevated temperature (high 99’s) for about three days. I learned that staying very well hydrated helps flush out the bladder and any lingering blood and little micro-clots. Antibiotic pill the day before, day of, and day after biopsy.
Alas, the biopsy results came back positive. Although this sounds perverse, I was actually relieved at the positive results, because I just “knew” that prostate cancer was there, based on my PSA value and its fast rise in one year. Had the doc not found it this time, I would have had to wait a few more months for another biopsy, thus delaying needed treatment. I am now two weeks past a successful DaVinci Robotic prostatectomy surgery, but that will be the subject of another post.
Summary: Don’t fear or delay a prostate biopsy, if at all indicated. It could save your life. Corollary: Have your PSA checked very regularly.
About me: 58 years old, otherwise fit and healthy, no meds, PSA 5.1 Jan-2011, +2.6 in 1-year; Biopsy Feb-2011, 3 of 12 cores positive, 25-30 % cancer in those three cores, Gleason 4+3=7 (left & right); CT scan and bone scan Mar-2011, clean; DaVinci Robotic surgery Apr-2011, pathology organ-confined, negative margins, lymph nodes and seminal vesicles clean, Gleason downgraded to 3+4=7 left, 3+3=6 right, cancer ~ 5% of total prostate volume.