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Biopsy – Concerns with lack of information from doctor

danegg
Posts: 1
Joined: Jun 2018

During my regularly scheduled physical exam as a fire fighter, the doctor found a nodule on my prostate during a DRE and referred me to an urologist. My PSA is 0.3 for three consecutive years, but he felt a follow up with an urologist was warranted.

The first urologist did a DRE and based on my age (56) and lack of family history, he told me to wait six months and perform a follow up PSA test.  I obtained a second opinion and the second urologist told me a TRU biopsy is recommended. He felt a hard nodule and believed that a TRU will collect enough samples to determine if the nodule is malignant (he gave me the talk that 25% of nodules are malignant).

The biopsy is scheduled for 4 week out. What should I expect? Of course, my mind goes to the worst case scenario, so I am looking for similar experiences. Any feedback or advice is greatly appreciated.

Thank you!

Dan

VascodaGama's picture
VascodaGama
Posts: 3030
Joined: Nov 2010

I translate your term of "TRU" into "trans-rectal ultrasound" (TRUS) biopsy. This is the traditional biopsy done with a template of 12 to 14 needles to check for prostate cancer. I would recommend you to request the urologist to direct at least one of the needles to that area found in the DRE.

You did not inform us your age but the PSA of 0.3 could be low if you are a 50 years hold. However, we know that aggressive high grade Gleason cancers produce lesser amounts of PSA serum. I hope this not to be your case, but the positive DRE needs to be checked for peace of mind.

Best wishes,

VG

 

Clevelandguy
Posts: 461
Joined: Jun 2015

Hi Dane,

With my case my digital rectal exam showed no lumps or buldges but yet I was confirmed with 3+4 via a biopsy after they did the MRI.  I wonder if there might be other places inside your Prostate that could be hiding cancer.  I think what I would do is ask for a MRI before the biopsy to check out the rest of the Prostate.  As in my case cancer was there but was not detected during the rectal exam.  The MRI could also point them to other areas if they are detected on the MRI to biopsy. 

Just my 2c worth................

Dave 3+4

Rickdean
Posts: 17
Joined: Mar 2018

If you are talking about the biopsy itself don't worry.  My doctor had me take an Oxycodone .75 and a .5 valium 30 minutes before biopsy.  He prescribed it a few weeks before.  Make sure they numb the prostate before taking samples.  The numbing is slightly painful but the 12 samples they took from me were almost painless.  No pain or blood after the biopsy.  Its like it never happened and I was in Walmart 20 minutes later.  No big deal at all.  This all happened about 6 months ago.

Grinder
Posts: 441
Joined: Mar 2017

I know a cancer diagnosis will sound ominous... but with today's treatments it is not the scary near death sentence it used to be.

I myself am an anomaly because I was expecting, even hoping for, a cancer diagnosis because I wanted to get my prostate out as I was dealing with a recurring staph infection that was increasing in frequency.

If you have prostate cancer and it is contained in the prostate, you have several treatment options available to you. And prostate cancer treatments today are no worse than visits to the dentist... with the exception of the biopsy itself, which is a much worse procedure than the treatments themselves.

So "worst case scenario" is not "you have prostate cancer" anymore. Worst case scenario is you did not have your prostate checked regularly and the cancer broke out of the prostate or invaded surrounding tissue and has now metastasized and invaded other organs and has become too diverse to treat effectively. THAT is the worst case scenario, so as the song says...

Don't worry, be happy.

Rickdean
Posts: 17
Joined: Mar 2018

Regarding the Biopsy....If the Doctor numbs it first with a local the procedure is nothing.  Actually I thought it was kind of fun watching the doctors computer screen as he positioned the probe.  I almost told him...."you need to get that side too".  No worries.  3 months later I had it removed.  You can see my day after surger video here.  3 month post surgery my PSA is .09.

https://youtu.be/VT5ThDnq0Kk

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