Received MRI Results Today

I had the transrectal, transpereneal wasn't available at my provider. It was much easier and less painful than I had feared. I had read some descriptions of bad experiences here and on other postings. My urologist had done a lot of them and I think his experience was probably the most important factor.
As for infection risk, in addition to thorough prep cleansing (think pre-colonoscopy), they gave me an antibiotic pill to take the night before the procedure plus a shot in my buttock just before the procedure. That shot actually hurt more than the biopsy!
The biopsy itself included a local anesthetic which I believe was applied with the same tool that contains the ultrasound head and that fires the needles. That numbed the area where the needles penetrated. Then he warned me each time before he "fired" them so I wasn't surprised. There were pauses as he studied the ultrasound image to target specific zones. He had the benefit of several MRI's but the actual procedure was not fusion guided.
The "firings" felt like a strange, snap sensation but no pain. The procedure was over in 15 or 20 minutes including talk time, undressing and getting situated on the table. Easy-peasy!
I had actually postponed the biopsy quite a few months out of unwarranted fear.
One thought I had that got me over the hurtle of fear was to ask myself, why wouldn't I accept a biopsy of a likely cancerous tumor if it was anywhere else on my body? That forced me to face the fact that all I had to fear was fear itself.
Just my two-bits worth. I hope it helps and all goes well with whatever you choose.

Thank you for sharing this. It sounds like you didn't have an infection which for me and many is the most concerning.

You're welcome! No, no infection. The biopsy pathology was (3+4)7 , favorable intermediate and my subsequent RARP surgery pathology was the same i.e. wasn't upgraded to an 8 or 9. So the biopsy was very similar to actual conditions. I know the needles can miss the cancer.

By the way, I am 78 and surgery was 7 months ago, PSA 0.009 (3 mo) and 0.006 (6mo). No regrets, here.
Best

Good to hear. I don't think surgery will be offered because of my age (84). I'll look at other options once the biopsy is done (right now scheduled for 20 Feb).

I am researching radiation treatment for prostate cancer. I have an intermediate case and was advised by my Urologist to meet with radiation oncologists due to my age. Has anyone been treated with Cyberknife or HIFU (high intensity focused ultrasound) and, if so, I would appreciate hearing about your outcomes, including side effects like incontinence and ED. Thank you

I don't remember if it was the CyberKnife brand, but I've had SBRT twice — once post-op after the metastasised tumour was removed from my spine (20 gy spread over 5 days), and once to the prostate itself (60 gy spread over 20 days).

The procedure itself each day is quick and painless. There are some expected outcomes from radiation to the prostate, like losing the ability to ejaculate (your orgasms become dry), but otherwise, most people either have no side-effects, or mild ones that disappear in a few weeks or months

I was an exception, since I did end up with mild radiation cystitis (bladder irritation) that seems to be permanent. I should mention that since I have stage 4 we knew the cancer had already escaped the prostate, and they promised to "throw the kitchen sink at it"; your treatment might be more tightly targetted.

I suffered a few months of urge incontinence due to the irritation (and a couple of UTIs), but now I barely notice it unless I drink too much caffeine, alcohol, or carbonation together, or let myself get dehydrated. Definitely worth it, from my PoV.

Surgery wouldn't have made sense for me, because it wouldn't have dealt with any cancer that had spread just outside the prostate. Radiation (at the level I got) is as effective as surgery for the prostate itself, and also catches any adjacent spread.

I did not have SBRT (Cyberknife or Mridian/Elekta MRI guided), but had 25 IGRT sessions for recurrent cancer.
But many men “of age” do choose a 5 session treatment since the side effects are much less than surgery ( no recovery either) and the outcomes are the same.
I personally know men who’ve had it and they all give it a thumbs up.

Thank you. This is very helpful.

I had Tulsa Pro in July. Painless and no incontinence or ED. No sign of cancer on my 6 month follow up. My experience: https://connect.mayoclinic.org/discussion/tulsa-pro-experience-mayo-clinic-mn-july-2024/

Thank you very much. Your experience strengthens case for targeted radiology. Best regards