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Thread: What I Need to Know About About Prostate Biopsy

  1. #11
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    Not one bit of pain!!!!!!!!!!!!!!!!!!!!!!

  2. #12
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    Quote Originally Posted by rumaco View Post
    Not one bit of pain!!!!!!!!!!!!!!!!!!!!!!
    How did they manage that?
    I will resume more active participation when the bellicose forum culture improves.

  3. #13
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    I would not recommend it being done with local only especially if you are younger(not wanting to step on the toes of any other prostate cancer brothers!). My surgeon said it seems to be tougher on younger patients and I agree. I am 47 and had biopsy done 12/2013. I had robotic prostatectomy 1/2014 and the biopsy was the worst experience of the whole deal for me. Everyone has different experiences of course but I see no reason for this procedure to be done without sedation or better. Breast biopsies are always done with sedation where I live and this procedure is more invasive.
    Its not the end of the world if it is done under local like I experienced, but in retrospect I would ask for
    sedation.
    Last edited by anesthesia96; 05-21-2014 at 03:15 AM. Reason: extra words

  4. #14
    Quote Originally Posted by anesthesia96 View Post
    I am 47 and had biopsy done 12/2013. I had robotic prostatectomy 1/2014 and the biopsy was the worst experience of the whole deal for me.
    Yes, everyone does have different experiences. The biopsy scared the hell out of me. And, because I was so paranoid about having needles stuck in my prostate, I prolonged my diagnosis by a couple of years. I guess we could call this "watchfull waiting".
    I was very nervous during my biopsy, but amazed at how painless it was..for me.
    When the first biopsy was suspicious, my urologist asked me if I would be willing to have another biopsy. He said that he now knows where to look for the cancer. I agreed immediately.
    The second biopsy was also painless. He must know the exact spots to anesthetize because it was so easy.
    Also, I'm sixteen years older. So that could be a factor.
    Marty
    Age 64
    2/07 PSA 5.5
    2/09 PSA 7
    1/13 PSA 14.2
    12 Core Biopsy 3/13 Results Suspicious
    12 Core Biopsy 4/13 Positive for PC
    Left Apex: Prostatic Adenocarcinoma
    Gleason Score 4+3=7
    1 mm; 5% of tissue
    Size 56.4 grams
    Bone Scan Negative

    Da Vinci Surgery 6/24/13 Nerve Sparing, age 62.
    Post Op Path Report
    87 Grams (Big One), 5x5x5 cm.
    Largest focus within Left and Right Apex
    Gleason Score 3+4=7 (was 4+3)
    Positive Margins Extending to Right and Left Apex Margin
    No Extra Prostatic Extension Identified
    No Lymphovascular or Perineural Invasion Identified
    Left and Right Pelvic Lymph Nodes Negative.
    PSA 09/13 <0.05
    PSA 01/14 <0.05
    PSA 04/14 <0.05
    PSA 07/14 0.06
    PSA 01/15 0.34
    Began Salvage Radiation 3/2/15
    Completed Radiation 4/23/15
    PSA 05/15 <0.05

  5. #15
    My urologist used a local and some sort of "nerve blocker". No pain at all, just a jolt when the needle went into by sick prostate... Of course, each time I had the biopsy, it just so happened the prettiest nurse was there to assist...
    BD: 1959 PSA 4.9 11/2012 (no symptoms)
    Biopsy 12/2012 Negative
    PSA 5.9 05/2013 (still no symptoms)
    Biopsy 6/2013 3+4 (thank goodness for PSA tests)
    1 core positive (upper left), 1 suspicious (lower left) out of 12
    DRE: bump right side T1c; PCA-III = 20 (normal)

    Da Vinci 7/18/2013: Invasive carcinoma involves left lobe of prostate only, extends from left apex to posterior mid region of left lobe Gleason 7/10 (4+3); G4 tumor comprises 75% of invasive carcinoma present
    Estimated total volume of carcinoma in entire prostate gland: 10%
    TNM: T2b NX MX (Stage IIA)

    8/13 11/13 2/14 8/14 2/15 8/15 3/16, 8/16, 3/17,9/17,4/18, 9/18 PSA undetectable
    3/19: .1 (damn), 4/19,6/29 retests: .1 (damn)


    My Story:
    T-Minus-36-Hours-until-da-Vinci...
    Catheter is Out!

  6. #16
    Quote Originally Posted by ddayglo View Post
    Of course, each time I had the biopsy, it just so happened the prettiest nurse was there to assist...
    Funny, my urologist has the most beautiful nurses too. My kids even commented on this. I bet they do that for distraction!
    Marty
    Age 64
    2/07 PSA 5.5
    2/09 PSA 7
    1/13 PSA 14.2
    12 Core Biopsy 3/13 Results Suspicious
    12 Core Biopsy 4/13 Positive for PC
    Left Apex: Prostatic Adenocarcinoma
    Gleason Score 4+3=7
    1 mm; 5% of tissue
    Size 56.4 grams
    Bone Scan Negative

    Da Vinci Surgery 6/24/13 Nerve Sparing, age 62.
    Post Op Path Report
    87 Grams (Big One), 5x5x5 cm.
    Largest focus within Left and Right Apex
    Gleason Score 3+4=7 (was 4+3)
    Positive Margins Extending to Right and Left Apex Margin
    No Extra Prostatic Extension Identified
    No Lymphovascular or Perineural Invasion Identified
    Left and Right Pelvic Lymph Nodes Negative.
    PSA 09/13 <0.05
    PSA 01/14 <0.05
    PSA 04/14 <0.05
    PSA 07/14 0.06
    PSA 01/15 0.34
    Began Salvage Radiation 3/2/15
    Completed Radiation 4/23/15
    PSA 05/15 <0.05

  7. #17
    Experienced User wolfgang's Avatar
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    It depends on the biopsy type

    I had two type of biopsies done. The first two biopsies were TRUS type which stands for Trans Rectal Ultra Sound guided. Unfortunately for me both missed the aggressive PCa I already had in there. These were performed under local anesthesia and the initial shot hurt like hell. It was a long syringe (like those they use for horses) and it was stuck directly into the prostate through the perineum area (the area between the scrotum and the anus). The other needles that take samples were introduced through the rectum and were not hurting except the unpleasant sense of tearing the tissue. The anesthesia effect was almost gone before the last needle was stuck and that started to hurt a little bit.
    A couple of years later I decided to go with a new recently developed type of biopsy called Saturated 3D Perineal Mapping biopsy. Not all insurance companies cover this type of biopsy due to several times higher expenses. Depending on the prostate size, samples are taken up to 100 times through the perineum by using a template with holes on every 5mm. In my case I got punched 52 times and out of those 7 cores were malignant. If I didn't go to this type of biopsy I would be still in denial that PSA doesn't mean I have PCa. Thanks to this invention, I caught the last ship to salvation since my Gleason score was 9 and I was asymptomatic all the time while my PSA has tripled over 5 years.
    The last biopsy was performed under general anesthesia and I felt nothing at all. Much better experience than the first 2 TRUS biopsies which turned out that may miss significant cancer cores as in my case. The statistics shows that it might be up to 30% undetected PCa cases.

  8. #18
    Moderator Top User HighlanderCFH's Avatar
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    Hi all,

    I subscribe to the free Johns Hopkins medical newsletter, which often sends articles about prostate cancer. Today, a couple of very promising new diagnostic tools were discussed. Tools that might help estimate the need for a biopsy and whether a possible case of PC might be low risk or aggressive.

    They freely allow subscribers to send the newsletters to friends, so I guess it should be fine to paste the article down below for all to read.

    Thanks,
    Chuck

    Do You Really Need a Biopsy?
    Two New Tests Help You Decide

    It's the holy grail -- a prostate cancer test that can, with complete accuracy, distinguish men who have prostate cancer from those who are cancer free and, when prostate cancer is diagnosed, determine whether it's an aggressive form that requires prompt treatment or a slow-growing tumor that may only need close monitoring.

    While no such diagnostic tool is on the near horizon, a number of companies have introduced new tests that could push us closer to that goal. There's still a great deal to be learned about these tests and their proper role in the management of prostate cancer. Published studies are limited, and none of the tests has a long-term track record in the real world where doctors screen, counsel and treat patients. It's also important to recognize that prostate cancer tests can be marketed without proof of benefit and that unsubstantiated claims abound for many tests.

    For now, the tests are intended to augment -- not replace -- a doctor's clinical judgment and existing tests currently used to screen for and monitor prostate cancer. Whether the new tests add information that will significantly affect treatment decisions remains to be seen.

    Do you really need a biopsy? An elevated prostate-specific antigen (PSA) level can indicate that a man has prostate cancer; however findings may also be elevated in men with other less serious conditions, such as benign prostatic enlargement (BPE). Yet most men with elevated PSA levels end up having an anxiety-provoking biopsy to rule out prostate cancer. Two new tests appear to be able to more accurately identify appropriate biopsy candidates.

    * Prostate Health Index. Commonly known as the phi test, this assay measures blood levels of PSA, free PSA and a precursor (or early form) of PSA, known as pro-PSA or p2PSA. Research suggests that pro-PSA levels are a better indicator of prostate cancer than total or free PSA levels and that men with elevated pro-PSA levels are at high risk for having an aggressive form of prostate cancer. Using a mathematical equation, the phi test combines all three variants to better determine whether prostate cancer is present.

    The test is indicated for use in men age 50 and older whose digital rectal exam showed no signs of cancer and who have a total PSA value between 4 ng/mL and 10 ng/mL -- a gray zone that could indicate prostate cancer or a less serious condition such as BPE. The phi test doesn't deliver a definitive answer about whether or not to have a biopsy. Instead, the phi test's results, which are scored from 0 to 55 and above, reflect the probability that a biopsy will detect cancer. For example, a phi test score below 27 is associated with a 9.8 percent probability that prostate cancer is present, while a score of 55 or more suggests a likelihood of greater than 50 percent. Phi test results must be considered in light of a man's other risk factors.

    * 4Kscore. This blood test measures levels of three PSA variants (total PSA, free PSA and intact PSA), plus an enzyme called human kallikrein 2 (hK2), which is elevated in men with prostate cancer. Some scientists believe hK2 may promote the growth and spread of prostate cancer. The 4Kscore also uses a mathematical algorithm to calculate the risk of prostate cancer in a man with an elevated PSA level.

    ----- END OF ARTICLE ----
    July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA 9/ 2011 = 5.7.
    Local uro DRE revealed significant BPH, no lumps.
    PCa Dx Aug. 2011 age of 61.
    Biopsy DXd adenocarcinoma in 3/20 cores (one 5%, two 20%). T2C.
    Gleason 3+3=6. CT abdomen, bone scan negative.
    DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
    Surgeon was Dr. Matthew Tollefson, who I highly recommend.
    Final pathology shows tumor confined to prostate.
    5 lymph nodes, seminal vesicules, extraprostatic soft tissue all negative.
    1.0 x 0.6 x 0.6 cm mass involving right posterior inferior, right posterior apex & left
    mid posterior prostate. Right posterior apex margin involved by tumor over 0.2 cm length,
    doctor says this is insignificant.
    Prostate 98 grams, tumor 2 grams.
    Catheter out in 7 days. No incontinence, minor dripping for a few weeks.
    Seven annual post-op exams 2012 through 2018: PSA <0.1
    Semi-firm erections without "training wheels," usable erections with 100mg Sildenafil.
    NOTE: ED caused by BPH, not the surgery.

  9. #19
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    You need to know - that when they say "there will be blood in your semen" that it's a lot of blood. Your first few ejaculations will look like a special effect from a horror show. Or at least mine did.

  10. #20
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    My biopsy was done with local anesthesia. It was uncomfortable and somewhat painful. I had slight nausea for about 3 days after the biopsy. I also was somewhat incontinent for about 24 hours after the biopsy.

    Drink lots of water for two days after the biopsy. There will be blood in your urine, which can lodge in the urethra. Drinking lots of water will flush out the blood quickly. If you don't drink water, some blood might coagulate in your urethra, causing some pain when you urinate. So, bottoms up!

    I had blood in my semen for about 5 ejaculations. You may need to ask your partner to lend a hand to help clear the blood out of the semen.
    4/2013 PSA: 2.4
    8/2014 PSA: 4.8
    9/2014 PSA: 4.4

 

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