Guest guest Posted January 25, 2011 Report Share Posted January 25, 2011 As the lurking spouse of a 6 yr survivor of a RRP, let me echo Terry's words: As to your concertn about biopsy: there is absolutley no reason for this to be painful. If you are concerned about pain, then ask your docor to provide you with local anesthesia. If he or she is not inclined to do that, change your doctor. The sooner you take charge of your own health decisions and make these with a competent medical advisor the better for you. It should only be a mild discomfort. Local anesthesia and maybe even a Valium (or some such) to calm you should definitely be an option for you. Bonnie Welcome to the site, . You’re not Crusoe in being worried/concerned/frightened at the thought of a potential cancer diagnosis. Most of us have been there and done that – and most of us have come out the other side to live our lives. Can I suggest you might get some comfort, because you will get some information, from a booklet I wrote specifically for newly diagnosed men and for men who might be concerned about a prostate cancer diagnosis. I called the booklet A Strange Place and you can read it and download it at http://www.yananow.org/StrangePlace/index.html If you would lke me to I’d be happy to send you a hard copy if you give me your postal address – my e-mail is terryherbert42@... You might also like to read PSA 101 at . This will give you a better understanding of the vagaries of PSA. As to your concertn about biopsy: there is absolutley no reason for this to be painful. If you are concerned about pain, then ask your docor to provide you with local anesthesia. If he or she is not inclined to do that, change your doctor. The sooner you take charge of your own health decisions and make these with a competent medical advisor the better for you. This can be a frightening time and it is important to bear in mind what Dr Jon Oppenheimer, one of the leading pathologists in the US has to say on his blog at http://theprostateblog.blogspot.com/ For the vast majority of men with a recent diagnosis of prostate cancer the most important question is not what treatment is needed, but whether any treatment at all is required. Active surveillance is the logical choice for most men (and the families that love them) to make. All the best Prostate men need enlightening, not frightening Terry Herbert - diagnosed in 1996 and still going strong Read A Strange Place for unbiased information at http://www.yananow.org/StrangePlace/index.html From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of QuillSent: Wednesday, 26 January 2011 7:06 AMTo: ProstateCancerSupport Subject: Biopsy Help Hi folks new to the group here. I had a check up a few months ago with regular GP and he sent me to a specialist urologist. He checked me over and said I need a biopsy as I had a hardness on one side of the prostate. I didn't get it done at the time as to overwhelmed. I did go back though and had another check up and he said it was still there and my psa has risen a touch in four months from 2.79 to 3.01. I did reluctantly ok the Biopsy but just scared to death as some say it is so painful other say its not so bad so I don't know what to expect. Just thought I would ask here if someone would like to chat about things. My doctor here doesn't seem to want to talk to much five minutes tops and says just have it done that's it. So not sure what to expect. Again I am just afraid that's all. Thanks Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 25, 2011 Report Share Posted January 25, 2011 I had a biopsy a few months ago at Lourdes Hospital in Binghamton NY. My doctor used Novocain and I felt no pain during the procedure. 14 samples were taken. Had a little bleeding but that cleared up within an hour. It was no problem except one sample showed some cancer. After a lot of research and talking to many others I chose s Hopkins as the best place to get my prostate removed. They use nerve sparing and have a very high success rate. Don't go anyplace else. I am awaiting the surgery which was delayed due to some heart concerns. I am 67 in great shape but JH is very careful. Hope things work out OK with you. God Bless, Larry (snip)> I did reluctantly ok the Biopsy but> just scared to death as some say it is so painful other say its> not so bad so I don't know what to expect. Just thought I would> ask here if someone would like to chat about things. My doctor> here doesn't seem to want to talk to much five minutes tops and> says just have it done that's it. So not sure what to expect.> Again I am just afraid that's all.A doctor who will not talk with his patient to explain matters is, IMO, almost worse than no doctor at all.No one can say whether any particular individual will experience pain or not.There is, however, a pretty certain way to avoid the possibility: order that the area be treated with an anesthetic. If the medic refuses, he should be fired. You are in charge, not him.Regards,Steve J"'MD' does not mean 'Medical Deity.'"-- B. Strum, MDMedical OncologistPCa Specialist------------------------------------There are just two rules for this group 1 No Spam 2 Be kind to othersPlease recognise that Prostate Cancerhas different guises and needs different levels of treatment and in some cases no treatment at all. Some men even with all options offered chose radical options that you would not choose. We only ask that people be informed before choice is made, we cannot and should not tell other members what to do, other than look at other options. Try to delete old material that is no longer applying when clicking replyTry to change the title if the content requires it Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 25, 2011 Report Share Posted January 25, 2011 Welcome to the site, . You’re not Crusoe in being worried/concerned/frightened at the thought of a potential cancer diagnosis. Most of us have been there and done that – and most of us have come out the other side to live our lives. Can I suggest you might get some comfort, because you will get some information, from a booklet I wrote specifically for newly diagnosed men and for men who might be concerned about a prostate cancer diagnosis. I called the booklet A Strange Place and you can read it and download it at http://www.yananow.org/StrangePlace/index.html If you would lke me to I’d be happy to send you a hard copy if you give me your postal address – my e-mail is terryherbert42@... You might also like to read PSA 101 at . This will give you a better understanding of the vagaries of PSA. As to your concertn about biopsy: there is absolutley no reason for this to be painful. If you are concerned about pain, then ask your docor to provide you with local anesthesia. If he or she is not inclined to do that, change your doctor. The sooner you take charge of your own health decisions and make these with a competent medical advisor the better for you. This can be a frightening time and it is important to bear in mind what Dr Jon Oppenheimer, one of the leading pathologists in the US has to say on his blog at http://theprostateblog.blogspot.com/ For the vast majority of men with a recent diagnosis of prostate cancer the most important question is not what treatment is needed, but whether any treatment at all is required. Active surveillance is the logical choice for most men (and the families that love them) to make. All the best Prostate men need enlightening, not frightening Terry Herbert - diagnosed in 1996 and still going strong Read A Strange Place for unbiased information at http://www.yananow.org/StrangePlace/index.html From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of Quill Sent: Wednesday, 26 January 2011 7:06 AM To: ProstateCancerSupport Subject: Biopsy Help Hi folks new to the group here. I had a check up a few months ago with regular GP and he sent me to a specialist urologist. He checked me over and said I need a biopsy as I had a hardness on one side of the prostate. I didn't get it done at the time as to overwhelmed. I did go back though and had another check up and he said it was still there and my psa has risen a touch in four months from 2.79 to 3.01. I did reluctantly ok the Biopsy but just scared to death as some say it is so painful other say its not so bad so I don't know what to expect. Just thought I would ask here if someone would like to chat about things. My doctor here doesn't seem to want to talk to much five minutes tops and says just have it done that's it. So not sure what to expect. Again I am just afraid that's all. Thanks Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 25, 2011 Report Share Posted January 25, 2011 (snip) > I did reluctantly ok the Biopsy but > just scared to death as some say it is so painful other say its > not so bad so I don't know what to expect. Just thought I would > ask here if someone would like to chat about things. My doctor > here doesn't seem to want to talk to much five minutes tops and > says just have it done that's it. So not sure what to expect. > Again I am just afraid that's all. A doctor who will not talk with his patient to explain matters is, IMO, almost worse than no doctor at all. No one can say whether any particular individual will experience pain or not. There is, however, a pretty certain way to avoid the possibility: order that the area be treated with an anesthetic. If the medic refuses, he should be fired. You are in charge, not him. Regards, Steve J " 'MD' does not mean 'Medical Deity.' " -- B. Strum, MD Medical Oncologist PCa Specialist Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 25, 2011 Report Share Posted January 25, 2011 Apologues. I left out the address of PSA 101 – it is http://www.yananow.org/PSA101.htm All the best Prostate men need enlightening, not frightening Terry Herbert - diagnosed in 1996 and still going strong Read A Strange Place for unbiased information at http://www.yananow.org/StrangePlace/index.html From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of Terry Herbert Sent: Wednesday, 26 January 2011 7:18 AM To: ProstateCancerSupport Subject: RE: Biopsy Help Welcome to the site, . You’re not Crusoe in being worried/concerned/frightened at the thought of a potential cancer diagnosis. Most of us have been there and done that – and most of us have come out the other side to live our lives. Can I suggest you might get some comfort, because you will get some information, from a booklet I wrote specifically for newly diagnosed men and for men who might be concerned about a prostate cancer diagnosis. I called the booklet A Strange Place and you can read it and download it at http://www.yananow.org/StrangePlace/index.html If you would lke me to I’d be happy to send you a hard copy if you give me your postal address – my e-mail is terryherbert42@... You might also like to read PSA 101 at . This will give you a better understanding of the vagaries of PSA. As to your concertn about biopsy: there is absolutley no reason for this to be painful. If you are concerned about pain, then ask your docor to provide you with local anesthesia. If he or she is not inclined to do that, change your doctor. The sooner you take charge of your own health decisions and make these with a competent medical advisor the better for you. This can be a frightening time and it is important to bear in mind what Dr Jon Oppenheimer, one of the leading pathologists in the US has to say on his blog at http://theprostateblog.blogspot.com/ For the vast majority of men with a recent diagnosis of prostate cancer the most important question is not what treatment is needed, but whether any treatment at all is required. Active surveillance is the logical choice for most men (and the families that love them) to make. All the best Prostate men need enlightening, not frightening Terry Herbert - diagnosed in 1996 and still going strong Read A Strange Place for unbiased information at http://www.yananow.org/StrangePlace/index.html From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of Quill Sent: Wednesday, 26 January 2011 7:06 AM To: ProstateCancerSupport Subject: Biopsy Help Hi folks new to the group here. I had a check up a few months ago with regular GP and he sent me to a specialist urologist. He checked me over and said I need a biopsy as I had a hardness on one side of the prostate. I didn't get it done at the time as to overwhelmed. I did go back though and had another check up and he said it was still there and my psa has risen a touch in four months from 2.79 to 3.01. I did reluctantly ok the Biopsy but just scared to death as some say it is so painful other say its not so bad so I don't know what to expect. Just thought I would ask here if someone would like to chat about things. My doctor here doesn't seem to want to talk to much five minutes tops and says just have it done that's it. So not sure what to expect. Again I am just afraid that's all. Thanks Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 25, 2011 Report Share Posted January 25, 2011 : In my experience, the biopsy was painful but necessary. Your doctor is far too typical; that's why this and other PCa support sites exist. Happy to talk about it anytime. TKL60123@.... Tom Lauterback From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of QuillSent: Tuesday, January 25, 2011 2:06 PMTo: ProstateCancerSupport Subject: Biopsy Help Hi folks new to the group here. I had a check up a few months ago with regular GP and he sent me to a specialist urologist. He checked me over and said I need a biopsy as I had a hardness on one side of the prostate. I didn't get it done at the time as to overwhelmed. I did go back though and had another check up and he said it was still there and my psa has risen a touch in four months from 2.79 to 3.01. I did reluctantly ok the Biopsy but just scared to death as some say it is so painful other say its not so bad so I don't know what to expect. Just thought I would ask here if someone would like to chat about things. My doctor here doesn't seem to want to talk to much five minutes tops and says just have it done that's it. So not sure what to expect. Again I am just afraid that's all. Thanks Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 25, 2011 Report Share Posted January 25, 2011 , like Tom I found the biopsy rather painful, but not unbearable, rather like being stung by a bee a dozen times. I suspect the urologist did not wait long enough after he gave me the novocaine shot before starting. Two neighbors who also had biopsies said they had minimal discomfort, so it clearly depends on the uro and tha patient. I also agree that it's necessary. My biopsy was triggered by my GP finding that the prostate "didn't feel quite right" in that it was "a little firm" when it is supposed to be soft. Two urologists checked it and said it was marginal, but my PSA had risen to 4.95 from under 2 two years before, so the biopsy was called for. Of 12 samples in the biopsy, 7 were cancerous. It turned out, after RLP (DaVinci), that there was cancer on both sides of the prostate, but it had not breached the prostate wall. I echo all who have said read all you can starting now, including the book by Dr. McHugh, a urologist who himself had prostate cancer: The Decision, your prostate shows cancer, now what?. Also, check out the Prostate Cancer Research Institute's website. Mike C. Subject: Biopsy HelpTo: ProstateCancerSupport Date: Tuesday, January 25, 2011, 3:05 PM Hi folks new to the group here. I had a check up a few months ago with regular GP and he sent me to a specialist urologist. He checked me over and said I need a biopsy as I had a hardness on one side of the prostate. I didn't get it done at the time as to overwhelmed. I did go back though and had another check up and he said it was still there and my psa has risen a touch in four months from 2.79 to 3.01. I did reluctantly ok the Biopsy but just scared to death as some say it is so painful other say its not so bad so I don't know what to expect. Just thought I would ask here if someone would like to chat about things. My doctor here doesn't seem to want to talk to much five minutes tops and says just have it done that's it. So not sure what to expect. Again I am just afraid that's all. Thanks ------------------------------------There are just two rules for this group 1 No Spam 2 Be kind to othersPlease recognise that Prostate Cancerhas different guises and needs different levels of treatment and in some cases no treatment at all. Some men even with all options offered chose radical options that you would not choose. We only ask that people be informed before choice is made, we cannot and should not tell other members what to do, other than look at other options. Try to delete old material that is no longer applying when clicking replyTry to change the title if the content requires it Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 25, 2011 Report Share Posted January 25, 2011 With regard to Mike’s reference to Dr McHugh, there are links to his Diaries and documents on the Yana Choices page at http://www.yananow.org/choices.htm All the best Prostate men need enlightening, not frightening Terry Herbert - diagnosed in 1996 and still going strong Read A Strange Place for unbiased information at http://www.yananow.org/StrangePlace/index.html From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of Clowes Sent: Wednesday, 26 January 2011 8:09 AM To: ProstateCancerSupport Subject: Re: Biopsy Help , like Tom I found the biopsy rather painful, but not unbearable, rather like being stung by a bee a dozen times. I suspect the urologist did not wait long enough after he gave me the novocaine shot before starting. Two neighbors who also had biopsies said they had minimal discomfort, so it clearly depends on the uro and tha patient. I also agree that it's necessary. My biopsy was triggered by my GP finding that the prostate " didn't feel quite right " in that it was " a little firm " when it is supposed to be soft. Two urologists checked it and said it was marginal, but my PSA had risen to 4.95 from under 2 two years before, so the biopsy was called for. Of 12 samples in the biopsy, 7 were cancerous. It turned out, after RLP (DaVinci), that there was cancer on both sides of the prostate, but it had not breached the prostate wall. I echo all who have said read all you can starting now, including the book by Dr. McHugh, a urologist who himself had prostate cancer: The Decision, your prostate shows cancer, now what?. Also, check out the Prostate Cancer Research Institute's website. Mike C. Subject: Biopsy Help To: ProstateCancerSupport Date: Tuesday, January 25, 2011, 3:05 PM Hi folks new to the group here. I had a check up a few months ago with regular GP and he sent me to a specialist urologist. He checked me over and said I need a biopsy as I had a hardness on one side of the prostate. I didn't get it done at the time as to overwhelmed. I did go back though and had another check up and he said it was still there and my psa has risen a touch in four months from 2.79 to 3.01. I did reluctantly ok the Biopsy but just scared to death as some say it is so painful other say its not so bad so I don't know what to expect. Just thought I would ask here if someone would like to chat about things. My doctor here doesn't seem to want to talk to much five minutes tops and says just have it done that's it. So not sure what to expect. Again I am just afraid that's all. Thanks ------------------------------------ There are just two rules for this group 1 No Spam 2 Be kind to others Please recognise that Prostate Cancerhas different guises and needs different levels of treatment and in some cases no treatment at all. Some men even with all options offered chose radical options that you would not choose. We only ask that people be informed before choice is made, we cannot and should not tell other members what to do, other than look at other options. Try to delete old material that is no longer applying when clicking reply Try to change the title if the content requires it Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 25, 2011 Report Share Posted January 25, 2011 My GP referred me to a urologist and I went for two visits. After the second visit, I realized that I wasn't that comfortable with the urologist. He seemed too abrupt and too quick to decide what my options are for me. For example, he just matter of factly stated, we need do a biopsy to find out if you have cancer and, if you do, the best thing to do is just take it out. That's way too cavalier to me, and, no, there are lots of options even if I do have cancer beyond just, "the best thing to do is just take it out". I went back to my GP and asked if he could suggest a different urologist who was better at explaining things and better at having more of a two-way conversation with his patients. My GP said that some people love the first urologist I went to, and some people not so much. But, he said whoever I end using as a urologist, it is probably going to be a long term relationship, so I might just as well make sure it is someone I am going to be comfortable dealing with. He gave me the name of another urologist and I went to him -- much better. I told the second urologist that I needed someone that was a little better at explaining things etc. and that's exactly what he did -- he took his time. So, my first suggestion is to try going to a different urologist. You might as well make the change now before you get too far down the road with the first one. As far as pain on the biopsy, I haven't had one yet although I am supposed to be getting one soon. The second urologist said that he does all of his biopsies the way they do colonsocopies -- with what they call conscious sedation. In other words, you don't feel any pain whatsoever, but you have to have someone with you to drive you home afterward. Not all urologists do that. Some will just give you pain medication (I assume lidocaine), and I think some just say it's not that bad so they don't do any pain medication or sedation. The point is that you have lots of options. There is also no rush. You do not have to race to get this done. Try getting another opinion from another urologist, and at the same time see if that urologist is someone that you are more comfortable working with. Good luck. Subject: Biopsy HelpTo: ProstateCancerSupport Date: Tuesday, January 25, 2011, 3:05 PM Hi folks new to the group here. I had a check up a few months ago with regular GP and he sent me to a specialist urologist. He checked me over and said I need a biopsy as I had a hardness on one side of the prostate. I didn't get it done at the time as to overwhelmed. I did go back though and had another check up and he said it was still there and my psa has risen a touch in four months from 2.79 to 3.01. I did reluctantly ok the Biopsy but just scared to death as some say it is so painful other say its not so bad so I don't know what to expect. Just thought I would ask here if someone would like to chat about things. My doctor here doesn't seem to want to talk to much five minutes tops and says just have it done that's it. So not sure what to expect. Again I am just afraid that's all. Thanks Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 25, 2011 Report Share Posted January 25, 2011 I have read a number of the posts. I totally agree with things that have been stated. You MUST be comfortable with your urologist! Remember also that there are many things they DON'T tell you about things that can elevate the PSA. Do not exercise or have sex 48 hours before (includes bike riding). My PSA had doubled in a year and in 3 months almost doubled again (went from 1.2 to 2.5 to 3.9), yet only had 1 core show cancer with a Gleason 6 (3+3). I consulted 2 different urologists, 2 radiation oncologists, and discussed treatments with patients and researched on the net. My urologist encouraged me to find it all out before I decided. I finally decided on DaVinci. I still stay up on the treatment plans and attend man to man support group meetings sponsored by the American Cancer Society 2-1/2 years post op! DO YOUR HOMEWORK!BTW, the post op biopsy showed a bit more involvement but it was contained. I had 3 sectors with cancer and 3 that were atrophied but the Gleason score was confirmed. My PSA is now at 0.0!Steve Snna, ARTo: ProstateCancerSupport Cc: Sent: Tuesday, January 25, 2011 3:22 PMSubject: Re: Biopsy Help My GP referred me to a urologist and I went for two visits. After the second visit, I realized that I wasn't that comfortable with the urologist. He seemed too abrupt and too quick to decide what my options are for me. For example, he just matter of factly stated, we need do a biopsy to find out if you have cancer and, if you do, the best thing to do is just take it out. That's way too cavalier to me, and, no, there are lots of options even if I do have cancer beyond just, "the best thing to do is just take it out". I went back to my GP and asked if he could suggest a different urologist who was better at explaining things and better at having more of a two-way conversation with his patients. My GP said that some people love the first urologist I went to, and some people not so much. But, he said whoever I end using as a urologist, it is probably going to be a long term relationship, so I might just as well make sure it is someone I am going to be comfortable dealing with. He gave me the name of another urologist and I went to him -- much better. I told the second urologist that I needed someone that was a little better at explaining things etc. and that's exactly what he did -- he took his time. So, my first suggestion is to try going to a different urologist. You might as well make the change now before you get too far down the road with the first one. As far as pain on the biopsy, I haven't had one yet although I am supposed to be getting one soon. The second urologist said that he does all of his biopsies the way they do colonsocopies -- with what they call conscious sedation. In other words, you don't feel any pain whatsoever, but you have to have someone with you to drive you home afterward. Not all urologists do that. Some will just give you pain medication (I assume lidocaine), and I think some just say it's not that bad so they don't do any pain medication or sedation. The point is that you have lots of options. There is also no rush. You do not have to race to get this done. Try getting another opinion from another urologist, and at the same time see if that urologist is someone that you are more comfortable working with. Good luck. Subject: Biopsy HelpTo: ProstateCancerSupport Date: Tuesday, January 25, 2011, 3:05 PM Hi folks new to the group here. I had a check up a few months ago with regular GP and he sent me to a specialist urologist. He checked me over and said I need a biopsy as I had a hardness on one side of the prostate. I didn't get it done at the time as to overwhelmed. I did go back though and had another check up and he said it was still there and my psa has risen a touch in four months from 2.79 to 3.01. I did reluctantly ok the Biopsy but just scared to death as some say it is so painful other say its not so bad so I don't know what to expect. Just thought I would ask here if someone would like to chat about things. My doctor here doesn't seem to want to talk to much five minutes tops and says just have it done that's it. So not sure what to expect. Again I am just afraid that's all. Thanks Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 25, 2011 Report Share Posted January 25, 2011 " larrybcarroll@... " wrote: > I had a biopsy a few months ago at Lourdes Hospital in > Binghamton NY. My doctor used Novocain and I felt no pain > during the procedure. 14 samples were taken. Had a little > bleeding but that cleared up within an hour. It was no problem > except one sample showed some cancer. After a lot of research > and talking to many others I chose s Hopkins as the best > place to get my prostate removed. They use nerve sparing and > have a very high success rate. Don't go anyplace else. I am > awaiting the surgery which was delayed due to some heart > concerns. I am 67 in great shape but JH is very careful. Hope > things work out OK with you. Larry, With only one biopsy sample showing " some " cancer, did the Hopkins doctors talk to you at all about the possibility of Active Surveillance. Dr. Walsh at Hopkins was the inventor of nerve sparing surgery, and Dr. Epstein at Hopkins published the most used criteria for active surveillance (AS). If I remember correctly, the best candidates for AS have the following criteria (don't take my word for this as gospel, ask an expert!) Only one or two of a dozen biopsy samples shows cancer. Cancer occupies less than 50% of those one or two samples. PSA < 10. Gleason < 7. Patient is 60 years old or older. Here's an article from Hopkins on Active Surveillance: http://urology.jhu.edu/prostate/advice1.php On the one hand, I think everyone would agree that Hopkins is as good a place to be treated as any place in the world. But on the other hand, wherever you get it done, radical prostatectomy is still major surgery and still has side effect and other risks. Both RP and radiation are very invasive. They change things in your body. I'm not trying to talk you out of treatment. It might be the right thing for you. I just want to be sure that a knowledgeable doctor has discussed Active Surveillance with you and compared your disease characteristics to the established criteria for AS. It is worth asking whether your cancer is ever likely to hurt you and whether the treatment might cause you more trouble than the cancer would have. Good luck. Alan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 25, 2011 Report Share Posted January 25, 2011 Alan Meyer wrote: > Only one or two of a dozen biopsy samples shows cancer. > Cancer occupies less than 50% of those one or two samples. > PSA < 10. > Gleason < 7. > Patient is 60 years old or older. I think another one may have been no palpable tumors in the prostate, i.e., the doctor doesn't find any hard spots when he sticks his finger in to feel the prostate. Alan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 25, 2011 Report Share Posted January 25, 2011 Larry, give us some more information. What was your Gleason score? What was the staging? What was your PSA and how had it changed over time? As Alan hints, it seems to be unusual to be heading for surgery with only one cancerous core out of 14. What was the volume of involvement in that one sample? Don't rush this surgery. Consider active surveillance. Mike C.(snip)> I did reluctantly ok the Biopsy but> just scared to death as some say it is so painful other say its> not so bad so I don't know what to expect. Just thought I would> ask here if someone would like to chat about things. My doctor> here doesn't seem to want to talk to much five minutes tops and> says just have it done that's it. So not sure what to expect.> Again I am just afraid that's all.A doctor who will not talk with his patient to explain matters is, IMO, almost worse than no doctor at all.No one can say whether any particular individual will experience pain or not.There is, however, a pretty certain way to avoid the possibility: order that the area be treated with an anesthetic. If the medic refuses, he should be fired. You are in charge, not him.Regards,Steve J"'MD' does not mean 'Medical Deity.'"-- B. Strum, MDMedical OncologistPCa Specialist------------------------------------There are just two rules for this group 1 No Spam 2 Be kind to othersPlease recognise that Prostate Cancerhas different guises and needs different levels of treatment and in some cases no treatment at all. Some men even with all options offered chose radical options that you would not choose. We only ask that people be informed before choice is made, we cannot and should not tell other members what to do, other than look at other options. Try to delete old material that is no longer applying when clicking replyTry to change the title if the content requires it Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 25, 2011 Report Share Posted January 25, 2011 Hi , I'ld just like to re-iterate what most of the other guys are saying. i.e. the biopsy should not be painful. Like you I was nervous beforehand - well terrified really. The nurse put me at ease and said it would not hurt. Local anaesthetic is essential. There is quite a lot of paraphenalia to get up your back passage before the local anaesthetic is given so if you have never had anything up there before you might want to experiment with one of your wife's/partner's sex toys beforehand. No offence intended, but a small dildo is about the size of the biopsy equipment. I had a local aneasthetic and 13 samples were taken. The Uro 'fired' the equipment first to let me know what the sound would be like which was very considerate. I heard but did not even feel 11 of the samples, the 12th I felt a sensation but it wasn't pain and the 13th was a split second sting - again not really pain. The last 2 were samples from the seminal vesicles where the anaesthtic had not reached so much. My biopsy was 4.30pm and I had not been allowed to eat all day beforehand. After it was over I felt fine, though annoyingly moist from KY ! (take some wet wipes - the paper towels I was given just didn't clear all the lube up) I went for a coffee and a snack in the hospital canteen before my partner drove me home - big mistake the anaeasthetic had worn off and boy did I feel everybump in the road!. I got home and slept for an hour then rested a couple of hours in bed. A dull ache for the evening but definitely not what you could call pain. 100% fine the next morning. Be prepared for your first orgasm to be unsightly - I was shocked at the colour of my output. Absolutely no pain but be ready for the sight. Good luck with the biopsy, to sum up I found it much less tramatic than a visit to the dentist. Hope this wasn't too graphic. Malaga,Spain Biopsy Help Hi folks new to the group here. I had a check up a few months ago with regular GP and he sent me to a specialist urologist. He checked me over and said I need a biopsy as I had a hardness on one side of the prostate. I didn't get it done at the time as to overwhelmed. I did go back though and had another check up and he said it was still there and my psa has risen a touch in four months from 2.79 to 3.01. I did reluctantly ok the Biopsy but just scared to death as some say it is so painful other say its not so bad so I don't know what to expect. Just thought I would ask here if someone would like to chat about things. My doctor here doesn't seem to want to talk to much five minutes tops and says just have it done that's it. So not sure what to expect. Again I am just afraid that's all. Thanks Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 25, 2011 Report Share Posted January 25, 2011 My biopsy was so painful they had to pull me off the ceiling after each sample. I was then made to lay down until the color returned to my face and the doctor proscribed some pain medication. Something he usually doesn’t do. This was after he had said that he had given me the maximum amount of pain medication during the procedure. Now that I have scared the heck out of you I would go through it all again and was glad I had it done. The results of my biopsy showed that I had a very aggressive fast growing form of prostate cancer. My PSa was not showing much activity, it was lower than yours. I have learned with prostate cancer the earlier you discover the better the possible outcomes and treatment options. To not go through the process because of some pain (ok for me a lot of pain) is foolish and you are setting yourself up for a lot of problems latter on. GET THE BIOPSY ASAP. Now my case is one of the extremes. I have known of many men that has had biopsies done and they were really nothing more of a minor inconvenience. Little prep work, in and out of the office, back to work the same day. Chances are you will end up somewhere in between. Do yourself a favor, don’t wait, get the biopsy and then you can come back here and lament with the rest of us about what it was like. From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of Quill Sent: Tuesday, January 25, 2011 3:06 PM To: ProstateCancerSupport Subject: Biopsy Help Hi folks new to the group here. I had a check up a few months ago with regular GP and he sent me to a specialist urologist. He checked me over and said I need a biopsy as I had a hardness on one side of the prostate. I didn't get it done at the time as to overwhelmed. I did go back though and had another check up and he said it was still there and my psa has risen a touch in four months from 2.79 to 3.01. I did reluctantly ok the Biopsy but just scared to death as some say it is so painful other say its not so bad so I don't know what to expect. Just thought I would ask here if someone would like to chat about things. My doctor here doesn't seem to want to talk to much five minutes tops and says just have it done that's it. So not sure what to expect. Again I am just afraid that's all. Thanks Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 25, 2011 Report Share Posted January 25, 2011 , it's darn near impossible to actually find out what's going on in the prostate without a biopsy. When I had mine 5 years ago I had no anesthetic. The first sample wasn't so bad, and I was thinking this isn't all that bad. Each needle was worse. Number six was a real experience, then it started all over for the other side. Get some numbing in that gland. And by all means get a doctor you're comfortable with. I had a real good first impression with my Urologist and as it turned out he was pretty darn good. But with your symptoms I wouldn't mess around too long. Something is going on in there. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 25, 2011 Report Share Posted January 25, 2011 Hello ;Ask the doctor, or his assistant, if they will give you a couple of valiums to take before going in for the biopsy. I hear that may help calm your nerves some. I was so terrified that my blood pressure shot through the roof, and the uro aborted the bio. He had me go in the hospital as an out patient, and did the biopsy under general anesthesia. That worked for me.I didn't know that I could have been prescribed a valium or something similar before I went in for the biopsy. If I had known, I certainly would have taken advantage of it.Just my experience,Good luck on your journey,Dan HarrimanOrange TexasIf at first you don't succeed, maybe you shouldn't try sky diving! Biopsy Help Hi folks new to the group here. I had a check up a few months ago with regular GP and he sent me to a specialist urologist. He checked me over and said I need a biopsy as I had a hardness on one side of the prostate. I didn't get it done at the time as to overwhelmed. I did go back though and had another check up and he said it was still there and my psa has risen a touch in four months from 2.79 to 3.01. I did reluctantly ok the Biopsy but just scared to death as some say it is so painful other say its not so bad so I don't know what to expect. Just thought I would ask here if someone would like to chat about things. My doctor here doesn't seem to want to talk to much five minutes tops and says just have it done that's it. So not sure what to expect. Again I am just afraid that's all. Thanks __._,_ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 26, 2011 Report Share Posted January 26, 2011 Hello and the rest of the group This is my first post so greetings from London. I have a great urologist who is always cheerful and considerate and gives me as much time as I need. He did my biopsy under general anaesthetic and I’m really glad he did. As you will gather it can be very painful. Of course it depends how well you tolerate a GA where there is always a bit of a risk. I had a carpal tunnel done under local anaesthetic a few years ago and passed out big time. When my biopsy came back positive (and only two samples were), the urologist said great, we’ve caught it early, whip the prostate out and no more problems. Unfortunately that was wildly optimistic. The vesicles and lymph nodes were fine but there was extra-capsular extension so we did not in fact catch it in time. In spite of 7 weeks of radiotherapy to the prostate bed my PSA has refused to go below 2 and is now up to 5.24 with a doubling time of between 4 and 5 months. My oncologist (a lady) is a rather up-tight person and I find her a bit difficult although she has a good reputation. This is a shame – as the others say your relationship with the medical team is very important. On the brighter side I am symptom free and continent. My sex life is not great but my wife doesn’t seem too bothered and things do seem to be improving so I live in hope. Bob Bishop Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 26, 2011 Report Share Posted January 26, 2011 Alan, Chuck and Mike, Thanks for your input. Here is more of my story: I'm 67, never had a PSA test before, August 2010, since my GP felt it wasn't necessary. He has done the finger test several times over the years and said I had a slightly enlarged prostate but no feel able tumors. When my RN sister came to my last appointment and insisted that it be done, the doctor said OK. The results came back at 6.8. I know there is a lot of tolerance on the number but that steered me to a urologist for the biopsy. (As I mentioned, it was painless.) The results came back with a Gleason of 3+3. I'm not sure of the stage but I believe it is moderate. I had the slides sent to JH for a second option and they agreed with the results. The surgeon at JH did another finger test but could not feel any tumor and set me up for the da Vinci surgery. While I was on the bed, surrounded by the operating team, I was asked if I ever had chest pains. I said, yes, once in while. Doesn't everyone my age? They looked at my ECG and felt I should not have surgery until I had a stress test. The heart doctor said my ECG was just a little slow but fine for surgery and they should have done it. (I ski, BR dance and hike in the Adirondacks). After the stress test the doctor felt I should have a cath and possible stent which I will have tomorrow. After that, I will reapply to JH for the surgery. Getting old is not fun anymore. I have looked at all the options and spoken to a lot of friends and feel I need the surgery. This will also clear up my slow stream problem. My local urologist said I needed the surgery or this could kill me within 10 years, 5% chance. He could do it the old way or have another doctor use the da Vinci System. After inquiring at how many da Vinci prostate surgeries they have performed locally, I felt I should, "get out of Dodge" and have it done at JH. Larry "larrybcarroll@..." wrote:> I had a biopsy a few months ago at Lourdes Hospital in> Binghamton NY. My doctor used Novocain and I felt no pain> during the procedure. 14 samples were taken. Had a little> bleeding but that cleared up within an hour. It was no problem> except one sample showed some cancer. After a lot of research> and talking to many others I chose s Hopkins as the best> place to get my prostate removed. They use nerve sparing and> have a very high success rate. Don't go anyplace else. I am> awaiting the surgery which was delayed due to some heart> concerns. I am 67 in great shape but JH is very careful. Hope> things work out OK with you.Larry,With only one biopsy sample showing "some" cancer, did theHopkins doctors talk to you at all about the possibility ofActive Surveillance.Dr. Walsh at Hopkins was the inventor of nerve sparing surgery,and Dr. Epstein at Hopkins published the most used criteria foractive surveillance (AS). If I remember correctly, the bestcandidates for AS have the following criteria (don't take my wordfor this as gospel, ask an expert!)Only one or two of a dozen biopsy samples shows cancer.Cancer occupies less than 50% of those one or two samples.PSA < 10.Gleason < 7.Patient is 60 years old or older.Here's an article from Hopkins on Active Surveillance:http://urology.jhu.edu/prostate/advice1.phpOn the one hand, I think everyone would agree that Hopkins is asgood a place to be treated as any place in the world. But on theother hand, wherever you get it done, radical prostatectomy isstill major surgery and still has side effect and other risks.Both RP and radiation are very invasive. They change things inyour body.I'm not trying to talk you out of treatment. It might be theright thing for you. I just want to be sure that a knowledgeabledoctor has discussed Active Surveillance with you and comparedyour disease characteristics to the established criteria for AS.It is worth asking whether your cancer is ever likely to hurt youand whether the treatment might cause you more trouble than thecancer would have.Good luck.Alan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 26, 2011 Report Share Posted January 26, 2011 Hi The biopsy I had was not particularly painful. The Urologist was very careful, he injected me with novacaine and he told me everything he was going to do. My fear was not of the procedure but rather of the result. Mine was positive for ca which was devistating to me since there was some capsular penetration. I had surgery and IMRT radiation, along with ADT (Zoladex) That was 18 months ago. So far my PSA is between .007 and .008 I feel pretty well but I am still concerned every time I get a PSA I guess what I am trying to say is don't let fear of the procedure scare you afterall it is all they have to help you determine the next step in your treatment. The biosy is a lot less painful than many dental procedures I have had. good luck to you. HarrySubject: Re: eeiopsy HelpTo: ProstateCancerSupport Date: Tuesday, January 25, 2011, 11:28 PM Hello ;Ask the doctor, or his assistant, if they will give you a couple of valiums to take before going in for the biopsy. I hear that may help calm your nerves some. I was so terrified that my blood pressure shot through the roof, and the uro aborted the bio. He had me go in the hospital as an out patient, and did the biopsy under general anesthesia. That worked for me.I didn't know that I could have been prescribed a valium or something similar before I went in for the biopsy. If I had known, I certainly would have taken advantage of it.Just my experience,Good luck on your journey,Dan HarrimanOrange TexasIf at first you don't succeed, maybe you shouldn't try sky diving! Biopsy Help Hi folks new to the group here. I had a check up a few months ago with regular GP and he sent me to a specialist urologist. He checked me over and said I need a biopsy as I had a hardness on one side of the prostate. I didn't get it done at the time as to overwhelmed. I did go back though and had another check up and he said it was still there and my psa has risen a touch in four months from 2.79 to 3.01. I did reluctantly ok the Biopsy but just scared to death as some say it is so painful other say its not so bad so I don't know what to expect. Just thought I would ask here if someone would like to chat about things. My doctor here doesn't seem to want to talk to much five minutes tops and says just have it done that's it. So not sure what to expect. Again I am just afraid that's all. Thanks __._,_ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 26, 2011 Report Share Posted January 26, 2011 > > Hi folks new to the group here. I had a check up a few months ago with regular GP and he sent me to a specialist urologist. He checked me over and said I need a biopsy as I had a hardness on one side of the prostate. I didn't get it done at the time as to overwhelmed. I did go back though and had another check up and he said it was still there and my psa has risen a touch in four months from 2.79 to 3.01. I did reluctantly ok the Biopsy but just scared to death as some say it is so painful other say its not so bad so I don't know what to expect. Just thought I would ask here if someone would like to chat about things. My doctor here doesn't seem to want to talk to much five minutes tops and says just have it done that's it. So not sure what to expect. Again I am just afraid that's all. Thanks > , I have had two procedures. No problem at all!they were not any better or worse than colonoscopy. I did get 'numbed' on both and you hear the click but no pain at all. Good Luck Dan (727 643-4200) if you have any questions Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 26, 2011 Report Share Posted January 26, 2011 Geo: There is only one time to get the intel and strategy of your native self prior to treatment and that's now. First--slow down, it's OK. Even with aggressive PCa it's worth " backing it up and looking it up " as we say in the hazmat world. Second, I found too late (I acted quickly and locally) that it's the same price to go to a world class guy like Duke Bahn or Fred Lee who can use Color Doppler Ultrasound guided biopsy and actually see what others cannot see. Between that and the MRI-S at UCSF (I live in CO) I had much more intel than what my eager local surgeon with boat payments could see. Spend the money with a cheap airline to go to the best of the best. PCa deserves the best of intel. Call or email Dr. Israel Barken, San Diego PCREF.org and have Freda send you the checklist for accumulating the knowledge you need. Your docs don't have the time to do what is necessary. You and your caregiver will need to gear up and learn all you can about this threat. You'll do well! Gleason 8 Failed local surgery HIFU ADT3 therapy 4 year survivor and living a life I love Catheterizing 5-9x/day x 3+ years Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 26, 2011 Report Share Posted January 26, 2011 Larry, I had triple bypass surgery almost 16 years ago, and my surgeon and anesthetist wanted a stress test before they woul operate. I flunked the stress test (actually, I ran for 10 minutes without problem and recovered quickly but the lower lobe of the heart showed a weakness). Next, they wanted an angiogram, which I had and which found that one venous graft was only 40% blocked, the second was only 20% blocked, and the arterial graft was completely clear, terrific after 15 years, so I was good to go. While you are awaiting the surgery, check out the Memorial Sloan Kettering website. On the prostate cancer section they have a calculator into which you put the various stats (PSA, number of samples, Gleason score etc.) and they give you the 5 and 10-year recurrence probabilities for each treatment method. It's very useful. Mike > I had a biopsy a few months ago at Lourdes Hospital in> Binghamton NY. My doctor used Novocain and I felt no pain> during the procedure. 14 samples were taken. Had a little> bleeding but that cleared up within an hour. It was no problem> except one sample showed some cancer. After a lot of research> and talking to many others I chose s Hopkins as the best> place to get my prostate removed. They use nerve sparing and> have a very high success rate. Don't go anyplace else. I am> awaiting the surgery which was delayed due to some heart> concerns. I am 67 in great shape but JH is very careful. Hope> things work out OK with you.Larry,With only one biopsy sample showing "some" cancer, did theHopkins doctors talk to you at all about the possibility ofActive Surveillance.Dr. Walsh at Hopkins was the inventor of nerve sparing surgery,and Dr. Epstein at Hopkins published the most used criteria foractive surveillance (AS). If I remember correctly, the bestcandidates for AS have the following criteria (don't take my wordfor this as gospel, ask an expert!)Only one or two of a dozen biopsy samples shows cancer.Cancer occupies less than 50% of those one or two samples.PSA < 10.Gleason < 7.Patient is 60 years old or older.Here's an article from Hopkins on Active Surveillance:http://urology.jhu.edu/prostate/advice1.phpOn the one hand, I think everyone would agree that Hopkins is asgood a place to be treated as any place in the world. But on theother hand, wherever you get it done, radical prostatectomy isstill major surgery and still has side effect and other risks.Both RP and radiation are very invasive. They change things inyour body.I'm not trying to talk you out of treatment. It might be theright thing for you. I just want to be sure that a knowledgeabledoctor has discussed Active Surveillance with you and comparedyour disease characteristics to the established criteria for AS.It is worth asking whether your cancer is ever likely to hurt youand whether the treatment might cause you more trouble than thecancer would have.Good luck.Alan Quote Link to comment Share on other sites More sharing options...
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