Anesthesia for a Prostate Biopsy

Posted by rick137 @rick137, Mar 2 11:14am

Given DRE, PSAs and MRI results to date which indicate possible prostate cancer, my next diagnostic is a prostate biopsy. Because I have intermittent AFib, although I consider well controlled by careful attention to diet and exercise regime, the urologist needs cardiac clearance before doing the biopsy in a clinic environment. Fair enough. However, the cardiology resources are in great demand so cardiac clearance would be several months. The alternative is doing the biopsy under anesthesia which I welcomed since the wait time is only a month. Well, hopefully since I have to pass anesthesia clearance. I had two operations under anesthesia in 2017 without issue but then I was 76 and now am 82. I am in no way questioning the procedure, just would like to know any comments from people who have had a prostate biopsy under anesthesia.

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@rick137

My understanding is the standard at Mayo Phoenix is also an in-office procedure done with a local. Anesthesia in my case will be a work-around for not being able to obtain timely cardiac clearance.

Given the importance of the biopsy I am surprised it was done by a PA. Was it a MRI fusion biopsy?

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It was not real time MRI fusion, but they used the MRI along with ultrasound to pinpoint the lesion from the MRI. They then randomly sampled both sides of the prostate in addition to the focused lesion.

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Over the past 7 years I’ve had two biopsies. Both times, from two different urologists, a numbing agent was used. No pain or discomfort at all. The only side effect was I urinated a small amount of blood for a couple of days. The second biopsy, at age 71, showed two cores of cancer, and I had my prostate removed in November. So far all is well. Good luck with your decisions!

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I have just had an MRI scan and then needed a petscan. I now need a biopsy. My question is does the petscan identify the presence of actual cancer or just that there is something there that needs to be further investigated?

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@klem55

I have just had an MRI scan and then needed a petscan. I now need a biopsy. My question is does the petscan identify the presence of actual cancer or just that there is something there that needs to be further investigated?

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Imaging studies (CT, MRI, PET, etc) can be "suggestive of" or "correlated with" cancer, but NOT diagnostic. For that, you need to look at the cells under a microscope, which requires a biopsy or surgical speciman.

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Not taking into consideration your specific case, I believe everyone has a level of tolerance. My first biopsy was in office and was a horrible experience for me. Second biopsy was with anesthesia. Didn’t have to think about it. Just went to sleep and woke up. Done! I wish you the best of luck on your journey with PC.

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@jbonsoe

At 77 I also had my biopsy in Urologist's office. My PSA 4.6 I had been told by GP not to worry about it. However, my Uroligist was and asked me to agree to biopsy. Doctor administered lidocaine which kept me as comfortable as possible.
I decided to go to Mayo, Rochester for a second opinion. Mayo's recommended Proton 5 treatments. To prepare for that I had Space OAR injection. They told me I could do without anesthesia if I wanted. However, the tech who got me ready strongly recommended that I agree to mild anesthesia which would put me in a semi awake state and not remember anything of the procedure. I am happy I did that. I could hear voices, faintly, but not remember anything that was done or said. The 5 Proton treatments were a piece of cake with none of the side effects other people I know who had Photon treatments.

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jbonsoe,
I agree with you 100%. I think what should be stressed is some can deal with anxiety better than others and thus not having anesthesia or just a local. I have PTSD with anxiety/panic disorder so I wanted anesthesia. You are right it is NOT deep it is light.

When I mentioned Mayo Rochester it was coming from urologist at Mayo Jacksonville. He is the one who told me a urologist had developed a procedure there to just use local anethesia which appears the procedure is no more wide spread that when I was told which was over a year ago.

When I had my markers and Space/Oar done it was done with local anesthesia not general. I was nerve racking and I was using laughing gas and tranquilizer. If had been given option would have chosen anesthesia. The anesthesia used now with these types on non deep surgery is usually propronol. It really brings you down but not out. What it does do is eliminate your memory of the procedure and nothing done during it.

I would have liked to have the 5 dose high dose but my UFPTI radiologist/oncologist wanted to do the 30 rounds. They do a lot of research on both high dose and low dose. My PCP at Mayo also does research on treatments so can recommend to his patients. His research showed some increase in side affects for high dose. But I would expect this as it high does and probably side affects are sooner that with low dose done over 5-6-8 weeks of treatments.

Again for me the mental anxiety is big and would have like to have got it over more quickly but I listen to my radiologist/oncologist and my PCP which help guide me as well as a lot of research I did on my own.

If I had to do it over choosing 5 dose or 30 dose quite frankly don't know. Heard so much different opinions and outcomes it comes down to making a decision for yourself and what is best for you mentally and physically.

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I’m 74 and I had my biopsy done under anesthesia. Totally out! Talking to other men in PC groups I think I did the right thing. More the one person said they wished they had been under.

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@klem55

I have just had an MRI scan and then needed a petscan. I now need a biopsy. My question is does the petscan identify the presence of actual cancer or just that there is something there that needs to be further investigated?

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@klem55, did you have your biopsy in the meantime?

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@colleenyoung

@klem55, did you have your biopsy in the meantime?

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No I just had it 2 days ago. The doctor for waiting times and travelling distances got me to do the petscan first.

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Just remember when they say......" a well lubricated ultrasonic probe about the size of a finger"..........the "finger" they reference is on the hand of Andre the Giant.......

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