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First ever biopsy today

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.

Re: First ever biopsy today

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!!

best wishes,
john

Re: First ever biopsy today

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.

Re: First ever biopsy today

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.

Don

Re: First ever biopsy today

Congrats on the good news ! Yes, I had no freezing either...and 2 low grade hits of cancer out of 13. Only one was painful. Hopefully you are done with this site.
Bob in Canada

Good News

Hi Don,
Congratulations on the good news from the biopsy. As you are now no doubt aware, HGPIN is regarded pre-malignant lesion of the prostatic, so just remember to continue screening.

best wishes,
john

Re: Good News

Yes, Thanks John

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.

Thanks for your advice and knowledge.

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