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I wanted to share my experience cause I have some questions and want to make sure I understand what I should understand. Any comments are appreciated.
BEFORE - I asked the Urologist for some percocet or similar due to the up to 70% of folks that reportedly have significant pain during biopsy. Dr thought it could lead to constipation (with my already enlarged prostate - adding three possible impediments to being able to pee I guess) so instead wrote an Rx for anxiety pills - which I think helped. Pain is somewhat subjective and if one is fearing pain one will often experience more pain, or so the theory goes. I also took 1000mg acetaminophen as well which probably helped.
I also found an NIH document that said about 1/3 of urologists use no pain meds at all for TRUS biopsies. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4170156/ No wonder so many guys have awful experiences. See https://theprostatedecision.wordpress.com/2010/05/31/the-dreaded-prostate-biopsy-revealed/
DURING - My doc uses lidocaine topical and injected (lidocaine I think). The gold standard as I understand (or misunderstand it) http://www.ncbi.nlm.nih.gov/pubmed/16280735 Getting a filling was worse and I have never had a bad dentist visit. Actually almost a pleasant experience. I would recommend my doc but he is moving in June.
During the procedure he took 14 samples. I get results in one week. Only slight pain with first injection of pain med - that was it. Otherwise it felt like a toy gun was lightly tapping against my butt. At one point he said one of the later samples would be more painful but it wasn't.
AFTER - blood of course - I asked about a pad or whatever but they didn't do that. Have to throw away a pair of shorts now - I guess next time I will bring a depends brief. Gets kind of achy when the Tylenol wears off - but not bad at all when it kicks in.
NEXT APPOINTMENT- As I see it I have a lot of reading to do no matter what the results are that I get next week.
1) no cancer found - so how often should I come back for a psa or a biopsy or maybe the new 4KScore test - if it makes it here soon from Cleveland. http://consultqd.clevelandclinic.org/2015/05/new-blood-test-is-highly-accurate-in-identifying-patients-at-risk-for-prostate-cancer/
2) Low grade/score cancer - lots to read about whether to watch and surveil or to get it out.
3) High grade cancer - surgery or radiation or what? Being 57 I suppose surgery is the best option. There is a lot to staging that I need to learn once I get results, but I would like to be prepared to ask useful questions. Odds are 60% that no cancer is found, 23% that it is low grade and 17% that it is high grade according to the Cleveland clinic calculator http://www.clevelandclinic.org/lp/prostate-cancer-risk-assessment/index.html
Thanks for any insights or reminders to go back and read the basic pages of this site - since I may be forgetting some basics.
Hi Don, I and others could probably write a book in answering your questions. It might pay you to be a tad more specific in asking questions to elicit responses. So fire away (excuse the pun) and I shall try to give you some answers.
Regarding biopsies, as a confirmed wimp, I chose to have an anaesthetically induced snooze. Never felt a thing!!
Good point, John. Maybe I will keep quiet till the appointment and then ask more specific questions. I want to be educated but can't become an expert on all possibilities by Thursday! I have a couple recommended books to read that are filling my brain as fast as it can be filled, anyway.
Thanks for all your responses - and to everyone else as well.
Biopsy negative except HGPIN in two samples. Which means followup psa in 6 months and possibly another biopsy or MRI first in the next three years depending on PSA, etc. From what little I have read. If you know better feel free to correct me.
I am keeping my conditional membership but may not post much till the next PSA test. Thanks for your support and knowledge. A wonderful site and community of people caring for each other.
Page 179-180 of the book by Patrick Walsh was reassuring that although it is often associated with PCa and found next to cancer - it is not as feared as it once was. It just means to keep on watching and testing. My Doc suggested an MRI if PSA keeps rising before another biopsy.