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PUBLIC SERVICE ANNOUNCEMENT: For those getting a prostate biopsy....
First-get your biospy. It's the most important thing you can do to get yourself treated to move past this difficult time. I'm just sharing info on my prostate cancer biopsy experience from a newby.
Things my doctor didn't tell me...
Yes, they told me to expect some blood when you urinate and poop for a few days after the biopsy But, they never mentioned blood when you ejaculate. Holy murder-was that incredibly disturbing. It's a lot of blood too, much more than urination. Goes on for a while too, but gets better over a few days (eventually changes color from bright red to a muted maroon and then goes away) So, be forewarned.
A positive is that they do a very good job at numbing you up before inserting the probe up your butt as you lay your side. They position the probe using a sonogram-like machine. Inside the probe is a spring-loaded needle that you don't really feel much because of the numbing shot, which I wholly appreciate. But, you can totally feel the pressure as they press the probe against your prostate...and then shortly after, they trigger the spring-loaded needle. So, after the first needle jab , I was wincing, awaiting the inevitable spring sound for the needle jab. So, it's more the sound than the actual poke that plays with your head. It's kind of akin to getting a glaucoma test at the eye doctor as you wait for the little poof of air...but, yeah, a whole lot different.
They had me take some valium before the procedure because I not a person enjoys things up my butt and tense up. I don't know if the valium helped or not, but guessing it made things better. Valium didn't affect me much, but I did feel sleepy later.
I'll also mention that I was under the impression that for most biopsies they do 12-15 core pokes. Mine was 24...so the whole time, I was like....OK, no doubt, they definitely know its cancer. Maybe they do more than the 12-15 as standard practice now, but it was what I had read.
Another thing I experienced is that even though I didn't need to get up at night to urinate, pre-procedure, I definitely did have to get up at night after the procedure for a while. I think it's because your prostate is angry after having 24 freaking holes poked in it. The good news is that settled down after a week or two. (yes, I"m fortunate not to have such an enlarged prostate that I have get up through the night).
So, perhaps you all get more info ahead of time...but that was my experience.
Big picture; You need the biopsy to get information because they can treat you and save your life. In my case, they found where the cancer was located and you want all the information you can get.
Extra factoid I just learned: You always hear that the size of prostate is the size of a walnut (20-30 cc). But that is only for men under the age of 30. But, by the age of 60, the prostate typically will grow to the size of a lemon or tennis ball (40-50 cc). In my case, I was 45cc. There's lots of variability by individual. But, yeah, a walnut sounds small. A tennis ball in your pelvis is definitely going to affect things. The good news is that an enlarged prostate does not mean you have cancer.
I figure knowledge may not be power as patients, but it does help you process what is happening.
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@jc76 Gosh, I wasn't offered that option...but wish I had. If the trasnperineal biopsy is more accurate and less likely to create infection, I 100 percent would have chosen that option.
Note to newbies who are reading this list, definitely ask to ge tthe transperineal biopsy.
Either way, I rolled with the punches and they got the info they needed; 9 of 24 cores positive, rated a 3+4=7.
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1 Reaction@grandpun
Wow! You are a trooper. Seems like they shoulda given you a bullet to bite on or a shot of whiskey.
@bobgolf Glad yours were relatively painless. Mine was so much pain as for discomfort....trying to relax as they probed and then keep my mind calm as they poked. But, I got through.
My plan is to do surgery next, so maybe I won't have to have another biopsy like this for a good while.
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1 ReactionFor those who have had a biopsy (bx): When a hallmark reason might suggest a need for an additional one get the EpiSwitch test [PSE]. It is quite accurate for detecting prostate cancer. If it shows very low risk then you may defer the biopsy. Be aware that this test will impact the way urologists practice in the future
and may not be greeted with joy at your desire to obtain its information. The test was developed in the UK at East Anglia University. Oxford Biodynamics is the production company. If the test is not available at the shop your provider operates out of Quest diagnostics can accommodate you with a written prescription.
Medicare accepts it.
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2 ReactionsI chose to have a perineal biopsy for a few reasons.
One was supposedly less infections would be possible compared to rectal. It made sense, as the rectum is loaded with organisms that are not good if they get into other areas of the body. So far though, as far as I know, data shows no big difference probably due to the antibiotics they give you when undergoing a transrectal biopsy.
The other reason was there is a problem with all this antibiotic use that is leading to the creation of antibiotic resistant strains of bugs. Apparently the drug companies don't make enough on new antibiotics, so there isn't much in the pipeline in the way of new antibiotics. Less or no antibiotics are apparently the norm with transperineal, so do one for the team, and request transperineal. At least that's how I looked at it. Some jurisdictions have abandoned trans rectal biopsies altogether - the U.K. for instance.
Some docs report that they get patients reporting a bit more pain with transperineal.
My experience was hardly any pain. The worst was when the doc inserted the first needle - it contained some pain killer, so needles after that did not hurt at all. I had blood in my urine and semen afterwards, but very little and it was dull brown in color. No copious quantities of red blood. I didn't like the what seemed to be loud clicks as the doc pulled the trigger and seized another bit of tissue, but I got used to them after the first few.
Overall, I concluded, if that's the worst thing that I experience on my prostate cancer journey, its no problem at all.
I've been sentenced to ADT, HDR, and EBRT. Had I done PSA testing with more diligence, and accepted my first urologists prescription for a biopsy right away instead of delaying a number of months, perhaps I would not be facing as much treatment. The treatments are liable to be way more of a problem than any biopsy....
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3 ReactionsThey put me to sleep. Can't say I had any of the problems you had. A little blood for a couple of days. Just wasn't a deal. Didn't sprint home to shag the wife either.
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1 Reaction@chippydoo Wife probably appreciated that 🙂 Guess there's a few out there who had more side effects than others.
@climateguy Yeah, but please don't beat yourself up now. Regret is a tough burden to carry. You had no way of knowing what was ahead. None of us do.
Thanks for sharing your transperineal experience. For me, just a hint of blood in urine. But, a ton in semenial fluids. That was the shocker for me.
@fritzo
We were all newbies at one point. PC is such a widely researched and discussion topic. I came on Mayo Community Connect (MCC) 3 years ago. I had not idea it was out there until I heard it at Mayo Jacksonville seminar on PC and it was mentioned.
My urologist tried to have mine done transrectal. I had no idea what was out there other than he going over the two types, why, and pros and cons. He did not want to do my transrectal as it would require being under anesthesia and he did not want to that as I have heart failure.
So he went over the two pros and cons and I decided then, no, I want it transperineally. So I contacted my heart failure (HF) specialist who encourages me to exercise and approves me doing Sprint Triathlons to contact my urologist as I wanted done transperineally. My heart failure doctor contacted him saying there was no negativity of me having anesthesia. Urologist then contacted me and said I was told no concern by your HF so we will do transperineally.
Again many on MCC will post did not have a problem with transrectal. But I did not want it being done through my rectum, and I wanted to be asleep, and when he told me there was 2% increase in infection rate but if I got infected would only have to spend a couple of days in hospital.
Good luck on your journey!!
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1 Reaction@fritzo Yes seeing pure blood come out instead of semen can be a real shock!