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Just completed biopsies

CowboyBob
Posts: 2
Joined: Oct 2013

Thank you all for your contributions to this site. I have gleaned consdierable information from the first hand experiences I have read here. My story is just begining. Have a family history of prostate cancer with my father undegoing RP and subsequently radiation therapy for Gleason 4+4.  I have had some obstructive symptoms for several years and a PSA of 5.0 (age 56) led to a urologist referal. He repeated the PSA (right afetr the finger wave) which was up to 7.0

 

Had an ultrasound of the prostate with an estimated size of 47 cc and PSA density of just shy of .15 Urologist identified a couple of hypo-echoic but ill defined areas and had the prostate sampling (12 biopsy specimens) taken under a a local anesthetic (that smarted a bit!)

 

That was 4 days ago and I am still having a dull ache in the perineum. Although I have already had my biopsies, I am wondering what people think about the course of my evaluation. What do you think of repeating the PSA right after  an agressive digital rectal exam and using that value as a predicate for ultrasonography/biopsy? Was the urologist being over agressive?  Do most people still have some discomfort several days after the biopsy procedure. (had a little blood in the urine and in the semen (that hurt a bit too))

MichaelF1002
Posts: 54
Joined: Mar 2013

Hi Bob, welcome to the forum.  As you have already learned, there are a lot of well-informed and helpful folks here.  Even though my biopsy was only 6 months ago, I don't remember much about it except that it hurt during but not much afterwards.  As far as the PSA test after the digital exam goes, according to Johns Hopkins' Dr. Patrick Walsh, author of Dr. Walsh's Guide to Surviving Prostate Cancer, it should have been the opposite -- PSA first, then digital -- as the digital itself could cause a rise in PSA. He says blood in the semen, sometimes for several months afterward, is normal.  He mentions blood in the urine, but says it is normal "immediately after the procedure," and that the bleeding "should" stop the same day or the next day. He says that if there is blood in the urine that is "significant" or "lasts more than a few weeks," you should call your doctor immediately.  I would call now to see what he has to say. Let us know the results of the biopsy. 

Regards,

Michael

VascodaGama's picture
VascodaGama
Posts: 1528
Joined: Nov 2010

Bob

You got reliable answers from Michael above. The PSA results from blood sampled after DRE cannot be used for diagnosis. Your doctor may be of the group of those that do not believe in the PSA test (and there are many) so that he gave more importance to the DRE results and to your family history with PCa, to consider your status. The PSA test was merely used to complete the initial diagnosis as a high or low result. However, by having a father with cancer one is at threefolds of high risk (150%) for contracting it. Read this;
http://www.cancerresearchuk.org/cancer-info/cancerstats/types/prostate/riskfactors/ 

The biopsy is a simple procedure but painful if it causes inflammation. You can take some pain killers while waiting for the results.
What is surprising is that the size of your prostate is at the high end of normal classification, which could be ruling an existing BPH case. That would also justify your “obstructive symptoms along the years”. The condition could be also behind your high PSA of 5 (ng/ml).
In such a case doctors recommend firstly a protocol of antibiotics and then go through a series of image studies before embarking on a biopsy.
Your doctor by his experience seems to have already considering you a prostate cancer patient.

In any case, you have to wait for the biopsy results and should prepare yourself for whatever answer you will receive. Having PCa is not the end of the world. There are many ways to treat it and get cured.

Should the result be positive, you should get second opinions from proper specialists. You should do things coordinately and timely.

Best wishes and luck in your journey.

VGama  Wink

Are you a real Cowboy? One of those that ride horses and drive herds along arid fields as the ones we see on the movies?
Riding horses may cause high levels of PSA serum.
Cool  Cool

CowboyBob
Posts: 2
Joined: Oct 2013

The urologist called and let me know that all the biopsies were negative for cancer and he wants to see me again in 6 months. So , good news. Thanks for all the information

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