I had my biopsy done by a partner during lunch. I took an antibiotic and nothing for pain. My partner did attempt a prostate block but it did not work. He took about 16 samples and it lasted about 20 minutes. It was very uncomfortable. My biopsy experience. I am trying to think if I under tell patients about the pain involved.
I give each patient a sedative and a pain pill prescription (such as an ativan and a percocet) that they take an hour before the procedure and I also perform the prostate block which is guided by the ultrasound. (For any of you that are interested, that is a space easily identified on ultrasound just lateral to the seminal vesicles at the posterio-superior aspect of the prostate. That’s where the nerves that enervate the prostate run and responsible for the pain.)
There are about three kinds of pain associated with the biopsy and my little protocol, and I would be surprised if most urologists don’t do something similar, limits all of them. First there is the pressure pain associated with the ultrasound probe itself, this is like a rectal exam done by large thumb and is five inches long-a generalized pressure pain. Then there is the irritation the rigid instrument has on the prostate and the prostatic urethra. (Any one reading this and trying to determine what type of treatment you are planning to pursue needs to understand the prostatic urethra and how it is affected by all the treatments. This is about a good a tip I could ever give you. I’ll put something today into the ” Decision Process” section of this blog.) The pressure on prostate gives you an intense sensation that you need to urinate, so be sure to empty your bladder before the procedure. And then of course, there is the actual biopsy itself. We all use a spring-loaded biopsy gun now, so you’ll hear a clicking sound before each biopsy and it feels like a bee sting. (A patient told me one time, ” Hell doc, that ain’t no bee sting, that’s a Texas wasp.) By the way, I went up to the river yesterday and while I was looking for a stick to throw into the river for Penelope, I got stung by two or three wasps on my ear….right on the lobe of it. Man oh man… I hate those things.
The blood that is referred to in the piece below is hematospermia and this does get your attention but is harmless. It doesn’t hurt anyone and usually goes away in a week or so, but not always. When there becomes a brownish tint to the fluid, you are almost done with it. It can last for weeks however. After the biopsy-from ” The Decision.”
As urologists we worry most about a fever or difficulty voiding after a biopsy. This type of stuff occurs about 3% of the time and is why we give an antibiotic before and after, usually Cipro, and tell the patient and family to call if any voiding issues. If you are already on a drug to help you urinate or are having difficulties now, you are more at risk for problems voiding and this is something you should make known to your urologist. I do about 100 biopsies a year and in my 24 year career I have had to admit someone for a biopsy complication probably about 5 times.
I feel that I am fairly discerning about the pain. I ask my nurse to watch the patient’s expression and that will often tell you if there is undue discomfort. If we sense it, we stop and do something else… redo the block or consider giving something I.V. This is a recent post of a patient that did impersonations during his biopsy, if that tells you how he did pain wise during the procedure.
The other component to the piece that follows has to do about men and how much they will talk about pain and their medical condition. I think its fine and appropriate to say to the urologist at the time of the scheduling, like I do with a Dentist, ” I don’t like pain. Can you give me something?” If the urologist says no and you want medicine…get another urologist. It is really that simple, I doubt many will say no however.
More about men and what they will disclose. If you know someone who had robotic removal, most likely they will almost brag about having had it removed that way. It is almost as if they think they were cutting edge or ” informed.” But… if you ask them how are they doing, particularly with continence and potency, then that’s different story. I mention this to be careful to separate out from the conversation ” the procedure ” and the ” aftermath.” That’s a world of difference and you’ll have to really dig and persist to find out how they are ” really doing.” You might ask, ” Why would persist into something that is personal?” Well, my friend you are trying to make a decision about what to do and if you make it based on how the procedure went but not how things ended up ” functionally” then you have made a decision in error. Robotic and Brachytherapy are similar in this aspect. Patients often make the decision based on the procedure attributes and not on a full understanding on how they will ” end up.”
As my mother said, ” Don’t value short-term gratification over long-term gain.”
Urologists Take Note – The Real Truth About A Prostate Biopsy!
At first I thought I was just a “wimp.” At the urging of my family doctor I went to a urologist for a prostate check. She (my family doctor) said my PSA was a bit high for my age – 4.58 PSA and I was 47 years old.
Now let me state…I didn’t even know what a PSA was until she forced the test when I was having routine blood work done. Something I hated as I had a fear of needles.
The urologist did the “bend over boy” routine finding nothing with his “DRE” – Digital Rectal Exam. Now I have to be honest, that wasn’t the most exciting exam, but all in all it didn’t cause me any great pain. But, as the urologist said, “Better to be safe than sorry. Let’s schedule you for a biopsy.”
Now let me be frank…I had no clue what to expect other than what my doctor told me. He said there would
be some minor discomfort but mostly I would be annoyed by the sound of the instrument when the sample was taken. “Other than that,” he commented, “most men don’t really feel much.” I do recall asking if there was pain, and again, my urologist stated, “Most men feel very little. Nothing to be concerned with.”
I have been interviewing men from all around the English speaking world who have been diagnosed with prostate cancer. With few exceptions everyone reports the same thing. The damn biopsy hurts! When they report this, I ask a follow up question: “Did you tell you doctor this?” Their response – “Well, no, I just took it like a man.”
GUYS…WHAT A CROCK!
In Dr. Sheldon Marks book, “Prostate and Cancer” he describes the biopsy as follows:
In a biopsy of the prostate, multiple tiny sliver-like ppeces of tissue are obtained for microscopic analysis to see if cancer is present. These pieces are obtained through a long but very thin needle, specially designed to open inside the prostate, take the sample and then close.
For most men, biopsies can be done as an outpatient office procedure without anesthesia and with usually only temporary discomfort. Now we can get a good representative sampling of the entire gland with minimal trauma to the gland.
He is right…it is done outpatient most of the time. Where I beg to differ is on the pain issue. Thus far, well over 70% of the men I have talked with have reported that their urologist misled them when it came to what to expect and the pain. All but two men interviewed would, in retrospect, have desired pain medication before the biopsy. One man reported that had he known it would have hurt as bad as it did…he would never had submitted to the test. (Although the test might have saved his life).
Several men stated that they felt that ALL UROLOGISTS should have a biopsy on their prostate so that they would know exactly what their patient was going through. In that way, the urologist might be willing to volunteer provide some local anesthesia to reduce the pain and trauma.
Urologists…do you get the picture. What is reported to you is inaccurate (men don’t want to admit to their pain) and it (the biopsy) freekin…hurts – SO GIVE US SOMETHING TO TAKE THE EDGE OFF.
WHAT ABOUT AFTER THE BIOPSY? For most men normal functions – exercise, work, activity will all resume as normal either the next day or day after that. Now, when I say normal functions…that also includes sex.
I’ve scoured the Internet and seldom do I see PRACTICAL ADVICE that men need to know – so here’s some. A few days after your biopsy you may engage in sexual activity. Be prepared! When you achieve orgasm your ejaculation will be bloody. Guys I don’t mean a trace of blood, but bright red bloody. And, gentlemen, if you are unprepared for that, it can cause alarm. That alarm may be to you and/or to your partner. Nothing can change the mood of an intimate evening of sexual play than to achieve an orgasm and find that you look like you just hemorrhaged.
GUYS… The biopsy is necessary so in no way take this entry as anything other than solid information. Have it done, and more than once if necessary. My personal advice is – request pain medication.
Chuck Gallagher is a business ethics and fraud prevention speaker and author. Having been diagnosed with Prostate Cancer, he spends time working to help educate men and their families about the practical aspects of Prostate Cancer and how to survive.
This entry was posted on Monday, November 10th, 2008 at 5:12 am
Prostate Diaries 
When I had my biopsy the nurse said the doctor would give me something to take the edge off the pain, and I believe he did, but either it didn’t work, or my pain threshold is much lower then I thought, and when I was in my 20s I played 60 minutes of rugby after breaking a rib (no replacements allowed in those days). Anyway, the biopsy hurt. Dr. McHugh, the guy you quoted about the Texas wasps was exactly right!
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About time someone gave an honest over view of the prostate biopsy. I also suggest that men stop “biting their stiff upper lip” when it comes to pain also please be honest when subjects infringe on their masculinity.
As a researcher it has astounded me that men do not honestly report, to their treating physician, that they are experiencing erectile dysfunction after prostate cancer treatments. The Urologists are then able to skew their results and data is totally misleading. However,this isn’t the worst omission in my opinion. When another prostate cancer survivor; when asked about his erectile function by a fellow survivor, blantently lies stating “no problem.” Men you have no idea how disheartening this is. Defunitely not helpful!
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I was composing a list of prostate cancer survivors for Listamania on Amazon. I came upon an interview with Harry Belafonte. When asked how his sex life was after the surgery for his prostate cancer, he said something to the effect of, ” My wife and I have a meaningful relationship.” I think that makes your point nicely Ph.D Jo-An. Men just don’t go there.
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Well, I just had my biopsy done today. The doctor told me that I would feel something like a pinch and of course the loud clicking of the biopsy gun or whatever they call it. I have to say that I think the worst part of the whole thing was when the ultrasound probe was put in and moved around. I felt some uncomfortable pressure but not really pain. The doctor first put in a needle to numb the area which apparently worked. When the first sample was taken, I jumped a little, but this was mainly from the loud click the instrument made. It’s definitely an uncomfortable procedure and I was very glad when it ended, but I have to say I don’t feel it was really painful, just uncomfortable mainly from the pressure.
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thanks for your response…. it will probably be of help to others having to ” endure the process” like you and me.” I hope your results are good for you. JM
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Hi i had mine done yesterday I was nervous but it was a breeze no pain and I don’t like pain blood in my urine four an hour then all clear
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I found the procedure very painful and it was two weeks before back to normal. That first ejaculate apears like brown sludge coming out – quite disgusing and very offputting.
In this I learn that when anything is probing around down there it is instinct for every orifice to tighten up as tight as possible quite reflexively. I found that automatic tighening caused the most pain. So I worked hard at relaxing the orificies to reman relaxed. And it worked quite well. Trouble is that I hadn’t figured it out until the 10th of the 12 biopsies! I have another coming up, lets see how it works next time. Also when I told my urologist he prescribed some Ativan (minor tranquilizer) to take about an hour ahead of time. What would be a good preventative pain-killer? The injection did nothing for me.
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Be sure to have an empty bladder before the procedure. Consider a slightly larger dose of ativan and then add with it something like percocet. If you and your urologist are lucky, the prostate block (is this the injection you are talking about?) will aid the meds quite well. In cases where a patient is very uncomfortable we have added a small amount of I.V. meds. These biopsies are no fun and there is always some discomfort associatied with the probe itself, however with a little luck and the right meds, it can be made to be tolerable. Good luck. The fact that you are having another one means that you either had no cancer or that you did but it is a small amount and you are pursuing surveillance. In either case that’s good. jm ps…i’ll visit you site pss… I don’t see a problem with taking four advil before the biopsy with an ativan.
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‘I do recall asking if there was pain, and again, my urologist stated, “Most men feel very little. Nothing to be concerned with.”’
Sounds exactly like my urologist and yeah, it hurt like hell. After the first click of the gun I gasped & told him it felt like a bomb had gone off. I felt the pain travel up my spine.
The doctor didn’t response & didn’t care. I was sweating from the pain by the time it was over.
Later I emailed him that the procedure had been very painful & that I had many shooting pain episodes later that day.
Guess what the jerk wrote back. Yeah, the quote above…it’s like urologists are brain dead & parrot whatever they hear at their annual (anal?) convention when they should be listening to their patients.
I don’t buy the argument that other guys say nothing about the pain — we know we’re living in the 21st century & there’s no reason to suffer such pain. Every dentist provides novacaine & some provide more.
Puritanism is alive & well in this regressive USA & this doctor didn’t want to give me anything to ‘feel good.’ The fact I have never abused any medication did nothing to mitigate the ‘Thou Shalt Not’ attitude of health ‘professionals’ living in the 17th century mindset.
I recommend having any such medical procedure outside the United Staes.
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I had the same procedure, and was told I would feel a little discomfort. This is how I would describe it:
Having your ass attached to your balls from inside with a staple gun!
If they won’t drug you, pre drug yourself.
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This is a very good post, I just had a biopsy done a few days ago. I had been putting off for a few months because of fear of the unknown. I got a second opinon and let the second doc do the job. He let me know up front what to expect and gave me 1 mg Alprazolam tabs to take the night before and the day of. Plus Hydrocodon 30 mins before. At 52 i’m not afraid to say that this all scares the heck out of me. My Dad had Prostate Cancer and has spent the last 15 years cancer free but not problem free.
Now with two days past I still have a little pain in the ass. I find that kind of funny. People love to say things like ” that a pain in the ass. Well guys after you have the deal done you can really say the you have a pain in the ass.
Maybe its just me but Alprazolam made this whole deal a lot eaiser for me.
Am I a wimp when it comes to stuff like this. Yes!
Do happy pills help? Yes!
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I just had my second biopsy; my first was a few years ago. Up until yesterday that was, far and away, the worst experience of my life. At the time the doctor had told me that I would feel a “… little discomfort…”; that was something of an understatement but I was naïve enough to believe him. All of the descriptions here are accurate but I’ll add my own; Put a BB gun up your ass and shoot yourself with a pellet 8 times.
So when the doctor told me I needed another biopsy he made sure to add that the procedure was different and “… Not too bad…”. Fool me once shame on you, fool me twice shame on me! I fell for it again and believed him.
I’m not sure what part of the procedure had changed, maybe the color of the probe? Without a doubt the part about the excruciating pain was still exactly the same, even worse because I don’t remember yelling “F&&K!” the last time.
We started with the doctor saying he was inserting some numbing cream and I’m quite certain that this hurt way more than it should have hurt. I firmly believe that he could have been a little gentle and he would have saved me some pain. When you go to the dentist and he gives you a shot, doesn’t he generally give you 15 minutes or so before he starts drilling? My dentist usually checks to make sure that I’m numb before he digs in. This was not to be with my biopsy, the doctor put the cream in and followed immediately with the probe and started banging away. I think I started to numb up on the drive home.
I had a shoulder operation in June and I still had 3 Percocet left over and believe me when I say that I thanked God before I swallowed each one. I will never do another one of these again without taking the Percocet BEFORE the procedure and I’ll add a Valium to a shot of Jameson and let my wife drive. Now I’m waiting for the results!
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Just had the biopsy done yesterday; was thinking about the best way to describe the worst medical procedure I have EVER been through… and I thought “like ramming a BB Gun up your butt and firing away.” I will NOT be doing that again without full sedation. Made me laugh to see someone else describing my experience.
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A drink and pill before the biopsy sounds like a plan to me! I have never had Jameson tending toward maybe a bit more frugal Famous Grouse. I wish you good results. jm
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Had my 1st Biopsy this AM at Atlanta VA Hospital.A Little discomfort with probe going in and moving around, Doc did a block, only felt a Thump on each probe firing- no pain, Glad it is over, very professional team. praying for good results! BC
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I was given NO pain medication. I had a 12 core TRUS done at the Lahey Clinic. By the third “snap” I was begging for it to be over. Bee sting [bleep] more like a firecracker going off in your abdomen. The special icing on the cake were the two nurses sitting outside the door watching the men stagger out of the biopsy room after the TRUS, laughing. Just my own very personal opinion. Needless to say I did not go back to the Lahey. I am now being treated well, at the Dana Farber.
Martin Miller
thousandfeathers.com (a blog on phytonutrients that fight cancer)
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When will they “Get It”???? It is very simple: IT HURTS!!! It most certainly does not resemble a bee sting and it’s not discomfort… IT’S PAIN. Good Luck with that, I hope you get the same news I did.
My doctor called to tell me the results were Normal and we’ll have to do this again down the road. I told him not without an Rx for Percocet!!! I won’t go in there again without self-medicating first.
Tom
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I see the last post was 2010, so here is a current one. The biosopys saved my life and I have an excellent doc; however, he told me the same thing that others have reported: “I will deaden the area and you won’t feel much.” WRONG!! I have never had anything hurt so much in my life. I am 66 and have had some physical pain, but nothing like this experience. Personally, this procedure should be treated as a colonoskopy. Patients with this procedures should all be put under!!
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Sorry, did not see the October 2011 post
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I just had my first prostate biopsy yesterday. The most painful part was the probe that was used for the ultra sound to measure the size of the prostate. As far as the samples being taken, I hardly felt them at all. Also painful was when the probe was moved so samples could be taken on the other side of the prostate. The anxiety I experienced beforehand was way worse than what actually happened. I am waiting for results. Dave
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As a follow-up to this situation, I developed a fever the second night and had extreme chills and night sweats. It was the weekend so I let it play out until I had to call the doctor’s office Monday. The got me right in and started me on antibiotics. I eventually went to the ER that night with a 103 fever. UTI they said. So I spent about 5 hours getting fluids and more antibiotics. I was cleared and given another prescription for 30 days, this made 75 days in all, including the original pre-biopsy 30-day dose to get my PSA down in the first place.
Now 4 months later the regularly occurring symptoms are gone. To complicate things, I had a vasectomy done as well (this was my original reason for going, but had to be put off for 6 months to deal with elevated PSA.) I may experience random bouts of weak urinary stream or erection issues, but not sure to which to attribute this.
All-in-all content with the situation now. Just wish I had been more aware of what to expect.
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1st 6 needle biopsy not so bad…freezing needle was painful. Second biopsy a year later was 12 needles, and got some Ativan for that, but the needle still hurt like *&&*^% and it didn’t work on the last 6…they offered to “freeze” it again, but I figured the biopsy needles couldn’t hurt as much as the freezing needle, so I declined and just said “get it over with”…F*%#! . Now they say I have to have a biopsy every year? I’m only 57! …they found the smallest amount possible on a measurable scale in one tiny portion of one core. One doctor told me they probably found the portion we all have. *sigh*
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Hi dave
Same story hear found a tiny bit of cancer in one core after a psa reading of 4.5 thats now 2.9 and now im on the active serveillance train for the rest of my life 54 now and about to go for my second biopsy and theres no way in hell am i being awake for it!
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Well my biopsy came back positive for cancer. 7 out of 10 were positive. I am scheduled for a robotic assisted prostatectomy in a week and a half. My Gleason score was a 3+4
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My story? I went for a biopsy yesterday and told the nurse afterwards that I would want it again. No pain for me. The problem I am experiencing is that I cant…..pee… other wise known as dysuria. It was so bad last evening that I had to go to the Emergency department, and asked to be catheterized… mega relief…ahhh… today I am at home, took a sick day and am walking around with a catheter and attached bag…. Am to return tomorrow A.M. to get the catheter taken out… I hope it happens because I cant go to work like this!!!
My overall experience of the actual biopsy procedure? Not as bad as I anticipated… However I asked the radiologist why in the world would God put the Prostate where it is! He said it was a design flaw. No! I suspect God must be a woman and she was getting her revenge on us…
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difficulty voiding after a biopsy may indicate underlying prostate enlargement….be sure to tell your urologist about any antecedent voiding symptoms of obstruction before the biopsy..ie. slow stream , getting up at night, hesitancy, stop start stream ect. good luck with your “voiding trial” and the results of your biopsy. jm
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I had a biopsy performed several weeks ago. I was given ( 3 ) Valium pills to take an hour before the procedure. The procedure was a walk in the park. Honestly, I felt a little sting, I guess for the numbing, and also slight stings each time he took a sample. It was over before you knew it. If I have to go for another biopsy, I will not be the least bit upset. Trust me gentleman, if you request valium to take before the procedure, you will be fine.
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I patted myself on the shoulder as I read through the posts, for having my prostate biopsy performed under sedation last week. The only needle stick I suffered through was the IV line placed into my arm… the rest was a walk in the park. Until the next day, that is. Feeling a bit clammy, I checked my temperature; 99.5… no big deal, I’ll call the doctor, get something prescribed to take care of it. Right? WRONG!!!!!
My fever registered 101 within a couple of hours. A trip to the emergency room landed me in a hospital bed for 4 days, on 5 different IV antibiotics – with fever spikes near 104 between doses – to cover whatever type of bacteria that was transferred from my asshole to my blood stream during the dreaded biopsy.
Great news though; my biopsy results showed no prostate cancer!
The price: a picc line in my arm for a 12-day course of antibiotics at home, to treat the special strain of gram rod negative bacteria .. PLUS pills for pain, nausea, small ones, red ones.. AND, urinating still hurts like the dickens, even more than before, which was the reason this all came to be in the first place.
Would someone please talk about this prostate biopsy-associated disaster.
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Wow… that sounds like the procedure from hell. I’ve had 2 prior biopsies and I’m going in for my third on Monday. No preblems with the first 2 execept that they hurt like hell. I requested an Rx for Percocet to take the morning of the biopsy and I have anti-biotics. My guess is that you also had the ABs and still got an infection? That’s scary!
I don’t know, wtih all of the information in the press about this recently, everyone I speak to has an opinion!!! Do it, Don’t do it!
I think I want to know if I have cancer; if it comes back positive I’ll have some decisions to make but for the present I do want to know.
I know one thing, I’m 57 and I’m not spending the next 20 or more years wearing diapers. Maybe I’ve already made my decision…
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Are there any physical restraints after a biopsy? My husband does grappling and wrestling and just had a biopsy 2 days ago. Do I need to be concerned? The doctor didn’t really say anything.
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Hi…there is normally some bleeding after a biopsy which goes away with time. If he has blood in the semen this usually takes the longest to clear. If he is on no blood thinners and the immediate post procedure bleeding clears, patients usually can then gradually get back to their normal level of activity. I wish you a good result on the biopsy. JM
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Hi, I had the biopsy done, which was painless in my case, due to the ( 3 ) valium I took an hour before the procedure. I had blood in my semen for at least 6 weeks after the procedure. I was told by my doctor that the blood in the semen is normal and can sometimes show up 6-8 weeks after the procedure.
You and your husband do not need to worry.
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My doc said no exercise and sex for a week. No aspirin or advil or Alieve – just Tylenol for pain.
I do with they would discuss specifics of aftercare when scheduling to allow you to plan better. But I’m going to start doing that with all medical procedures — if I can’t get a copy of the discharge sheet prior, I’m just skipping the procedure. I know things can vary and I’m OK with that, but doc suggested I “take a couple of days off from work” after the biopsy and it would have been nice to know that “on the front end”. That was never disclosed by their scheduler…
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Death or prostate biopsy? Death.
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A joke from my resident days that a fellow resident told to his attendings in New Zealand comes to mind,”Death or Achechi.” Brevity is indeed the soul of wit. jm
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I’ve had two of these. The first was, under that wonderful “numbing cream” was so horrific that I insisted on sedation for the second one. Describing it as a bee sting is pretty good, but for me it was more like having my eyeball flicked really hard with someone’s finger, sixteen times in five minutes. I agree totally that all uroligists should experience this themselves. It should be standard practice to at least use conscious sedation for this procedure. But sometimes doctors, smart as they are, are just dumb when it comes to patient comformt
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Continuing from my last post. . .Sometimes doctors and nurses are just dumb when it comes to patient comfort or dignity. In the first procedure, I was taken to the examing room and told to take all my clothes off and lay down on the table, but the nurse never left the room when I was stripping. During the biopsy, my butt was never covered and was visible to everybody in the room, including those entering the room for unrelated issues. Sheesh.
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Come on Richard – Speak up – or man up – tell them get me a sheet, a comment card, and your office manager- where was your wife- I’m sorry I’m Irish and indian, and yes in the medical field, Sorry you must be young! Not like this old baby boomer – keep the faith 😉
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Doris, too bad that as a woman you can’t go through this happy little procedure before telling somebody to “man up”. I’m sure you wouldn’t be so cavalier in your attitude if it was you facing uncertainty and fear. Does being “Irish and Indian” somehow excuse you from manners? It appears being in the “medical field” somehow does….
Richard, some folks are body conscious and there’s nothing wrong with that. Sometimes medical pros forget that, since they see many bodies in the course of their jobs. They sometimes become hardened to the pain, discomfort, modesty and privacy of others. All I can say is EVERYBODY’S day is coming. Let’s hope when their time comes, they handle the disrespect and lack of courtesy in the same way they expect you to. 🙂
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I am seeking advice on what damage a badly handled prostate biopsy can cause. During my procedure which was painful but manageable the last and final cut caused acute pain that created the most awful feeling (I am struggling to descibe the feeling!). The person taking the samples immediately apologised and I thought nothing of it until resuming sexual activity when the same ‘feeling’/’pain’ occurred upon orgasm. I am now in the position of having uncomfortable pain every time I orgasm and am starting to believe that what occurred during the biopsy was an ‘accident’ and should not have happened.
I need to understand what was ‘cut’ and what is causing the pain? I am frustrated that I do not understand the mechanics of what might have gone wrong and if the person taking the samples was incompetent and a danger to others.
I hope someone can help explain what might have happened to me.
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Well, I had my first prostate biopsy today. I explained to the nurse that I was very apprehensive concerning the level of pain and discomfort and confessed to her that I had been reading this blog. She assured me that most of the posts here were from men who had the worst of the worst experience and that the average level of discomfort would be much less. Not sure I believed her at the time.
Anyway the doc came in and explained everything and all along the way. Final discomfort level was a 3/10 and pain was 2/10. Much less than anticipated.
I am posting this here to help reassure those who are getting ready for this procedure that they should not regard the comments listed here as average. Odds are it will be much less traumatic than you imagine.
I go back next week for my results. Hope I get good news.
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I had my second prostate biopsy done today. The first was in 2006. (That one was negative, but my PSA has climbed from about 4 to 12 over the six years.)
Neither caused terrible pain – the doctor used a local anaesthetic gel in both cases. He did say that some men get far more pain than others. I was offered sedation (Versed/midazolam), but I do not react well to Versed, I would have had to take a week off after its use, it makes me very aggravated and grouchy for about a week. The doctor was more than willing to work with me to make sure that I would be comfortable during the procedure.
I was really concerned the first time, but I was one of the fortunate guys who only get the ‘bee sting or less’ reaction – to me it feels like a pinch, it grows in intensity for about a half a second and then fades slowly. By the time I left the office (five minutes after the procedure) the only noticeable discomfort was from my (quite sizeable) hemorhoids, but even that is resolved now, about an hour later.
Talk with your doctor about pain meds, sedation (Versed and other benzodiazepines don’t knock you out, but they relax you and give you ‘blackout’ – you remember little or nothing of the procedure). Because I can’t take Versed, the doctor that did my last colonoscopy suggested just using fentanyl – which worked out great. They started with 50 mcg and gave me another 50, which made the entire procedure painless, and didn’t give me a week of being an ogre. If your doctor won’t work with you to make you comfortable about your procedure, find another doctor.
One other hint that I learned from the ‘net before my first biopsy – bear down like you’re trying to push out a bowel movement whenever they’re inserting anything (finger, ultrasound probe, scope) into your rectum. It’s relaxes the sphincter and is much less unpleasant (relatively speaking!). Doubly helpful with hemorrhoids!
And no, most doctors don’t tell you this.
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I’m from Canada and my prostate biopsy was a breeze. My urologist said I could go to the hospital and be out completely under anesthetic if I wanted. My choice. I’m so glad I did. No pain at all from the procedure and I felt chipper and alert after I woke up. The only way to do it if you have the option.
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I’m very glad I found this blog, there is a lot of useful information and even though there are some horror stories, it somehow relieves some of my anxiety about the procedure. I’m 73 with a psa of 10.4 up from 6.5 in April and just made arrangements for a biopsy. I didn’t realize that an option for pain was to be out completely under anesthetic. Is that only done in a hospital setting? Is there any down side to having a biopsy that way?
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Joe, the only down side I know of is the usual very small danger of going under anesthetic. For me it was well worth it to be “out of the room” when the painful procedure was happening. I understand it can be pretty traumatic for some folks if they are awake. For me I was surprised how I wasn’t groggy or feeling out of it the next day. I was pretty well feeling great except for some discomfort peeing for a day. Perhaps some doctors don’t offer the option of being out for the procedure. I was very happy I did it. Best of luck.
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What are the downsides of ” watchful waiting” with mostly waiting and very little, if any at all, active “watching” ?Prostate
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I agree Watchful Waiting’ is a terrible term as it implies the man is the only one watching and waiting. I prefer to use the term ‘careful monitoring’ which I think implies team work between consultant,CNS, doctors and the man himself. Monitoring at intervals determined by previous tests and examinations.
The downsides to ‘careful monitoring’ are those that affect a mans psychological state. This is where prostate cancer support groups can be of great benefit I remember when I was first diagnosed in Feb 2007 with metastatic prostate cancer I visited the Princess Margaret Cancer Hospital in Toronto and what I saw there inspired me. In a corridor just off from the waiting area were 2 rooms one called ‘Man to Man’ where men could sit and chat to each other about things they may feel were too trivial to discuss with their consultant. A little further down the corridor was a room called ‘Side by Side’ it was for those who loved and cared for their men. It was again a place they could talk to others in a similar position about their issues in caring for a man with prostate problems. The groups that I am involved with in the UK have all benefited from sitting around and talking to other men who may have had a similar experience. After all most of us can use the internet to read medical facts in great detail but a page of medical text is unlikely to help a mans anxiety I am about to help create another self help group as soon as my health improves. Cancer is an awful disease and its mangement should always be focused around quality of life in my humble opinion.
Keith S Cass
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Thanks for this website, the information you and other paitents provide is incredibly helpful. I’m 47 and had an elevated PSA in Jan at my annual check up. Reffered to a Urologist, we retested every three months thinking it was an infection since I had a normal DRE. First of Sep we decided it was time for a biopsy. My urologist offered in office or sedation as an outpatient. He said the younger you are the more it seems to hurt. I went with sedation, it didn’t hurt but I was in pain until about midnight. Results, 18 samples 9 left prostatitis, 7/9 on the right with cancer 5-35%. Gleson of (6) 3+3 staging of T1c.
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I am 56 and had my first biopsy and cystoscopy on Thursday 18th October 2012.
I emptied my bladder before going in but not because I was told to.
In hindsight I think it was sensible although not premeditated. I had been waiting for a while and just decided to go.
The most discomfort during the biopsy was from insertion of the “tool”, the doctor explained due to large prostate.
After I was given the two numbing shots I then experienced more discomfort than pain.
I could definitely feel those first two shots, but they were not unbearable. I heard the other ones, … and counted them off.
The fear and dread I experienced prior to the procedure was misplaced.
…. but ……. I am extremely glad it is over … in fact, … positively ecstatic.
Now I am waiting on results ….. and praying.
I peed immediately after exiting from the procedure, not a pretty sight to watch …. and then could not pee for a couple of hours although I felt some urgency.
Blood in urine and stool was gone (as far as I could see) by yesterday, Saturday.
There had been a fair amount, clots and all, Thursday.
Soreness abated by Saturday too and can’t remember feeling any today, Sunday, three days later.
I’ll give myself a few more days before trying out my sexual function.
I was back to normal work activity on Friday, bar the blood and soreness.
Just took it careful.
I exerted myself physically for three hours doing some tough yard work today and don’t feel any the worse for it.
Thanks for the website.
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Just wanted people to know that Ativan, valium and all the benzo’s are muscle relaxants and anti-anxiety meds not pain relievers. If you are looking for pain relief find a narcotic to go with the muscle relaxant, they work very well together.
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As Kelly stated, ativan, valium,etc are to help you relax but do nothing for pain. I was prescribed 10mg of valium and oxycodone(took 2). I could not imagine doing without either.
If your Uro refuses to prescribe meds, get another doctor. Would you get a root canal w/o a pain local and just tough it out?? Unless you are one of the few who enjoy pain & torture then go drug free and have at it….
As already having a low flow, the next night I almost had to go to the ER, unable to void.I got was finally able to go a little after bowel movement and a hot shower. For me, flow problems are worse at night and improve while awake, so I stayed up, but it was very close to having a catheter at 3 am in the local ER
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Had my first 12 core biopsy in June 2015 ( no meds) urologist assured me it would be almost painless, by 5th core I was in agony however I made it through the 12. Waited 1 month for results, (called his office several times) Result 3 cores showed cancer Gleeson 6. I decided on watchful waiting. Next appointment the urologist suggests another biopsy in 12 months. I informed him, not without ” anesthetic ” and that I want targeted biopsy MRI. His reply was you’ll have forgotten about the pain in 12 months and it takes 9 months to set up MRI targeted biopsy. I made up my mind at that point I was with the wrong urologist. Got new urologist he said no problem if you want to go the targeted biopsy route I’ll set it up. Well I had second 12 core biopsy this week at (Princess Margaret Hospital Toronto) freezing on both sides of prostate it was better but still very painful by 8th core the urologist asked if I wanted him to stop, I said ” no just get it over with “. I agree the urologists should have to experience a biopsy before being allowed to tell patient’s it is almost painless. At least that is the way I feel at the moment. Having read the posts on this page I have come to the conclusion the urologist didn’t wait long enough after the prostate freezing (which in itself quite painful) my guess is he waited 2-3 minutes from what I have read he should have waited at least 5 minutes
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A few years ago I built a Urology Ambulatory Surgery Center. I now do the majority, not all, of my biopsies there with propofol general anesthesia. This drug is commonly used for anesthesia for colonoscopies. The benefit is that it is fast acting, requires no tubes or LMA, and patients wake up very quickly without significant after effect. Not all urologists have the benefit of a surgery center. If done in the office, an oral sedative like Ativan combined with a pain medicine such as Norco in addition to a nerve block (Lidocaine placed at the junction of the seminal vesicle to the prostate bilaterally- this area is easily seen on ultrasound) will usually provide very suitable anesthesia. What you see on this site over and over again in what appears to be insensitivity of the treating urologist to the patient’s pain. I don’t quite have the answer for that unless before you go to a urologist ask your friends for recommendations of who seems to be a more compassionate urologist. Then consider choosing that one instead of blindly going to one that your primary doctor recommended. Some times urologists are associated with the family doctor so the referral may be more out of habit than “who is the best or most compassionate.” I see 5-10 patients a month who have been to other urologists and disappointed with their care. I also might suggest that the burden of the evaluation of “getting a good doctor” I feel rests upon the patient himself doing his homework on the doctor “before the visit.”
It is better to cure at the beginning than at the end. JM
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I’m a 62 yr. old with an elevated psa fluctuating from 4.82 to 6.93 over a 13 month period and a negative DRE. In order to avoid the biopsy, I paid to have a MRI done at my own expense. The scanner was the latest 3.0 Tesla machine. The report stated that my prostate is enlarged, 55.9mm. Shows normal on T1 imaging but a possible abnormality on the T2 imaging (It states “On T2 imaging, there is a loss of the normally bright T2 signal in the peripheral zone, but this area enhances normally on the multiphasic gadolinium enhanced sequences. The capsule is intact, the surrounding soft tissues are normal, normal bone marrow signal”)
They also recommend a prostatic needle biopsy. I wonder if the private clinic is just covering their prosterior or should I get the biopsy done as the enlarged prostate is more than likely causing my elevated psa. Is anyone a radiologist and explain to me what that T2 report means, that portion seems to contradict the normal scan re: gladolinium enhanced sequences. Looks like I’m going to have a biopsy done anyways depending upon my psa test for Nov.
Thanks for any clearification.
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I had 2 biopsies – the first with 8 samples and the 2nd 20. The first required no painkiller. The 2nd I had a couple of pills to relax me. It felt the same as the 1st. The doctor was surprised I handled the 2nd one so well. It just did not seem to be that bad – inhale, bang…repeat. Perhaps I have a high tolerance for pain or perhaps I had no painful expectations – I did not consult the internet before I had the 1st one done.
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Thanks for this site, reading it has been helpful.
I am 56 years old and just had my first prostate biopsy today. My PSA went from 1.7 to 3.2 in two years and the doctor said in the digital exam my prostate felt a little enlarged. Prior to getting the PSA results he put me on Rapaflo, but that is a whole other story!
During the exam my prostate was given an injection for the pain. The exam was uncomfortable, but not real painful. I am experiencing more pain and discomfort since the exam than during it. Since being home I’ve had a bowel movement which made me dizzy and I’ve urinated some blood.
Reading this blog has encouraged me to call the doctor’s office to see what I can take for the pain I am feeling now.
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My prostate cancer was diagnosed after the fourth, yes, the fourth biopsy of my prostate. I swore to my urologist after the third that I’d never, ever have another one done. Then my PSA spiked from a baseline of 7 to a high of 26 and, on consultation, I decided that the fourth one was warranted. Glad I did.
In my experience, each biopsy was different. The first one was scary given the noise and the pain of the pain blocker, the probing and pushing. I felt relief when the whole thing was over. I had a bit of pain for the next few days, nothing that Tylenol couldn’t handle. The second biopsy went much easier. Now I was an “expert” and knew what to expect. I had less pain than from the first one but that was really a relative thing. My pain was managed but the bloody urine lasted nearly ten days and, while I was assured that it was nothing to be worried about, worry was there. The third biopsy was a killer. I had significant pain, bloody urine, and the pain lasted nearly a week after the procedure. I never wanted to do it again.
Then came the spike in PSA and as bad as my memory of the last biopsy was, I decided to submit because of the unusual PSA numbers. This biopsy went quite smoothly. Being an old pro at this procedure, I joked with the urologist that I could probably do this myself. I also joked that this one was relatively painless and that practice must make perfect. Even the aftermath of the procedure was nearly free from pain, a bit for the first two days and then nothing. Very little blood in the urine until about 5 days after the procedure.
This biopsy revealed a cancer with a Gleason Score of 4+4. This led to a bone scan and CAT scan which revealed no metastasis but, because of two replaced hips and a titanium back there was a lot of noise in the groin area so a definitive reading of lymph nodes could not be done there.
All this led to a Radical Prostatectomy and resection of the lymph nodes. The end result was that the cancer involving 35% of my prostate had not reached the margins, the lymph nodes were normal and I am now cancer free. I would put up with the pain of the biopsy several times over as a reasonable trade for the results I got. While not the most pleasant of all procedures, the needle biopsy of the prostate seems to have added many additional years to my life and I am grateful. Now if I can keep from being run over by a runaway bus…
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Im 51 with mild enlarged prostate symptoms. I was doing some year end stuff since all my deductibles were met, my insurance is likely to change to Obamacare next year, and my new GP was cooperative. PSA came back at 1 so I was very happy. Went for vasectomy consult. Urogist did DRE. And suggested biopsy based on that. Glad I only read this site the night before so my fear/anxiety was only for 12 hours prior to procedure.
When nurse/assistant asked if I knew about the procedure I said I read about it here. She said something to the effect of ‘Oh no’. I said I now knew blocks never worked and I was going to be in agony but would most likely live. She chuckled and said their blocks usually worked.
They treated me with as much dignity as possible. Their method seemed to be to start explaining what was next just as they did it. ‘We are going to (BAM!) the tool….” Which worked well. Lots of discomfort but no real pain. I was not able to play golf later in the day as I’d hoped but more like 2 days later. No blood in urine or stool but in semen. Waiting on results.
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Had my fourth biopsy this past Thursday. Dr wanted it done because of increased PSA levels – again! Had been down but spiked up again to 12.
Am a little worried but the urologist who did the biopsy was good. Gave local freezing after I told him of my usual experience with a dentist and needing more freezing so he doubled the local. Said it happens to him at dentist too so no problems to increase local. Halfway through on sample 7 of 12 he gave me 3 cc more freezing cause I jumped quite a bit but was okay after that until last one which he said is always the worst since it goes into a different area??
Some discomfort for rest of day took it easy. Now I wait for results with bated breath. I seem to have all symptoms of BPH so hoping my enlarged prostate is actual cause but who knows until result come back. Last results were atypical in some areas but non-cancerous.
Of note, my first biopsy was done without sedative or freezing. NEVER AGAIN. Second one resulted in septicemia [a blood poisoning of sorts because of biopsy location obviously] that hospitalized me for 5 days on IV antibiotics. Dr said ‘Eh, it happens and shrugged saying you have to accept risk when working in that area”. That was when I changed doctors!!!
Third biopsy went well but my urologist did say that having had three biopsies now could be a reason for increased levels of PSA since the biopsies could cause irritation of prostate. Don’t know but I want to believe that.
Wish me luck on result.
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I had only one Biopsy and will never do that again. Of course that is because my prostate was removed. I think the biopsy was the worst part.
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I must be one of the lucky ones. I had 12 samples taken without any pain relief. Although a little uncomfortable and a tiny sting I didn’t feel the need for any local anaesthetic.
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My one biopsy was done in 2008 after PSA went from 1.5 to 4.2 in a year. It was one of the most painful experiences in my life. The only thing given me was an antibiotic to take before and after. It was a 12 core sample. The probe didn’t bother me at all but each of the 12 hurt so bad that afterward I had to lie there for quite a while just to get composed and sweat to dry up. One of the core samples hurt so bad it was like a cattle prod hitting me and an electric shock all the way down through the tip of the penis, which left it throbbing with pain.
After that episode I immediately had ED which I had never had before, and now more than 4 years later the ED has not improved and there is less feeling in the penis. I am convinced that the one sample that caused the severe shock hit the nerves and caused some kind of permanent damage. Urologists have prescribed Viagra and Ciaslis, none of which has been very effective.
Oh – it was negative.
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I really appreciate your posts and wish that more doctors would be up front about what to expect after the biopsy. I had one four days ago and my wife and I just had our first encounter post-procedure earlier today. While my wife and I were prepared to see “a bit of blood” in my ejaculate as my doctor had warned, we were NOT prepared for the bloody mess that arrived. Lots of volume and almost all of it appeared to be blood.
Had it not been for your posts here, I would really have been sweating this. Thanks for putting my mind at ease.
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As an aside, the procedure itself was not plesant, but also not overly painful. My urologist did give me what I assume was a prostate block (an injection of something like Lidocaine) after targeting the prostate with the ultrasound probe. I’ll admit that I was nervous as hell and was expecting something much worse.
My dad had prostate cancer at 50, but had his prostate removed and is still with me at 90. I hope that I won’t have to make the same kind of decisions that he was faced with, but I’ll know more in about a week when my results are back.
For now, I just appreciate that there is a place where I can come for REAL advice and perspective from others going through the same thing. That’s a comfort that men of my dad’s generation didn’t have and it certainly helps.
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John, i just wanted to let you in on my story. i am 53 years old and had my prostate removed 1 year ago. 5 of the 10 biopsy samples had cancer. It all started when my PSA was elevated. It was between 4 and 5. My doctor referred me to a urologist who recommended a biopsy, where they found the cancer. I was having absolutely no symptoms at all. On March 5th of 2012, I had robotic surgery. If at all possible, I would strongly urge people that need the surgery to have it done roboticly. Don’t want to scare you, but I believe the PSA test saved my life.
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Thanks, Dave…I appreciate your willingness to share your experience with me. Given my dad’s success with a prostatectomy, that’s probably the route I’ll choose if the cards are dealt that way.
I’m wondering if you’d be willing to discuss any problems that you’ve experienced post surgery. I’ve read a lot from men who’ve experienced incontinace and some sexual dysfunction after prostate surgery. I know that my dad complained of both symptoms after his surgery and it’s obviously a concern. Thanks again.
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John, I would be glad to discuss anything with you.
Dave
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Well…I received my biopsy results yesterday and found that one of the twelve samples came back positive for cancer. if I understoond the nurse correctly, my Gleason score was 3.3. I’m scheduled for a bone scan next week and a follow-up with the urologist the week after that to discuss treatment/surgical options. Bad news – positive for cancer / good news – looks like we caught it early.
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John, she probably said the Gleason score was 3+3. Mine was 3+4 which is better than a 4+3. Both equal 7 but the 3+4 is lower by Gleason scores. One out of twelve samples is a lot lower than mine was. If you want to talk privately I can get you my e-mail.
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Again, I really appreciate your willingness to talk with me about your experiences, Dave. You can shoot me an email at this address: iftrep at gmail dot com. (Spelled out to avoid spammers and email bots.) Thanks!
– John
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Well I had my third biopsy 2 days ago. The only change is the probe is slightly smaller. All of the comments above are on target. It does hurt but at least it is over relatively quickly. I agree the sound of the clicker causes you to tighte up. My doc counts 1 2 3 and I am not sure that doesn’t make it worse.
My question is that since my biopsy I feel like I need to urinate every hour. Last night I got up 6 times where before the biopsy I got up 1-2 times at most.
Anyone else experience this?
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It may mean that you have some underlying prostate enlargement that has been exacerbated by the biopsy. I’d let your urologist know as he might add a med like Flomax in the short term to help with bladder emptying. He may want to check for an infection as well. When in doubt, call the docs office and let his nurse know. jm
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Thanks Doc,
I called the office but you have responded before them. I had the IV with antibiotics in addition to antibiotic pills for 4 days, so hoping to rule out infection.
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Well, I am 63 and no family history of prostate cancer. My prostate is 58 cc,enlarged, and the PSA increased to 4.2,although all DRE’s were OK. I decided to have ultra sound, against my general practitioner advise, and the result is prostate enlarged 58x38x46 mm, prostate is in inhomogeneous in echo texture, there is suspicion for a tiny eccentric hypoechoic nodule measuring 18×24 mm. This extends from the mid portion of the prostate anteriorly. so now any advice is welcome, because i do not know if a normal biopsy will check it out. Thanks for any advice.
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Carlos,
Not sure if this helps you or not. I am 64 and recently had my third biopsy (father died of it at 66). My doctor continuosly tells me I have a very large prostate.
Following the biopsy (which was negative) I was urinating every 20 minutes. Went back to the urologist and had to be catherized. Went back three days later and couldn’t urinate when they removed the catheter.
I had to leave town for two weeks so my catheter had to stay in. In 2 days I return and hope to have it removed permanently. If not I may need to have a different type of surgery.
Anyhow my psa was 9.7 and I was told it was negative in all 12 core samples. End result is that you can have the biopsy and get your results but the biopsy itself may cause additional swelling to the prostate causing a fun new issue.
But better than cancer.
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“But better than cancer.”
Is it? Given the statistics regarding the efficacy of prostate screening in preventing mortality and the side effects of treatment for a cancer that in all likelihood will not kill and that has not been shown to save lives?
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I the kicker is the “in all likelihood” it won’t kill you. Some people are not comfortable with that. To each his own. jm
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Thank You for your reply. I did not know that a biopsy could cause that kind of complications. But I believe I have no choice and do it, because the ultrasound found a suspicious nodule. Perhaps not knowing it makes it more difficult.
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I had a prostate biopsy some years ago, on the advice of my urologist. I don’t recall there being a whole lot of pain. However, I am very glad that I am not a married man. If I were, I’d have a very frustrated wife right now. Nocturnal emissions were bloody for months after the procedure. Since then, nocturnal emissions (the only type I have, being single and a virgin), except on rare occasion, have been absent of gelatinous matter, consisting of a small quantity of very “thin” fluid. Erections are very weak (almost non-existent), substantial erection is very rare. This is not necessarily a bad thing in my particular case, as prior to this my penis would go fully erect often, for no particular reason, which was just physically uncomfortable at times. I have an intellectual curiosity about what damage was done to my prostate, and have only recently thought of looking into it. Oh: I should point out that the test was negative. Judging from urinary symptoms, it looks like I have had an enlarged prostate since trying to use Pemoline in the early 80s to treat a mild case of ADD (this side-effect is not in the literature, apparently). My total PSA numbers generally keep climbing. As there is no history of prostate cancer in my family, I am not too worried about it. (My age as of this writing, 5/2013, is 57.)
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Had the prostate biopsy a few weeks ago. My doctor said he would do the biopsy in the outpatient surgical center. I was under general anesthesia.
My doctor suggested the general as he said he did not think I would tolerate biopsy well after the DRE. I was out, and can’t understand why this procedure is not done to all men with a greater effort to reduce or eliminate the pain.
How many dentists still extract teeth with the only anesthesia a story about a guy in the woods who had to cut off him arm with a pocketknife.
I’m grateful my doctor was as considerate as he was. His position was he could do the job better and faster if he was not concerned about my comfort.
The general anesthesia took care of that problem.
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It is very interesting to read all of the stories on prostate biopsies. I had my first, and hopefully only one done 8 days ago at age 62. I have been on testosterone therapy for the last year and half. My PSA which was 2.5 a couple of months ago, spiked to 3.9. That caused the center to send me to a urologist for a prostate biopsy. I had heard the doctor was decent, but his staff was horrible. The only instructions I was given was to get off blood thinners and aspirin 7 days in advance and to give myself an enema two hours before the procedure. Nothing was told to me about what to expect during the procedure or after it.
The doctor took 12 core samples and it was not a pleasant experience, but it was bearable. Yes, there was more pain than I was told there would be, but I tried to man up.
Again sent home with no instructions except to take Cipro for a couple of days. By the time I had gotten home, I was in real pain. I decided I had better drink a little water just to flush things out. I ended up drinking 32 ounces, which I think is quite a bit. I laid down on the bed and tried to relax, but the pain in my rectum was so bad I couldn’t stand it. I called the doctors office, which is no easy chore with their voice mail setup, but finally got through. The unenthusiastic staff member said I should get there before they start their 2 hour lunch. When I arrived, I told them of the extreme pain and I couldn’t sit in a chair. I also couldn’t void. The doctor felt my lower abdomen and told me I didn’t need to urinate. This wasn’t so……..but based on the pain, he did a DRE and said he felt a hematoma. He then sent me across the street to the hospital to get a CAT scan to confirm it. That took three hours of waiting and an ER admission. The scan did confirm and I had already been catheterized so I could urinate. Ended up having to spend the night in the hospital which was not a good experience as this particular hospital has a very bad reputation that they lived up to. Anyway, I’m 8 days out, haven’t gotten the results back from the lab so I have no idea about whether I have cancer or not. I am still having discomfort in the rectal area, almost like it is an itch. I’m having a lot of difficulty urinating and the doctor said that was because I had an enlarged prostate. The thing is, I’m having way more problems urinating now than before the biopsy.
I guess time is the only thing to see how this ends up, but the 7 minute procedure the doctor promised turned out to be a much larger adventure.
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Just had my 1st biopsy done yesterday. I’m 43 and because my dad was diagnosed last year with cancer, and my PSA is 2.5-3x higher than it should be, it made sense to get this done. I didn’t have much anxiety about this even though a friend has the same dr and recounted horror stories. He tends to embellish a bit, which slightly comforted me.
First of all I had a lot of trouble with the damn enima. Even though there wasn’t any pain, it was fatiguing and akward and felt imcomplete, if not ineffective.
The actually office visit went like this: I was given a shot of antibiotic to boost the 3-day prescription I was given (pre, day of, and post-procedure.) I waited at least 20 min in the office for the dr, all the while growing more anxious staring at the straight, but banana-sized probe. The probe entering my rectum created immense pressure, but not really pain. As the dr moved the ultrasound around to get pictures there were flashes of pain. I understood he had to get a comprehensive picture of my prostate and I just dealt with it. BREATHING DEEPLY HELPS!. I felt my whole body tense immensly in response to any movement. I had to keep reminding myself to relax, because it really didn’t help and I’d just end up sore tomorrow anyway.
The tissue sampling itself wasn’t that bad. He gave me a couple numbing shots through the probe, which I didn’t feel. They must have worked because I only heard the clicking of the gun 12 times. After he removed the probe there was a huge amount of relief and I just lay there for a moment to mentally recoup.
The recovery so far is mostly mental. Other than still feeling dilated, it’s fine. I’m waiting to see blood leave my body. Prostate size is normal, hopefully the results next week will be positive.
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Just had my first biopsy a few days ago, hadn’t read up on it much, but the day before the procedure, I sent the doctor a note asking for a valium which I’d never had, but I should have when I had the big V done about 9 years ago. Popped the valium 30 minutes before the procedure, the doctor & staff were very patient & supportive, they do 2-3 of these a day, so they see all types of patients. I wish I’d not have seen the ultrasound/biopsy “probe” prior to the event, but it was right there in plain sight, not a pretty thing at all. They lubed me up with a numbing jelly about 5 minutes prior to entry, the nerve blocker burned like hell, but afterwards the samples sounded scary, but I hardly felt them until the last 2 or 3. Had lunch immediately afterwards with a couple beers (wife drove of course) and conked out for the 1 hour ride home. All in all, it wasn’t terrible, I’ll do it again if I have to, but I’m sure glad it’s over with.
The doc said he didn’t see anything that looked concerning to him, so at 42, I hope I’m ok. PSA was 2 about 8 years ago, 2 years ago it was 4 and this year I hit 8, then 3 weeks later it was a 6. Glad I didn’t have to do this 10 years ago like my dad, they didn’t have the nerve blocker then, he said each sample taken felt like a firecracker up there. Praying for good news from the doc this coming week.
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Thanks so much for sharing. It means a lot to the “newbies” out there. I wish you the best. JM
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Just thought I’d add my experience…especially for men who are doing some research before the procedure.
I had my biopsy yesterday. I had done the research and I had asked questions of my urologist before the procedure. It went exactly as described.
The key is to relax and understand the process. The probe is designed for the job. There is some discomfort, but I would classify my reaction as discomfort, not pain. I had two injections for pain which were barely noticeable..again, discomfort. After the ultrasound images, the probe was removed. The urologist arrived, we talked for a couple of minutes while he got the probe ready and it was reinserted…again, just discomfort. I had been through the biopsy process with my wife during her initial breast cancer diagnosis so i was familiar with the sound of the device used to gather the tissue samples…a little disconcerting, but the doctor talked through each move…he was calm, obviously very experienced and down to earth. He had a great sense of humor which really helped. One point: if you start to imagine the procedure and you start to anticipate a horrible experience, you will heighten your anxiety…this procedure is done A LOT…find a doctor you trust and one you can talk to openly and candidly…It really helps if he or she has a sense of humor!
After the procedure, the doctor and the tech took a couple of minutes to go over post procedure stuff and they answered all of my questions. We had a couple of more laughs and I was out the door.
Post procedure there was some discomfort…but, a couple of Tylenol did the trick and, again, I would categorize the sensation as discomfort.
I began drinking water on regular intervals (suggest that you drink 8-12 ounces after every urination to keep things moving along).
Today I have no discomfort and things seem to be fine. I will continue the water regimen for the next week (I usually drink about the same as a diet aid anyway).
To the macho point- I watched my wife go through double mastectomy and chemo…she was a rock…she accepted my help and together we did what we had to do. It actually made our marriage much stronger…she’s my best friend and I actually felt honored to help her. I’m sure that down the line, she’ll do the same for me. No reason for the macho thing…read, meditate, talk to your doctor, best friend, and guys who have had the procedure… and then, do what you have to do. In the end, we cannot control what happens in our bodies…the body is not our self. You can only get great advice and proceed.
In conclusion: if they told me I would have to have this procedure every year…I’d do it without a thought.
Hope this helps. Be strong.
May all beings be happy and free from suffering.
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I am 53 and had my first PSA test in May at my primary care physician. It was 12 and was advised to see a urologist. When I was tested again in July by the urologist the PSA jumped to 15. Urologist also did the DRE and said the prostate is “tender”. I am not sure if tender means it is normal or abnormal. He also did urinalysis and said it is clear. He has scheduled me for a biopsy in a few days. I do have few symptoms that come and go and not severe – slight/dull pain and heaviness in the pelvic area, weak urine flow, some ED, and some occasional and slight burning after urination. All these symptoms only in the past couple of months, not before. No other symptoms or family history of PC or enlarged prostate. I am also borderline diabetic and taking a least dose medication. So what does it mean when the doctor says prostate is tender? Could enlarged prostate or another prostate related issue be the reason for the high PSA levels and my symptoms? Do you think the biopsy is necessary at this point or should he first try medications to lower the PSA? I am seeing mixed opinions here about the biopsy pain and infection/bleeding risks. The urologist and his nurse say there won’t be any pain or it will be insignificant with the local anesthetic. I am more concerned about the bleeding (possible blood clots and inability to urinate) and infection risks than the pain during the procedure.
Thank you in advance for your answers/comments/suggestions.
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A few months ago I had my third biopsy over a 10 year period. My father died of PC so as my psa rose to 9.7 and my urologist had tried all the usual tests PCA etc, it was time for the biopsy again. Over the years he continually told me I had a large but smooth prostate. After this biopsy I could not urinate. They catherized me and over the next few weeks they kept trying the “voiding test” with no success. So I opted for the green light laser operation. This was supposed to be out patient but when it took 3 hours instead of 1 they kept me overnight. When I left the next day still couldn’t urinate so I was catherized again but fortunately 4 days later it came out.
While not conclusive my rising psa numbers could have been partially triggered from a very large prostate as my biopsy was negative.
The surgery was successful but still having a lot of. Pain after 6 weeks.
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Sam,
Just read your post, hope you can get this before your biopsy. About a year ago my PSA went up and after a DRE by my primary, I was told my prostrate felt ‘boggy’. I had asked my Dr what he meant by boggy and he pressed on the web between my thumb and forefinger. He said–it felt like that, which is soft. He then pressed on my knuckle and said–it’s supposed to feel like this–firm.
He thought I might have prostratitis, and offered to give me Cipro for 6 weeks to see if it helped and then re-test PSA. It went down a few points, and I avoided the biopsy.
Up to you, but I’d try the Cipro first and re-test PSA again, the biopsy is no fun. My primary is the Dr who had recommended that, I think Urologists tend to jump into the procedures; it’s a bigger payday.
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“Bigger payday”…. Really?
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Len
Thanks for the info. Infact my urologist agreed to cancel the biopsy after I developed a mild fever (may be due to infection) and gave me Cipro, but only for two weeks though. He asked me to come back for a re-test, three weeks after finishing Cipro. So, will have to see if the PSA comes down and if the two weeks of Cipro was enough. I guess they want you to wait a few weeks after taking Cipro before re-testing so the antibiotics doesn’t change the PSA directly.
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https://theprostatedecision.wordpress.com/2011/10/05/risk-of-infection-with-prostate-biopsy-versus-the-risk-of-not-diagnosing-prostate-cancer-which-is-worse/
a blast from the past
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9 weeks since my green light surgery for enlarged prostate. Everything functioning well. Only difference is my orgasms are retrograde. Not a major concern but it is different.
Still having pain in lower abdomen as well as my anus. Hard to understand why I can ride my bike 22 miles with no pain but can’t walk at a quick pace for more than a block.
I see my urologist monthly but he is confused also. Checked for hernias and other issues but nothing. He said next month we may try an MRI. Urine test was still murky which meant I had not completely healed.
Just wish I knew what was going on.
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After my PSA trending up over a few years, it finally hit 4.17 and my primary care physician sent me to see a urologist. Had the biopsy on 8/1, and it was unpleasant but not unbearable. Afterwards though, as I lay there on my back, it began to feel like I had been hit square in the butt with a sledgehammer. I broke out in a soaking sweat and just about passed out before I recovered.
The following week I was told I do have PC, with 3 places all on the left side showing positive. Gleason score is 6, and I’m being told it is very treatable. The doc has ordered a CT scan and bone scan of my pelvis before beginning treatment however. That happens Thursday.
If I have to have another biopsy at any point, I think I will be requesting something for pain. I have some lingering ache just behind my scrotum and my rectum feels a bit tender. Strangely, this is worse after having sex a few days ago. BTW, 57 yo and more scared than I’ve ever been in my life. I appreciate this venue as a place to share and learn.
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Mark, I am 54 and had my prostate removed 17 months ago. My PSA ranged from 4.05 to 5.02. My doctor recommended I have a biopsy. 10 samples were taken. Cancer was found in some of the samples. My Gleason score was 3 + 4. Feeling great today and sure glad I had it removed. My PSA has come back negative each time I have had it checked post surgery. I am thankful to God for these results and continue to pray that they will stay the same.For me it was a no brainer to have the surgery. I in no way wanted to leave that cancer in my body. Dave
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Dave, I think the decision to have it removed was brave. My brother had his removed at age 55 for the same reason–he didn’t want cancer in his body. However, while he is glad the cancer is gone, he also tells me three years later that he is half the man he used to be. Basically, he has ED and apparently the available drugs like Cialis and Viagra are doing nothing for him.
Might I ask if you’d had any negative side effects from the prostrate removal?
I’m 61 and had my second biopsy last month. My PSA is 12.8 and feel it’s only a matter of time. I’m not sure what treatment option I’ll choose if/when the time comes. My primary says; “don’t learn how to speak French, if you might be going to Spain.” Good advice. Guess I’ll scroll back to look for blogs that talk more about the positive and negative effects of different treatments should I need to consider those options.
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Thanks, Dave. I have a CT scan and bone scan tomorrow morning. Then go meet with the urologist on the 23rd to discuss the results and path forward.
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Just had my first biopsy. The results were negative for cancer but urologist said I have PIN 2 cells. He wants to do another biopsy in six months. Is this common? Are these a warning that put me in a greater risk for cancer?
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I should mention that my PSA has been 1 to 1.2 for some time. The reason the urologist did the biopsy was because my prostate was asymmetrical. He is concerned about the PIN 2 cells after biopsy.
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Thank you Dr. McHugh. This is a great resource. My father is in his 70’s and he has a biopsy today. He has CHF and COPD. He doesn’t complain about things so I wanted to get some honest ideas of how he might be feeling to help me keep a better watch post biopsy.
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Thank you. I hope the biopsy turns out negative. jm
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Just wanted to post to hopefully put some minds at ease a bit. I had a biopsy two weeks ago. I had a local injected, felt the shots but just as as slight sting. I could feel each sample and at first it was just a bit of pressure, the more sample that worse it felt, but nothing really painful, more of just a sting. By the last one I was ready for it to be over but still certainly bearable.
I am glad I read this page though since 2 weeks later I am still having a light discharge on some urination and the discharge has gotten darker. Reading here I realize this is normal and actually probably indicates that it is almost over. While the doctor was quite good the original indications were that blood in the urine would last only a few days. When he called with the results I asked and he said the bleeding could last a couple of weeks but nothing about the changing color. I am going to mention to him that it would have been less anxiety producing to have a more complete picture
Results were negative with one sample showing some cells that might be ore-cancerous or might not. I have a follow up in 6 months but not for a second biopsy. He did indicate that if there was a future biopsy it would be with a general, but I presume that is because it would be a different type.
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Had my second biopsy (six months apart) after first one was atypical. Had Ativan before the procedure and was fine both times. The pain was tolerable and only really felt some towards the end of the procedure. It was over as soon as it started and hopefully I won’t need a third. Get the results back next Friday .
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I just got the results of my second biopsy and as I feared results were positive for cancer. On the positive side of this, it’s an early detection and i’m looking into cyber knife radiation treatment. The Gleason score is a six and the cancer is located within one segment. As far as all the complaints about the biopsy being painful, either I have a high pain tolerance or a lot of you guys are going to butchers. I have an appointment with a radiology oncologist this coming week and will learn further if I can have cyberknife radiation
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Don’t forget to research surveillance and to ask both your urologist and oncologist about that option. Google Johns Hopkins Surveillance. I wish you the best and thanks for opining. jm
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Hey Doc,
My urologist feels due to my age (52) knocking it out with the radiation now before it develops is the way to go. He feels afterwards it should be like it never happened. It seems like a no brainer to me but will know more after the visit with the oncologist. I’m sure he’ll schedule me for a scan first.
Thanks
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I had the “needle” in 2,000 on my lunch hour….It was cool outside and when I left the procedure my hair was soaking wet…..went back to the office and a co worker said what the h happened to you…the pain was real and there ought to be a law about modern day torture such as this…suggest anybody gets put under for this procedure.
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I just had my first prostate biopsy two days ago. Too bad I did not read these posts prior to my procedure. It was supposed to be an out of office procedure, relatively painless with only local anesthesia. My PSA was 8.0 nine months ago. My GP referred me to the urologist. He poked and prodded deep in my rectum. I hated it but only moaned my agreement when he asked if it hurt. He wanted to schedule a biopsy right away. I hesitated. Shouldn’t I do another PSA test first? He agreed and remarked that infections could at times cause the PSA to spike. Take a 10-day Cipro course and do the PSA test once more. New reading was 4.4. An improvement. At 59, that was still not good enough. He told me, “you’re on.” Again I hesitated. I want to watch it for a while, I said. He said come back in 6 months. Nearing the deadline, I took another test. Reading…4.8. This time there was no backing out. Shoot! I had a week to prepare. Nothing macho about this!
He gave me four Cipros. Take two before the procedure and two after. On the day of the invasion, I arrived early, palms were sweating and I am a black belt! I kept asking who it was came up with this dumb procedure in an outpatient format. The nurse ushered me in, trying to make me feel at ease and then left me for 30 minutes in a room with a stirrup, like I was going to give birth. Finally, the doctor came in calming my fears letting me know he would numb the area and I wouldn’t feel a thing. In fact, he told me every action he was going to take before he took it. I just hated that he had to count each slice he snapped for all 15 clicks. I can still hear the slow click of the gun and the fleeting sting that seemed to last longer than normal.
Did it hurt? Oh yeah. I was crushing the nurse’s hand all through it till she had to pull away and pat me on the belly instead. He said no exercise for sometime, and definitely no sex for two weeks and to avoid constipation. Each time I have a BM, blood gushes with my urine. I improvise diapers in my underpants to catch the stain with tissue or gauze. I eat a lot of prunes to soften the stool and that helps. Still waiting for results but regardless of the outcome, this is my last prostate biopsy. I love life but I would rather give it up than risk degrading my quality of life.
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I’m amazed to see biopsies being ordered on guys with PSAs in the 3 – 5 range as some have mentioned. Up to 4 is considered to be in the normal range…seems some docs are getting test crazy here. A few years ago I came down with sudden fever and chills and some urinary issues, my PSA (which had been less than 1) was now over 7. I declined the DRE as I always do but my GP still felt pretty confident that it was acute prostatitis and, sure enough, symptoms cleared up pretty quickly with antibiotics. We watched the PSA for a few months and it also went back down to less than 1. It sounds to me like a lot of docs out there would have been pushing for biopsies with a 7 plus PSA which would have been totally unnecessary in my case.
It would take a very serious and obvious situation for me to even consider letting someone do that to me.
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Firstly, thanks for a genuinely useful blog! I am a Brit living in France and just had my biopsy. The doc is great, even though we are not always understanding each other perfectly. I had detailed preparation including in no asperin for 6 days before, a depository laxative 3 hours before (it worked and I understand why it’s important post event) pain killers 2 hours before and after with anti biotic. Gas during the procedure. I can take a degree of pain but it still hurt and although off my head I was deadly worried I would pee or worse.
Post procedure a little blood in my piss, 2 days after way more in my semen. A shock after the piss was free of it after the first one! Fingers crossed it all settles down, fluids are up and functionality high. Oh, and that Gods great gift of cancer has passed me by.
All the very best to all of you.
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Howdy all, I’ve been reading all the posts here and have to say I’m sweating already. Tomorrow 9th of October I am having my first biopsy. I am a 57 year old and at my last check up my PSA came back 3.8, normal for my age should be around 3.5.
On doing the DRE the Urologist found one side of my prostate was a little firm and he found a small lump/bump on the other side.
I have already spoken to the Urologist and asked him if I can listen to music while he rips half my ass out, I figured it’ll go some way to helping me relax and if I have it loud enough I won’t hear the dread clicks and get all tensed up waiting for it to sting.
The Urologist has already said that I will be given a pain killer by injection to ease any pain. So saying that if any one is interested I will be happy to let folks know how it goes and how it felt for me.
Must admit I am tempted to tell the Urologist that as long as I don’t feel any pain while I’m on the table, he won’t feel any pain when I get off the table (just kidding)
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Well I just received a phone call from my Urologists office with the results of my biopsy. In total the doctor took ten samples and all samples I am happy to report came back negative.
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Great news!
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Great news !!
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Tim and Max, thanks guys. Much relieved here.
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Had my biopsy 5 days ago. Pain was ok but what freaked me out was the blood discharge from my penis during the biopsy. No one ever mentioned this might happen. Is this normal? Has anyone else experienced this during a biopsy?
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Hi Dennis, I can’t say that I had or noticed any blood discharge during the procedure. Certainly while urinating there was blood in the urine but that cleared up after two days. Did you mention it to your Urologist at the time?
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Delighted to have found this blog as I just met with my PCP and he referred me to a urologist after a doubling of my PSA in 6 months and an abnormal feeling DRE. I just turned 52. His concern seemed apparent and he stated a biopsy would likely be performed. Reading all the posts here, knowing my sensitivity to pain, feeling the anxiety already present and my experience of being quite alert and feeling way to much during a colonoscopy a year ago (despite 6mg versed and a total 150 mcg fentanyl….yes, I called the surgery center afterwards to inquire what I was given and the dosages so that I’d know going forward what didn’t work), I’ll know to set the expectation with the urologist that I’ll need adequate anxiety and pain control. I’m a wee bit freaked out about all this.
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Scott
Inquire as to where you can get an MRI guided biopsy. Often 2 or so samples rather than 12 or more.
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Had my first (and hopefully) only prostate biopsy Wednesday 11/13/2013. Done under “colonoscopy style” general in a local hospital. 18 cores taken. Results due 11/22/2013.
Pretty much typical side effects described here – butt very sore for 6-8 hours after the procedure. Had tylenol and water to take in the car in the parking lot. Kept that up continuously for 3 days or so. Someone else drove so I could sit sideways, etc (but it was required due to the anesthesia).
This site so helped with after care and expectations. VERY good.
One thing that I didn’t see here that did happen to me: if I bare down pretty hard (like a bowel movement), it will cause blood to drip from my penis. No real pain though. Might suggest taking a stool softener or a metamucil product a few days before and maybe continuing for a couple of weeks afterwards for a while during the healing process. Or increase your fiber intake. This started happening 4 days post-biopsy.
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Biopsy was a week ago tomorrow. 12 cores taken. The results should be in within the next day or two. The procedure was as described lots of writers above. The lead-up was 7 days with no aspirin containing products. I had a colonoscopy done the day before so the prescribed enema the morning of was anticlimactic. The actual procedure wasn’t pleasant at all. The first thing was the insertion of the ultra sound device. The doc said he’d first use some numbing meds then a shot of Novocain or some such product. Fine. All was well until that first click of the needle gun.
I grew up the second son of a mechanic living out in the country. I recognized immediately the exact sensation I experienced with that loud click. The first time I’d experienced that particular feeling was when my older brother, working on a 4 cylinder tractor had said to his somewhat gullible younger brother, “Joe, the #2 cylinder on this old thing doesn’t seem to be firing just right.” “Put your finger on that metal ring looking thing at the bottom of the black wire running to the spark plug and see if you can tell if it’s getting electricity.” It was.
The next time I experienced the feeling was when we visited an uncle who lived on a Missouri dairy farm. Shortly after arriving for an extended visit I noticed some calves held in an area closed by a one-wire fence surrounding them. Being young and inexperienced in farming of any sort I inquired of the older brother how our uncle expected such a puny fence to hold such large animals. He, with a grin on his face, explained how that they were just dumb animals and that it didn’t take much of a fence to make them stay put. “In fact,” he said, “go over there and bend the wire down, step over it and I’ll bet you can’t make those cattle push against the fence.” I did. Well, at least I touched the fence. I discovered that electric fences feel exactly like spark plug wires on running engines.
Suddenly, on the dr’s table I was 7 years old again discovering the wonders of high-voltage, low-amperage electricity. I don’t believe I let out the high-pitched shrieks of an electrocuted 7 year-old but I can’t be completely sure of that. I tried in a calm voice, hopefully without any references to my being a holder of a concealed carry license, exactly what I was experiencing.
The good doctor gave me a bit more of his injected numbing potion and the next two clicks were a bit more tolerable. Just. For these he explained that he had two more to do in an area very near the nerve connections. The following 9 clicks were more just pressure and that damn disturbing click. Very little pain. No electricity.
Shortly after the procedure I visited the men’s room to drain a rather full bladder. The doctor had indicated that there, “May be a bit of blood in your bowel movements, your urine and semen.” Actually, it appeared that there may have been a bit of urine in the blood that came out. Thankfully the “Oh my God I’m bleeding to death through my penis” blood content was only for that first draining. For the next few days I had just a tinge of red at the start of the flow. In fact, that’s still happening 6-days out. But it seems to lessen each day.
Semen. Have you ever had a bad sinus infection? One that creates thick green mucus with bits of semi-solid matter floating in it? Dense, slimy, stringy mucus that clumps on your handkerchief or tissue? Using your imagination color all that stuff bright red with black clotted floaters. Still happening. Whoever it was above that said his looked like something from an alien nailed it. Of course we’re only two shots into the recovery so who knows how long this fun will last.
Bowel? No blood there. But, as noted above I’d just had a colonoscopy the day before and an enema the day of. It was 2 days before anything moved anyway. That was apparently enough time for the entry site to close over.
If I ever have need of another biopsy I’ll make the doc read this before he works on me and I’d prefer a general anesthesia or a hammer to the head.
When the results come in I’ll update.
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9 of 12 samples showed cancer. They’re scheduling a MRI and bone scan right after the holidays. Surgical removal of the prostate in my near future. So, I guess I’m glad I had the biopsy even though it hurt like hell. Doc says survival chances out to 10 years is near 100% unless those scans show unexpected transmission outside of the prostate.
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I guess I sound like a fool writing this but would really appreciate a reply from someone. I am 71 yrs old in good health. Last year PSA was 1.5 and this year 1.9. This is the first time it went up 0.4…normally each year it might go up just a little or over a two year period it might rise 0.1 I have no symptoms. Now here is my dilemma. I was in the Marines in the Viet Nam era and due to what I went thru there I have a terrible, terrible fear of tubes of any type. I know it sounds foolish but believe me I cannot get over it..I have tried…it was a terrible experience. I worry if I go to a Urologist or even if I should would he give me something to knock me out totally if I need a Biopsy. Also, I read many Posts here and some say they had a problem voiding afterwards and needed o be catherized so here again is the element of fear. Does anyone have any information for me PLEASE????
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Charles, don’t be afraid to speak to your urologist and let them know of your fears. I have heard of guys who have been sedated much like when having a colonoscopy when they have had a biopsy done, Alan who wrote above had it done that way. Hell that’s assuming you even need to have a biopsy done at all. Good luck to you brother.
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Blu…Thank you so much for your reply. It makes me feel better. I hope I don’t sound like a baby because Pain doesn’t bother me but I was a POW for 11 months and they did some nasty and scary things and fear becomes a terrible thing. I’ll explain to the Urologist as you said. It’s funny how I wasn’t afraid of anything in my life but this is something beyond fear. May God Bless you Blu and your Family with good health always. If you hear anything else would you please mind telling me. I cannot thank you enough..I just want to be out cold if I need the procedure.
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Charles, you are more than welcome sir. I think I can understand how you feel. Like you I have served on the battlefield and thinking back one of my biggest fears was being captured, especially given some of the people we were up against at the time, they took prisoners but they made sure any they did take died real slowly. Not nice people at all.
I had my biopsy done back in October and thankfully the results came back negative. I’ll pray it’s the same for you brother.
Regards
Blu
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I was given the choice to have a local or be put under. I chose to be put under. It was so easy and pain free. A couple of hours and I was out if the hospital. I wasn’t groggy or anything after. I definitely would opt for that if I have to do it again.
By the way, the psa test is a measure in large part of inflammation in your body, perhaps completely unrelated to the prostrate. I felt I was eating too many acidic foods, drinking acidic pop etc and it might have been causing a higher inflammation in my body. I started using turmeric spice and drinking alkaline water. Maybe it was completely unrelated, but all my numbers dropped dramatically lower the next time to normal. And the biopsy was normal. You have to listen to your doctor, but for me, I’m convinced my food, drink, and my lifestyle was causing the higher numbers but they were unrelated to any prostate problems.
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Blu..Thank you for your Service to our Country. I am proud to be a Brother in Arms. I pray and hope that my Grandchildren and all our Families will someday see War as a word in a History book. I can tell you know EXACTLY what many of us went thru. Thanks again my good friend and please stay well.
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Hi Charles, sorry my friend but wrong country and wrong army. I was a British Paratrooper, seen a lot of good things in my time but also saw a lot of things I wish I could forget. However I do live here in the US, I have an American wife and three strapping lads. Saying that though, despite our different nationalities, yes I think I understand. Semper Fi my brother in arms. I hope your prayers for your family and grandchildren come to pass for all our sakes.
Utrinque Paratus
Blu
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Blu..As far as I can see and feel..British and America…well my good friend we are still Brothers in Arms..both serving our Countries…God bless us all…Take care of those three young fine lads and your wonderful Wife.
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Blu…I have heard your Motto in my Career and you must be very proud of your Country as I know the world is.
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Charles. You need not worry about such a small rise in your PSA. You are well below the normal level of 4.0. A large rise in the PSA reading of above say 2 in your case is reason to talk to your urologist.
Tony
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Gary..I am going to take your advise and keep my fingers crossed. Thank you more than you know for your reply. Can’t say thanks enough…I do want to wish you and your Family all the best and may God Bless all of you with good health every day of your lives.
CJM
USMC Ret.
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Blu, there is no “wrong country and wrong army”, only men and women performing a thankless job. So when somebody offers us a vote of thanks for service, it’s good to know some people actually give a damn, right? 🙂
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Thank you for this great blog; reading which has educated me more than the medical profession, much to their shame…. appreciate the forum.
My experience (in London area, UK):
Had a Trans rectal ultrasound image prostate biopsy today (now 10 hours post the test) having had an “elevated” PSA level of 5.89, then 6.2 then dropped to 5.27 discovered on a routine medical initiated by me privately, at age 60.
This led to a letter to my GP who, frankly, panicked telling me “to stop work and get tested… or I could die”! No more to be said on that issue; I was just unlucky to have an idiot as a GP.
Anyway, got more sense out of the urologist specialists after referral, and my own research.
So, the biopsy: injection of Gentamicin prior to procedure; probe inserted (with a bit of difficulty and an apology). Procedure (12 samples; 6 “each side”) was “mildly painful” to me but more painful than expected as the procedures tend to be described as “mild discomfort” by the medical profession. This description can be misleading as we all know that pain, and its tolerance, is a personal issue. This could have been explained much better (as pain was explained to me in a much better fashion when I had a hemicolectomy once).
Finished with a suppository of Metronidazole.
Now to the unexpected, and quite disconcerting:
– post procedure urinating was complete blood for 3 samples (not informed about this possible outcome as it was given as “after the test you may notice blood in your urine and stools and possibly in the semen as well”) and painful; I was surprised!!
– furthermore, there was significant pain, which continues as I write, both to urinate and, more so, in the rectum; (this was described as “you may experience some discomfort following the biopsy” (but with no reference to localisation). “Please take painkillers such as Paracetomol.”). Paracetomol did not work as the pain in the rectum was so severe I became dizzy and sweated and urinating stopped. Having some Cocodemol left over I use this now and the pain symptoms have relented and I can urinate without giving myself a seizure!. Another surprise.
– given Ciprofloxacin as anti-biotic against infection (2 x 500mg per day for 5 days).
On reading the research online I realise this is a “statistical game”. It is mentioned that 1% of people have “severe” symptoms but there is very little about the after-effects (which to me were much worse than the procedure itself… even urinating blood can be painful!!). These procedures, test after-effects and outcomes should, in my view, be presented in a more structured, statistical way (we are all familiar with chance and probability) and in that way we would be better prepared!! We are NOT all average people… we, unique individuals, make up the population from which statistical criteria are deduced… the medical profession needs to better recognise this and that all statistics may not fit the Gaussian norm!
There is also a lot of statistics, and argument about those statistics, on the PSA test and this should be discussed better, in my view (ok, I was unlucky to have an idiot GP; I shall learn to have second opinions in future!!).
Thanks again for providing the forum.
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Thank you for the information. Very helpful.
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I had a prostate biopsy done yesterday. I was advised that I might experience some “discomfort,” but was not offered pain control choices. I’ve fallen off the roof of a racquetball court, had 5 fractures at separate times in my life, and 2 motorcycle wrecks including one head on with an auto where I was thrown 20 ft and had a laceration revealing the shin bone. All this to say I have NEVER experienced greater pain than yesterday during the biopsy procedure. I am angry that I was not cautioned that the procedure could be extremely painful and offered pain management choices. Unless you are comfortable with the POSSIBILITY that your biopsy might feel similar to having a pneumatic nail gun inserted into your rectum and fired 12 times, each preceded by a click, then talk to your urologist about your pain management choices. Post procedure, I now learn my experience was not an isolated event. At least I now know to pay better attention to post procedure complications.
All this for a 3.7 PSA (up from 1.6 in 2007) with no other abnormalities or symptoms. If I had the proverbial “do over,” I wonder if a 3rd PSA test was in order before scheduling a biopsy?
So how many others must experience a pain score of 10/10 before the Standard of Care changes?
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Update from my post of 12 December 2013 (day of biopsy):
Severe pain lasted quite some time, mainly in the rectum, meaning it was difficult or not possible to sit down (7-10 days). I was taking paracetomol, which did not work, then tried Cocodomol (not prescribed but some I had left over from a previous operation) but that did not work either although the pain at night was alleviated, otherwise it was not possible to sleep.
By chance, someone had some nurofen when I ran out of paracetomol and this worked much more successfully. I used this til I got my results some 2 weeks later.
Results were benign, happily. I spoke with the urologist about the pain management when the results were imparted to me. But he just kept repeating that “normally” there is little to no pain. I asked what should be done if there was more than “normal” pain and, obstinately, he repeated the mantra that “normally the pain is mild”. He offered no remedy, which I considered neglectful. It appears that the NHS in England therefore only cater for the “norm” and are happy to disregard the experience of those who are outside the standard deviation of the gaussian curve. I must therefore consider seriously, in future, whether this exercise should be repeated and how I must manage it.
As to side-effects:
Urinating: still, after nearly 2 months I urinate differently; towards the end of a “stream” there is a pause then a second short “stream”. Not being used to this change, this initially caused me to “wet my underwear” which was a bit disconcerting!! This was a definite change from prior to the biopsy so I can only assume the biopsy caused the change.
Ejaculation: this has definitely changed both in manner and content, and continues. Initially, after 4 weeks (the initial “experiment”), there was blood content but this cleared up after 6 weeks. In manner, ejaculation happens in several long quite strong “spurts” whereas before they were shorter with a feeling of “relief” rather than “pain” as now occurs. In content, ejaculate is no longer thick and milky in colour but clear, very thin watery fluid (like urine although doesn’t seem to be urine itself). These changes must also be due to the biopsy. The fluid type does not appear to have a reason when doing research online so I must investigate this further. The “pain” at ejaculation does not appear to be reported anywhere so this remains a concern.
In summary there appear to be unexplained side-effects to the biopsy process which still need investigation and explanation in my case. In discussing this with a French friend of mine he says that there is a movement against the “automatic biopsy referral process” in France due to the pain after-effects and low results of malignancy. The French system appears to put more emphasis on doing “heavy” ultra-sound scans, at least initially, and only if considered a severe “high cancer cause” chance to move onto the biopsy. This appears a more reasonable process in my view and something I will pursue if my PSA gets elevated again. I am certainly not happy with the current “automatic” conveyor-belt process and its lack of concern for those outside the “norm”.
Regards and Good Luck!
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Three years ago I learned that there exists an MRI guided biopsy. The advantage is that only one or two samples are needed, not twelve or more. It is not widely available, but worthwhile to search out. Good luck.
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Thank you for your feed-back Jim K. I had heard about this but it would probably be available only through a private process in UK. I will investigate further, thanks.
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What Simon describes exactly matches my experience. Thank you for sharing your story.
Sent from my BlackBerry® wireless device
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Thank you for your report into your prostate experience. Your story mirrors my experience almost to the letter. Ejaculation is now a ‘painful’ sensation rather than an overwhelming relief of sexual tension.
When I mentioned this to my Consultant he simply dismissed the idea that this might be caused by the biopsy. Hearing your story has really opened my eyes to the fact that I have not been ‘imagining’ these painful ejaculations.
During my biopsy the taking of each of the samples was uncomfortable but bearable, however the last sample was the one that went wrong (the guy taking the samples said ‘oh sorry about that’ as if he had hit the wrong thing). It suddenly felt like everything inside me was being pulled out of my rectum. It was the strangest feeling I have ever experienced.
Whilst I am happy the biopsy showed nothing serious I am desperately unhappy that it has led to ‘painful’ ejaculations which has been dismissed by my Consultant as something that couldn’t happen!
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@Simon W.: Many of my experiences were like yours. See my post of 2 May 2013. It is posted under the name “Richard B.”
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Thanks for pointing me to your post.
As a ” by the way” the ultrasound during my biopsy indicated an “enlarged prostate”, due to what I don’t know. The volume measured was 35 ml. Online my research indicates a normal range, which is age related, of 24 ml to 38 ml for ages between 20 and 80.
The question arise as to why, if the ultrasound finds an “enlarged prostate”, this is not the cause of a higher PSA and thus to stop the procedure there.
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@Simon W.: I suspect they push on with the biopsies, even if the elevated PSA numbers are likely a consequence of an enlarged prostate, simply because they are afraid of sending a patient home who has cancer. I know that when my physicians see my elevated PSA levels, and then see that a DRE reveals a smooth prostate, they are visibly uneasy with the idea of not having a biopsy. The feeling I get is that they will want me to have another biopsy eventually, regardless of what the DRE reveals because of this fear. (Thus endeth my analysis. 😉 )
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I asked my GP to remove PSA screening from my blood work panel based on reading summaries of the outcomes of the two major U.S. and European integrative statistical studies and based on the U.S. Preventive Services Task Force recommendation.
http://www.uspreventiveservicestaskforce.org/prostatecancerscreening.htm
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Thanks for that. Excellent. What a contradiction to the “steam roller” process of the UK NHS!!!
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Sorry to read of the bad experience you guys had. I don’t know if it’s different from person to person or a rather dare I say it, a rather bad bed side manner. Speaking for myself my experience wasn’t too bad, I stopped seeing blood in my urine after about a day or so and sperm was back to normal after about two weeks.
Could be that when we hear the click of the of the needle or whatever it is we tense up and yeah, I know it’s hard not to be tense which could make the experience worse. When I had mine done I asked the doctor if I could listen to music played rather loudly while he got on with it. I found it helped me relax more and I couldn’t hear that dreaded click and it made the experience much more tolerable.
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Hi guys, I recently cancelled my biopsy after reading “Prostate Cancer Breakthroughs: New Tests, New Treatments, Better Options — A Step-by-Step Guide to Cutting Edge Diagnostic Tests and 8 Medically-Prov by Jay S. Cohen, M.D.”
Great book, really answered a lot of questions I’ve been having that my ex-urologist didn’t seem to answer for me. My biopsy was scheduled when my PSA jumped from 8 to 10. When I proposed using an DCE-MRI for the next biopsy he gave me the runaround. I promptly cancelled and now have an appointment elsewhere that can use the DCE-MRI. I had already scheduled a PSA test a week before the biopsy, I’m down to 7 now.
Here’s the targeted MRI, and a little on how it works http://en.wikipedia.org/wiki/Dynamic_Contrast_Enhanced_MRI
Here’s a bit of a summary of the book with a list of centers that have DCE-MRI capability: http://www.bottomlinepublications.com/content/article/health-a-healing/prostate-cancer-breakthroughs
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Just thought I would follow up here. After fighting with the insurance company since September, I go in a week from tomorrow to have fiducial markers implanted in my prostate in preparation for CyberKnife radiation in early April.
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This is an excellent blog. Thank you for your writings.
My dreaded biopsy is scheduled for March 6, 2014. I am apprehensive, but all of you sharing your experiences has been more than helpful. I swear the doctors should be treated to just one pull of the trigger so that they can more accurately communicate what you should be expecting, and offer some options to take the edge off this procedure. Here is my story. Sorry it is long.
At 55, my PCP said, “you have a family history of PC, so why don’t you at least get youself associated with the excellent local urology practice up the street. It is huge with 30+ urologists. Here is the name of a doctor I really like. . .” That was September of 2013. PSA at that time was 2.4 — much higher than the 0.77 I had in November of 2012, but no one raised any alarm bells. So after 4 months, I met my Urologist. Nice place, and she is a very pleasant and friendly sort. She talks to me about my family history for 15 minutes, does the front and rear check and feels all is in proper order except for some minor swelling on the left lobe, and she suggests a PSA test. They can do them right there and have results straight away. I agree, and we set another appointment for a few months hence.
The next morning she calls me back. “Your PSA is 3.9, and while it is below the warning threshold, the increase velocity is not acceptable. I am recommending a biopsy. My assistant will get you an appointment.She will call tomorrow.” There was more discussion than that, but you get the jist.
I am thinking, “What the h—- just happened?” I called my PCP for advice, and he said, “I would recommend an MRI before taking this further. He said that I happen to live in a town with a great medical research school also having excellent GU radiologists. Guys, note this. Ultrasound is not the tool to recognize diseased tissue in proximity to healthy tissue. It works great, though, for localizing the anatomical stuctures of the prostate and surrounding tissue. So it is a great guide for aiming a biopsy needle. The next job is giving the Urologist a target.
I went back to the Urologist with this. She said, “We normally do not start out this way. If a case returns repeated negative biopsies, but high and climbing PSA, we go there.” I appologized for making her work so hard, but in the end, she got me the MRI. It would have been beautifully played if it had come back clear. Sorry, although there were no lesions, there was enough inflammation on the left base margin to warrant sampling.
OK. Biopsy it is after all, but they have a new machine there that takes the MRI and fuses it with real-time Ultrasound. The radiologist decorates suspicious areas on the MRI in three dimensions. The day of the biopsy , the urologist marks these targets on the Ultrasound aquisition, and the machine maneuvers probe to align the sampling needle to the target. The advantage is that you get samples of the areas most likely to have trouble. The random way returns many false negatives, and who wants an unnecessary repeat of a prostate biopsy? One other advantage: because you cannot move once the MRI-TRUS fusion is processed, this procedure is routinely done under general anesthisia. If one must have a prostate biopsy, the consensus here seems to be that it would be better to be elsewhere while it is being done.
I will let you know how this goes if you are interested. Google: MRI-TRUS Fusion prostate biopsy.
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I am 56,my psa was 4.9 urologist said “if you were my brother I would highly recommend a biopsy” biopsy result was Gleason 6 small amount in one core. The biopsy really hurt I was sweating beads. I too was not prepared. “Most people complain about the antibotic shot most (yes that hurt but I barely remember that!) I will not be awake for my next. But what I really wanted to add to this blog is the aftermath of the biopsy. Three days later after the initial discomfort was quelling I began to experience bad tailbone and nerve pain and pressure in my rectum and groin area. Walking or lying down with a heating pad on my back are ok
But sitting working make the condition worse throughout the day. It’s a very strange uncomfortable feeling that’s very distracting it seems to get better and then seems to then go back to how it was days before. I finally found some Australian data that said nerve damage is rare and slowly improves but I have seen no one anywhere speak of this issue It is three weeks passed my biopsy now. If this stays like this I will be very depressed and making Making decisions such as observation or having my prostate out seem difficult to deal with since the current discomfort seems to distract me from even going there. I brought the subject up with my urologist at our consultation about my results but he seemed to blow me off with a comment of it sounds like nerve issues he gets them to sometimes in his lower back.
I never had anything like this before the biopsy. Sound familiar anyone ?
Buck
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Just had my biopsy March 06, 2014. I expected some pain and discomfort, and the initial insertion of the probe, measurement procedure and picture taking were not all that bad. The sting from the anesthetic needle no worse than a flu shot. The first few snips with the biopsy gun were bearable, but 3 of the 12 snips were excruciatingly painful for some reason, like a electrical shock into my testicles, which the Doc doing the procedure said should not have occurred, making note of same to my Urologist. We’ll see what that result is at the end of the month.
Post-procedure: the first few hours were NOT a joy, most pain relievers are a no-no as they thin the blood, so I just had to bear with it. You’re not supposed to have any alcohol, but a few shots of bourbon seemed to numb things a bit. Couldn’t sit or lay down, you pretty much have to stand with your legs spread, in my case that was 6 hours.
A few things the urologists don’t tell you, but I found out about from reliable online sources: no heavy lifting or bending, no strenuous activities (jogging, golf, etc., basically avoid any movement that will stretch your innards where the procedure was done), no blood-thinning type pain relievers for a week after (aspirin, ibuprofen, etc.), drink LOTS and LOTS of water …
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just a quick question, the prostate produces some of the fluid in your ejaculate. After the biopsy it is damaged and does not function properly. not as much ejaculate. when will that return to normal. Biopsy was done Jan 25
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I had my biopsy done over 2 weeks ago, Much to my surprise hardy any pain at all. Just pressure, Got my results back and all 12 samples are non cancerous. Boy I sure dodge the bullet. But its afterwards when all the complications started. The burning sensation started and never stop. It comes and goes, Sometimes my penis burns. I think maybe they might of damage something in the process. i went to the hospital twice. There is no infection which is great to hear. Now it seems like i am having a hard time ejaculating. When I do its dry nothing comes out. I was told by the doctors at the hospital in time this all will pass. We will see… Can this all be normal ?
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I don’t know what “normality” is in these circumstances as the professionals don’t appear to be concerned about any other “results” than about the binary cancer or no cancer indication from the biopsy.
As far as the ejaculatory function goes I can say that, now in my 5th month post biopsy, the pain (feeling of burning pre-ejaculation and pain on ejaculation) continues. The fluid content appears to have changed a little (ie it has gotten thicker and less watery) but has still not returned to anything like the prior consistency. [By the way I only had a short period when there was a lot less fluid so, contrary to your case, there has always been a fair amount of fluid since my biopsy.]
It still appears to me as if there has been some kind of permanent change/damage but I wait to see.
Hope this helps.
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I am a 59 year old male who just recently had a prostate biopsy. The uroligist took 12 samples of the prostate. And much to my surprise the procedure went very well. And there was no cancer at all. Its afterwards the problems all started. I now have erection problems, and when I do manage to erect. Its very painful. Burning sensation in the bladder which is another complication also. i was perscribed the drug Rapaflo which emptys the bladder completly but had to stop taking it because the side effect from the drug was retrograde ejaculation. Now I am on phenazopyrid which numbs the whole area around the prostate and bladder. it seems to be working very well.. Since the biopsy I been to 3 hospitals. They performed all kinds of test: Bloodwork,Urine culture, they even did a catscan. All of the test came up negative. No problems at all. No infection nothing,…. Than what is my problem ? They could not tell me they did not know. They informed me to to take this matter up with my uroligists.. The shockier to this whole thing is this: I went back to my uroligist. He looked at all the test including the hospitals. I explain to him in detail what was going on with me. His reply was this: ” i’m sorry there’s nothing more I can do for you. All of the test came up good. There’s nothing wrong with you nothing at all. You can go for a second opinion if you want.” I could not believe this. Talk about a shocker ! I than informed him. Doesn’t it seem funny to you that before the biopsy. I had no issues ! None at all! And now after the biopsy I have all these complications. He really did not know what to say. At one point he even said that this all could be in my mind.. So now I leave his office with my tail between my legs. And just hope down the road this all clears up. its been 3 weeks since the biopsy.
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I read this post along with the comments last night prior to have a biopsy this morning. After reading the comments I was expecting the worst.
My urologist prescribed some pretty decent levels of Valium and Oxycodone to taken 30 minutes prior to the procedure (as long as I was willing to have my wife drive me to and from the doctors office). I took the pills and definitely started to feel their effects before I was led back to the exam room.
Once there, I laid on the side. My doc inserted the ultrasound probe soon afterwards — to me, this was the most uncomfortable part of the procedure and it was really wasn’t bad at all. He then injected some local anesthesia, waited a few minutes, and started to take the samples.
Based on the comments above, I was expecting this to really hurt, but I didn’t even feel a hint of pain — nothing. All I felt were the clicks everyone described but there was no pain whatsoever associated with it. Before I knew it, I was getting dressed and leaving the doctors office.
I guess the combination of Valium, Oxycodone, and the local anesthesia made the whole thing completely painless and relatively easy. Even as the pain medicine wore off, I didn’t feel anything other than pressure in my bum — but no pain.
Now, that this is done, I just need to pray that nodules my urologist felt are benign.
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I need to print out your posting, wrap it around a brick and beat my urologist to death with it. I had nothing for anxiety or pain either pre or post procedure, and my experience was definitely different from yours.
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I’ve had two biopsies. After the first one, I told my urologist – if I have to go thru this again, I want something for pain. Because if your first biopsy is negative–you know it won’t be the last time. Inevitably PSA keeps going up and they’ll want to do another one.
Sure enough, when he wanted to do the second biopsy 2 years later, I asked about meds and he told me to take Advil. I told him that wasn’t cutting it, so he told me to start taking it earlier in the day. (Real empathetic.) Knowing what I was about to go thru, I spoke with my primary care doctor and explained (complained) to him. He understood and prescribed oxycodone for me.
If your urologist doesn’t want to give you something, ask your primary.
If you can get an MRI instead of a biopsy, that’s even better.
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Due to a high PSA level, my doctor decided a prostate biopsy was in order.
I did the usual drill. No blood thinners of any kind a week before. Started taking antibiotics the day before. Went to my urologist and got it over with.
The doc gave me a local anesthetic in the gland and other than the annoying clicking of the gun and slight twinges as the samples were take, I experienced very little discomfort.
Next day I felt fine. Even though there was no sign of bleeding, either in the urine or rectum, I drank plenty of fluids any way just to keep the urinary system “clean”.
The biopsy was on Monday, today is Friday and I was feeling pretty darned smug UNTIL sex. I got a jet of bright red and it scared the hell out of me!
I researched it on the web and have read several places that blood in the semen is fairly common and can be any shade from mild rust to stuck pig. That info calmed me a bit, but you’d darned well better believe I’m going to contact my doctor just to be sure.
I may be smug, but I’m sure as hell not stupid. 🙂
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By the way… the biopsy was negative. But since high PSA may not be a sign of cancer, it’s also true that a negative biopsy doesn’t guarantee you’re cancer free. So I’ve arranged to keep an eye on PSA at 6 month intervals and decide what to do if it continues to rise. Since it goes up and down, perhaps watchful waiting is the best course for now……..
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I wouldn’t want to discourage anyone from enjoying this barbaric procedure of having 12 or more 16 or 18 gauge needles “fired” thru the rectum into the prostate, but if the procedure is performed BASED ON PSA ALONE, I thought this article would be of interest.
Do doctors understand test results?
http://www.bbc.com/news/magazine-28166019
Do doctors understand test results?
Doctors have a poor grasp of statistics, an expert says, making it hard for patients to make the right treatment choices.
View on http://www.bbc.com
Preview by Yahoo
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“I wouldn’t want to discourage anyone from enjoying this barbaric procedure”
Sure you would. That’s what you’re trying to do right now, yes? 🙂
Comes a time when a person must stop being paranoid and put trust in somebody for help. The risk of prostate cancer is one of those times.
A bit of risk and pain now is sure as hell better than the alternative. And foregoing things because somebody who had an uncomfortable experience puts the fear of God into you is plain stupid… as is trying to erode the faith others have in their doctor’s ability to help….
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I just had a prostate biopsy done and the pain was BRUTAL. Each stab hurt worse than the previous one and the Urologist could have cared less. Take a percocet and a ativan tab beforehand? My Urologist would offer nothing, but I took one of each beforehand on my own (from previous dental work) and it didn’t a thing. I will never get another biopsy, nor will I ever see a Urologist again. I told my PCP to never order another PSA.
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Baby and the bath water?
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What baby? Where’s the science?
http://www.uspreventiveservicestaskforce.org/prostatecancerscreening.htm
The numbers don’t support the continuation of a procedure (PSA) that has not been demonstrated to save lives. I understand asking people to give up smoking, which demonstrably affects mortality outcomes. I understand asking people to exercise. But why does the Urology specialty continue to advocate a testing protocol that has not been demonstrated to have significant survival benefit while resulting in serious quality-of-life consequences to many of those who follow the diagnostic process to its conclusion (as most who get a positive diagnosis do)? I understand that doctors want to do the right thing by their patients. But one has to recognize that there are tremendous vested interests at stake here.
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What are your thoughts on the 30,000 or so that die of prostate cancer each year?
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Does having the PSA test reduce the patient’s chance of dying prematurely? The numbers from the metastudies that I referenced above indicate that PSA has little if any affect on all-cause mortality. The USPSTF task force recommends against PSA screening, stating “Based on this work, the Task Force concludes that many men are harmed as a result of prostate cancer screening and few, if any, benefit.”
The full recommendations are available here:
http://www.uspreventiveservicestaskforce.org/prostatecancerscreening/prostatefinalrs.htm
Leaving appeals to emotion aside, how would you respond to the points made?
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I am just wondering. My husband is having this done next week. He is now really concerned because we just learned a few weeks ago that he has been suffering with Lymes disease. He got so bad after knee replacement that he could barely move but my husband is the type that he feels that if you slow down or stop, you WILL die. He has sounded as though he were so weak he couldn’t talk at times. He has always blamed the knee replacement until we got right up to the Lymes disease. He needed it for the second knee and said “You know if I have it , I will die for sure. Is that what you want?” Of course I am doing all that I can. Now he knows it wasn’t the knee replacement. I am being told that if he has this procedure and it traumatizes his body again, the Lymes symptoms may reappear. I would like to have him put to sleep, but they are telling me that our medicare won’t pay if we do that. Could you tell me if this is true? His psa was 5.2 and he is 69. He has really suffered for the last five years and I really hate to see it happen again but I guess we would know what was causing it. Thank you for any help.
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Find out where he can get an MRI guided prostate biopsy. A couple of needles vs many. I didn’t know about that technique when I was diagnosed and treated at the same age and with a similar PSA three years ago. I opted for proton treatment at LLUMC, and Medicare and supplement paid for the treatments. Good luck and good health.
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I have just had my second biopsy in two years. I equate it to someone shoving a BB gun up your butt and then firing it at your prostate 12 or however many times. It is not comfortable at all and there is pain. I have had many kidney stones over the years and they are a 10 in pain, while the biopsy is about a 5. Urologist should offer something for the pain as everyone’s threshold is different.
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Let’s get to the pain issue first…at 56 and the first time I’ve had this done…I was pretty apprehensive but just wanted it over and done with. The pain level was minimal..akin to a sort of elastic band snapping up there but it just wasn’t what I would call any kind of agony..no. After I noticed no blood in urine, some in uh..you know ‘stools’ but it’s the first ejaculation (I waited a week) that will shock you. It ain’t pretty that’s for sure. Only been a week since the procedure so early days yet. But my God..that first ejaculation..whoahh.
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My wife and I stumbled on this site last night (night before my 1st biopsy). I just turned 50 and my PSA was 3.1. Just a year ago it was 2.3. I found this blog to be candid, humorous, informative and very helpful. Because of all that we read, I called the doctor this morning and asked for Valium & Percocet. Even with the Valium & Percocet as well as the local that the Doc gave me…..I still had pain, especially by the time he was at the 6th sample and there were 12 total. My follow-up is next week. Praying that the results are all negative.
I am a Navy Reservist and have been called up to active duty to go overseas and my Urologist wants to make sure everything is okay.
Thanks to all those who shared their experiences, fears & candid thoughts……..very helpful for me.
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My brother-in-law has had two biopsies done without anesthesia and described them “like being kicked in the nuts!”
Although my urologist said he has performed biopsies without anesthesia, he prefers with, which is the way mine was done on September 5. Maybe it also avoids possible reflexive spasms.
There’s no doubt I knew nothing about what was happening, and the soreness afterwards was minor for a day or so.
If your doctor won’t do it that way, find another. (Mine was one of the Top Doctors in The Washingtonian magazine.)
More info: I’m 74; three years ago, my PSA was 2.3, last year 3.4, this year 4.3. A digital exam found the prostate to be soft. Results: fortunately, negative, and reported within a week.
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I only wish I had found this site before my biopsy 6 wks ago. Some of your post are so similar to me . I am 55 and had no problems. A PSA of 4.0 and slow urination sent me to the table. One click sent sharp pain through the penis. The second night the throbbing pain awoke me. I now have bad pelvic and penis pain along with ED and a false sense to urinate.A good nights sleep is long a memory. Results did show early cancer gleason 6 I went back to the doctor who performed the procedure , he said you have cancer that’s why you have pain. funny the pain was not there before the biopsy. Many other doctors say remove the prostate and hopefully the pain will go. I feel lost and don’t know what to do.
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Jack
I read all the entries. I have a biopsy scheduled for next week. I will be knocked out or this won’t happen. May the force be with us all.
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Urologists make about $450,000 per year. If they told you about the pain, the false positives, the many men that die from old age that had this cancer, and the fact that early screening has not decreased the death rate significantly, they would only be making about $150,000 per year.
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And another thing: Has ANYONE had a urologist that gave them recommendations on diet and exercise? It is a medical fact that these two things prevent cancer, cost you virtually nothing, and provide an overall higher quality of life. And also stress can kill you, but all the typical urologist can do for you increase that stress level in all sorts of ways. Get on a healthy life plan, get regular checkups from a good GP that does not have a conflict of interest, and skip the PSA test. The PSA test can lead you down a high stress path that can indeed lead to your demise.
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My urologist certainly did give advice on both diet and exercise. My urologist, in fact, recommended that I increase exercise prior to surgery and I did that–I am sure that it helped with my recovery. He appears to follow his own advice as he is in shape for his age. You should keep in mind that PSA tests, etc do detect cancer and do lead to lives being saved from treatment. There is plenty of evidence for that (like a huge drop in prostate cancer mortality in the USA from the 1980s to present).
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Correction on salaries: WebMD has the average at about $350,000. But Forbes has them at about $460,000 as listed at http://www.forbes.com/sites/jacquelynsmith/2012/07/20/the-best-and-worst-paying-jobs-for-doctors-2/2/
At any rate, they are in the $400K range.
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I had biopsy of m prostate 3 weeks ago. During early bowel movement I notice blood in my urine. What might be the cause for this and why?
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It is not unusual to see blood weeks after biopsy. JM
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Had a biopsy done recently even after I told the doctor I had forgotten to take an enema (which was a pre-procedure requirement) and guess what happened? Two days later I develop acute prostatitis, wind up in the hospital for three days and now (for the past three weeks) there is no semen when I ejaculate. The procedure itself was awful, despite taking four hydrocodones before-hand. Guys, make the doctor “put you under. If he says no, then find a doctor who will. I just hope they removed the staple-gun from my ass when they were finished.cm
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I had 1 Percocet and 1 Valium before the procedure. I felt almost nothing. I didn’t even feel the lidocaine block being administered. After each core was taken there was a slight burning sensation. I had more pain on the drive home after the block wore off but nothing bad. Just a dull ache. I’ve had gas pain that was far worse. It went away after a few hours.
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After a peritoneal biopsy procedure two years ago that detected no cancer I have been left with no ability to ejaculate semen. Though, with sensation undiminished, a thin watery brown liquid is expelled instead with no viscosity that might indicate semen in the ejaculate. I have a sense I’ve had a vasectomy while biopsy was taken.
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After reading this entire blog I have to admit I was freaked out! Especially the post about feeling like a gun was shooting with each click and the bleeding for a couple weeks and worry about infection. Two days ago I endured the dreaded biopsy and my experience was …it was pretty much a non-event. yeah the ultra sound probe felt weird but not painful and not really that uncomfortable. My advice – practice some deep breathing and relax and think about being somewhere else. I did not like the 3-4 injections into the prostate to numb the area- had some minor brief pain in the tip of the penis. But without the injections, I imagine I would have felt the biopsy needles. I had the MRI guided ultra sound biopsy. Whoever wrote that the MRI allows fewer biospy target sites is wrong…my doc said they ALWAYS do the 12 sectors and then do more in areas the MRI suggest might be lesions or areas of concerns. Otherwise this would be malpractice. He also said that my 25% enlarged prostate is a good thing and it is one explanation for a higher PSA count. Also, after, I had zero blood in my urine, stools, no leaks, no fever, nada. And I flew home 6 hour flight less than 24 hours post procedure in coach. Will have the biospsy results next week. My PSAs have been in the 4’s for 4 months straight and my %free PSA is an 11. My PSA was 2.9 back in Oct 2012 before my 4.7 in 10-2014…leading to my biospy. MRI suggest signal abnormality in the right posterior peripheral zone mid apex (where most malignancies are found) which MAY be focal inflammation but a 3/5 chance of high grade disease Staying positive is my nature…no sense worrying about anything I cannot control. Back to my tomato paste, my wife and German Shepherd dog.
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There must be major individual differences in pain sensation. While the Trus-biopsy was not exactly comfortable (I don’t like a big metal wand up my rear, after all) I can’t say that it was painful. My urologist did inject a local into my prostate, that felt like a slight sting when he did it. He also said that I would quickly develop a metallic taste in my mouth from the local. I did not. I felt the 12 cores but that was like a “thrap” to my insides without much in the way of discomfort. Perhaps I was feeling too optimistic–the ultrasound detected no abnormalities and I was thinking that maybe I had been obsessing over nothing and no cancer would be found. THAT was unrealistic. Afterwards, I drove home, in the beginnings of a San Diego rush hour. Again, no problems. At home it felt as if I had a fist up my rear so it wasn’t comfortable though I could have gone back to work (I went home on the advice of the urologist). That night, I did have some blood in my urine and passed a couple small clots of it. About 24 hrs later I passed a little more blood but that was it for my urine. No other problems, I took the prescription of ciprofloxacin and avoided infection. Yes, there was blood in my semen for almost a month. By the time that cleared up it was almost time for the prostatectomy as the biopsy detected cancer in 7 or 12 cores and atypical cells suggestive of malignancy in 2 more. So far, I’m lucky in that it was Gleason 6 throughout but the throughout was extensive: 75% tumor in one lobe and 25% in the other. Glad I had it removed and hoping it will be lasting.
Given the many descriptions I’ve read on how unpleasant the biopsy is I am still a little perplexed. I don’t like pain and really don’t think that I have an especially high threshold for tolerating pain. It just didn’t hurt.
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After 3 weeks of anxiety, worry and speed reading about my impending prostate biopsy, finally had it done today. I was shocked!!! The lidocaine was injected, one minute later, the probe, which was uncomfortable for the first 30 seconds, but tolerable. One minute later, the needle started firing, 8-10x. I DID NOT feel any pain whatsoever. Every time I heard the click from the device, I was prepared to scream bloody murder. I DID NOT even feel a sensation of a needle going into my prostate. Exception to the norm? I don’t know. All I know is, my worry and anxiety was driven mainly by all of these negative, horrifying comments. I would not hesitate to do it again if I had to.
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If Pain could be given a rating like visual aspects of movies, my two Rectal Prostate Biopsy experiences would be rated ‘R’ and ‘Graphic”. It is all very fresh in my mind, (and rectum) since it has been 2 hours since my latest procedure and as i lay reclining on my couch, iPad between my knees, i can tell you the following:
The first instance of PAIN is from the large tubular gizmo the doctor inserts into the rectum, its big and i felt much intrusive pressure and the strrrretching of my rectum.
The next episode of pain can be compared to the Novocain shots the dentist gives, the needle goes in deep, gets moved around in various directions and there are several invasive punctures. This time, however, It is all deep within your rectum and prostate. O U C H, a real toe curler. The anesthesia used today was lidocaine and it didn’t work well at all or take effect soon enough.
The doctor went right to work with the next phase, the ultra sound; uncomfortable but tolerable.
Next came the main event, the biopsy sample-taking needles. For each sample i could FEEL, (key word here), the needle attempting to puncture the tissue of either the rectum or the outer wall of the prostate, the tissue resisting, then the tissue giving way and the needle penetrating deep into the prostate. After that, the ‘click’ was nothing and was kind of a relief because i knew the needle was about to be retracted. HOWEVER, this little scenario was repeated each time a biopsy sample was taken. The doctor and assisting nurse would deposit the sample in a jar and label each one, ‘A1’… ‘A2’… At about ‘C2’ I asked, “Uhhhh, how deep into the alphabet are we going today?” We went to ‘F2’. Is there blood, to be sure, it seeps out of the end of your penis and your rectum. There is RESIDUAL pain in the rectum from the large tubular stint-like appliance used to strrrretch the rectum. What a relief when that thing is finally removed.
In conclusion, lidocaine is no match for this AND if this procedure was employed by the CIA at Guantanamo for interrogating terrorists, the war on terror would be history by now. Anyone can blow themselves into the waiting arms of the mythical 72 virgins, but there is no heavenly reward that justifies a rectal prostate biopsy.
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You may have a career in medical writing! Jm
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I share your perspective, an excellent torture device. Why isn’t full disclosure of potential pain and pain management options the standard of care in the 21st Century?
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Thank you. That was very informative. Congrats on results. Jm
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Last year my PSA was 4.3, a jump from a gradual increase from 1.8 to 3.3 over the previous five years. My urologist uses an IV anesthetic, so I was glad to not have to estimate my pain threshold as so many of you have. Of course, there was the usual soreness, but no aftereffects, and the results were negative. They made sure to tell me that was good!
This year it was 5.9. My urologist said that although most doctors would just order another biopsy, he wanted to have an MRI first. If it showed nothing unusual, that was fine; if not he’d know where to concentrate the sampling. I was hoping it would show that my prostate had grown, resulting in a higher PSA. Or perhaps, at 75, it was just part of what some say is a normal increase with age.
Unfortunately, it did show some abnormalities. The important results were: “a small rounded neoplasm occupying < 50% of right peripheral zone, confined within the prostatic capsule" and a second area "within the mid LEFT peripheral zone" … "moderately suggestive of multicentric prostate neoplasm."
So I had another biopsy and this time I asked about the anesthetic. It's propofol, Michael Jackson's favorite. However, used properly, it works like a charm. One instant you're awake, the next you open your eyes back in the recovery area. I was a little logy for the rest of the day and this time the soreness was greater, no doubt because certain areas were being concentrated on. My wife also noticed that there was more blood on the sheet than the last time.
In fact, the soreness was enough to prevent urination. After three hours I was beginning to wonder if I might need a catheter, but I found that by sitting on the toilet, leaning forward, and relaxing, it came naturally.
And fortunately, the results were again negative.
But I agree with the previous poster who said if your urologist won't put you under, find another one!
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Just got back home from the biopsy. I took 3 Hydrocodon 10-325 beforehand. My appointment was for 2:15pm so I took the Hydrocodon at 1:30pm. It took 2 hours before they actually began the procedure which lasted no more than 4 minutes. I think one minute passed between the anesthetic shots to the prostate and the actual procedure. I think 2 Hydrocodon or less would have been better because after the procedure I was slightly nauseous and the actual procedure was nearly painless. I have had injections to the arm that were more painful. Really. But then again I was pretty whacked up on the hydrocodone which I had saved from my previous kidney stone procedure. So I am not recommending to any one to take 3 hydrocodone. I think one would have been enough actually. I don’t see how anyone could get hooked on the stuff since all it did was make me a bit dizzy. Anyway that’s my story and I go back in 7 days to get the results.
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Woke up 2:30AM the morning after the procedure and so far am experiencing no pain. Looking back, in my case they requested me to keep my long sleeve shirt on and it covered my genitals if I were to stand up, but I didn’t have to stand up. I was also allowed to keep my socks on. The nurse left for me to take off my pants and underwear in complete privacy and I had a paper sheet/blanket to cover my waist as I lay down on the table. They did not see my genitals at any time; only my behind. If I had a job I would probably have gone to work the following day; although I would probably have requested the day off anyway just to be safe, as it is still early to tell if there are no upcoming complications. Besides, I don’t like working anyway. There is still blood in the urine but not so much as to alarm me; more like from a kidney stone. For the record I am 64 years old and my father had his prostate removed, and is still living. Just hoping I have not waited too long to have had this done. If I had to do it again I don’t see why not. Just keep a Norco or two handy. I did throw up last night; not much though, believing it was the 3 Norco 10-325 pills I took before the procedure.
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Fever went to 102 last night and there is still a little blood in urine. Fever dropped to 99.7 this morning. Hopefully it will continue to diminish. Maybe it’s unrelated but the fever seemed to start after a bowel movement. I woke up feeling very cold Friday morning an was shaking uncontrollably. It was then I discovered a slight fever and it rose to 102 that night. I have a lingering headache, muscle aches and have used up the antibiotics.
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Just had biopsy done two hours ago. It was a set-up. Hurt like hell. Wanted to get up a leave if I could. Doctors need to consider doing this procedure under sedation. Scared to urinate or use bathroom now. Thought I was going to go for a walk, now all I want to do is stay home and be close to a bathroom. Thank god for Xanax!.
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I had a 7.5 percocet before hand and didn’t feel a thing.
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The
Most doctors in Michigan need to be educated in male patient modesty. They will have you to do the prostate ultrasound but some doctors aren’t trained to do them so I’ve decided that If I have to have one someone else will do the procedure. That’s what I’m paying him to do not surprise me with a female tech to do it when I get there. And if that were to happen, I would walk out of the appointment and nobody would get paid. I then would report it to the medical board.
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The verdict is in; as with my father who eventually had a prostectomy I have prostate cancer. So I was not as surprised or as shocked after my doctor said it. They are in the process of giving me a CT scan appointment to help make sure I do not have cancer in other areas of the body. Once that is determined, if the results are negative, I am given two options; a surgical prostectomy or prostate radiation beam therapy. I wasn’t aware up until now that a surgical prostectomy, like a vasectomy, renders you totally unable to have children. So I have a decision to make. To be honest I am leaning toward radiation of some type. My PSA is 7.5 with a Gleason score of 7. Doc says it was probably caught early since the PSA is under 10 so no need to be overly worried, and to be honest right now I’m not too depressed, however who knows as it sinks in how I will eventually feel.
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Don’t assume that radiation doesn’t have the same results. The idea is for radiation to cook the prostate. Yes the seminal vesicles are intact, but the prostate provides the delivery mechanism. A Gleason of 7 is the bottom end of agressive. There are many things to consider, so explore each option carefully. At 64, I’m surprised nobody offered brachytherapy. One-time procedure. That’s what I would have done if 65 rather than 55.
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Thanks for the tip. All my doctor gave me were pamphlets concerning the Da Vinci robotic method. After some research, just by googling “Da Vinci Problems” etc. I see CNBC has info as well as other sites on the machine stalling during operations and burning the patients insides by electrical arcing where it’s not supposed to arc. There is pressure allegedly on doctors and media to sell the product while there is growing evidence of injuries or deaths not being recorded or reported. I’m researching brachytherapy now. Pretty sure Da Vinci is out for me. At the moment I must get a CT scan to make sure cancer is not found spreading before I can really make a decision.
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Developed another fever from the biopsy yesterday which rose to 100.1 about midnight. Woke up with spots of blood on my bed sheets. In the morning the fever was gone. Expecting a call from the Doc’s office to get the CT scans needed to see if cancer has spread now that I’ve taken the required blood test. I’ve told no one that I have prostate cancer as of yet. I want all results to come in first so I know what I’m dealing with.
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Today CT and bone scan was done. Oddly after the bone scan the person that did it asked if I was experiencing any pain. She asked this before the bone scan also I believe. Seems like she saw something in the scan but I did not ask about it. Results are to be sent to my doctor within 48 hours. I think I’d rather spend my time until the doctor appointment not knowing. No more fevers or lower body aches and pains which occurred after the biopsy. Urine still dark though usually after a bowel movement. Researching Cryotherapy presently.
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Don’t sweat it. Both of mine came back “likely metastatic disease”. I was thinking it’s time to write my will. They sent me for MRI and xray and said all was OK.
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Thanks Greg. My results were given via email from the hospital. Nothing definite to indicate cancer spread in either the CT or bone scan. I have an appointment in a week with my Urologist who will undoubtedly go over these results and discuss my choices.
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My urologist wants to offer either robotic surgery, his specialty, or IMRT which he is affiliated with. He doesn’t seem to encourage anything else and gave my no further literature, except for the Da Vinci robot. He only touched on the other radiation therapies but skipped entirely over Proton therapy. When I mentioned Proton therapy he seemed to play it down, pointing out expense and the rarity of locations, although I see there are sites popping up under construction all over the country. He claims a 3 month stay if I go to Jacksonville, where I’ve been given info that its only two months. I’m looking at a definite rising trend in Proton therapy and figure there must be a reason. Presently I’m looking over the literature sent by the Jacksonville UF Health Proton Therapy Institute.
I have as yet told no one of my condition but may do so now that I have more info as well as what my urologist said that the cancer is probably still contained to my prostate. I have an appointment next week with his IMRT affiliate but am going mostly just for the sake of learning what his radiologist thinks of Proton therapy.
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That’s the way to do it. Jm
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I forgot to mention something I feel very important that just hit me in my discussion with my Urologist. As he was quickly rattling off the favorable statistics of robotic surgery success rates I asked him if these were across the board statistics. Did he actually follow up and make a record of his own statistics, i.e. success rates and failures with his own patients? He said no, basically because he was “too busy” to make a record of his patient follow ups and trusted the statistical info given (from the company?). I find that pretty outrageous.
I think the following are good questions for anyone to ask their Urologist to get a sense of where his/her head is at regarding the welfare of his/her patients.
1) How many patients have you treated in your field?
2) How many patients do you treat per year in your field?
3) Do you follow up on these patients and can you give a percentage of how many turned out incontinent?
If the answer is “NO” to number three I would think it is a pretty important red flag, yes?
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Bud, if you care to speak with a former PCa patient, email me your contact info.
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Much appreciated.
My email is buddy1065@live.com
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By the way I mentioned to my Urologist my urine was still cloudy after my biopsy. They tested my urine and found I have an infection. I was prescribed Cipro like they did after the biopsy. I wondered why they gave me so few pills then, 5 at one per day, and if I wouldn’t have this infection if they had prescribed what they are giving me now, twice a day at a quantity of 20. Fortunately there is only minor discomfort when I pee and no fever.
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Quite a few things have happened so far; two additional Urologist opinions and I was just accepted to UFHealth Proton Institute in Jacksonville according to a call I just received. The strange part is after all of the info I received about my insurance Blue Cross and Blue Shield of Florida denying claims for Proton, I was accepted and only have to pay $1266 out of pocket. I asked UFHealth if I should wait until next month for my birthday when Medicare would kick in but they said I would have to pay the same amount out of pocket. It’s also odd they approved me so quickly. As for the Urologist appointments the first one said radiation (not Proton) gives a one out of three chance for impotence and a 1% chance of incontinence. The second gave impotence a 50% chance. Surgery would be a lot worse, nearly 100% for impotence. These urologists don’t give out patient contact info, just like my robotic surgery urologist. ( I got 80 names, numbers and email addresses from UFHealth and have already gotten phone calls and email messages from former patients some which gave results 5 years or more after treatment). I think both Urologists agreed when I bought up Proton therapy it was only equal with other forms of radiation when it comes to side effects. One of the Urologists was a radiation specialist.
I’m still on board with Proton though. With the small amount I have to spend out of pocket I could use a two month vacation in Jacksonville. Their Third and Main Condo seems reasonably priced at the two month rate and it’s less than a mile to the Institute; walking distance. Pretty sure my mind is made up.
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Additional info: I am medium risk at T1c. My prostate is moderately enlarged. My latest PSA is 7.5 and Gleason score is 4+3=7, 3+4=7, 3+3=6 and 3+4=7 in various areas of my prostate.
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My first day at UFHealth Proton Institute. Agreed to what looks like a new procedure for them. Instead of sticking a balloon up my bum before each proton therapy procedure I get a one time Space OAR procedure which separates the rectum away from the prostate. Results have been excellent says my doctor. It’s done when they implant the gold markers. Hopefully less time to prep for each proton radiation session, no balloon discomfort and less embarrassment for the two months spent there.
http://www.spaceoar.com/what-is-spaceoar/
It turns out BCBS never agreed to anything and the $1269 was only an estimate of out of pocket costs. Although financially things seem to be up in the air they reassure me that since Medicare A and B will have kicked in by the time I start the procedure and I will still carry BCBS I should not have to pay anything. They imply they will fight BCBS if it refuses to pick up the rest of the Proton tab. Let’s hope it works out.
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Scheduled for a Gastroenterologist appointment next week since a colonoscopy is a prerequisite for the Proton therapy. Meanwhile I am regretting a certain radiologist consultation. My blood pressure is rising over what they billed me.
21st Century Oncology billed my insurance $1025 for a “Special Radiation Treatment” which I never received. I had only one appointment with them for a consultation and the Urologist only did a DRE. Upon calling the billing number they said I should contact the office. I call the office and they say call billing. I call billing and they bounce me back to office saying I should also contact my insurance for an EOB (explanation of benefits) for the charges. I call BCBS and confirm that their Health Statement they sent was the “EOB”. I explain I never received the procedure. But here’s the kicker: I ask BCBS if 21st Century sent a billing code for $10000 would they pay, having no way of knowing if the procedure was actually performed? They say YES.
Now I’m left with $83 out of pocket but the thought that I could be billed further for more procedures that I never received frustrates me and that’s what grinds my gears.
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Your state insurance commissioner should have a fraud hotline. Give them one more chance to correct the error or you will be filing a complaint.
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I had a biopsy yesterday. MUCH easier, less painful than one I had about 20 years ago. Very little discomfort, no real pain. Had only local anesthesia. A bit of blood in the urine as predicted. Felt fine right after, a bit more tired than usual in the evening and today, but not extreme. PSA only 2.4 but family history (age 74) but digital revealed a bit of roughness on one side. Uro is optimistic. Thanks for all the contributions, very helpful.
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Wow. Just had my third biopsy yesterday. Apparently there was a new procedure using the MRI and then mapping it out on the prostate during the procedure. My prostate is 112 Mls which is BPH. My PSA has been 6.7 for two years. I had 3 DREs by different Doctors in the last month. All said just an enlarged prostate. After the MRI my prostate was registered 3 which means it was inconclusive. So there you go. Another biopsy. The first two I had Versaid which was great. This time they said we only give IV Valium 5 mil. I insisted they give me Versaid. Ok. I went in got the IV and this Dr walks in doesn’t say hi or anything. The Valium was only in for 5 min. I told the Doc I had hemorrhoids and be careful. He didn’t say a word. Then he proceeded to ram the probe up my butt. I felt he was driving a train up my ass. Sorry. I have never experienced such paid. He did 17 needle probes and every one was horrible. I have never experienced such pain. He said the hard pat is over after working the probe in and out of me till I thought I was going to pass out. He then just walked out. Needless to say my hemorrhoids were hanging out like grapes. This was at 10:30 and by 6 pm I could hardly walk. Ice and prep H helped. I called and filed a complaint. They said “He is a great Dr”. I said “I don’t care how great he is”. No patient should have to go through this. When he calls I’m going to suggest he have a coke bottle rammed up his butt and see how it likes it. I’m really pissed. Men make sure you get Versaid. A lil Valium won’t do it. No blood in urine or bowls except 1st hour.
Good luck
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I got nothing when I had mine almost 3 years ago. I was told it would be no worse than a DRE. When it was over I broke out in a sweat that soaked my shirt and almost fainted. My advice to anyone that goes in for a biopsy and the doc attempts to do it without any pain abatement is to punch that son of a bitch in the nose as hard as you can and leave. I’m sorry you had this experience, guy sounds like a dick. Good luck.
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I had a 7.5 Percocet about 40 minutes before the procedure. Didn’t feel the lidocaine block being administered. Only felt pressure from the needles and a slight burn. Barely noticeable. Every time the needle snapped I jerked anticipating the pain others had described. Never happened. Someone told me not to do it without the Percocet. Glad I listened.
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I had the procedure performed last October 2015. I had a female doc and of course female nurse. When I entered the room for the procedure there were 2 more women. One was a student and I do not know who the other was. The first thought I had was “did they sell tickets to this event?”. At any rate I did everything I was told.
Question I did not get answered was how long before prostate returns to normal. Its has been 6 months and I will still get occasional discomfort when driving in auto for long periods of time or when riding a snowsled or motorbike. At unexplicapable times I will get a minor shooting pain. Is this the way it is to be for the rest of my life?
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My “recovery” took quite a while (see my previous comments).
So, time wise, it wasn’t til after about 6 months that the effects started to wear off. Then a year before most things returned to “normal” with brief periods of pain, tightness while peeing etc.
Now, some two years afterwards I am beginning not to notice things too much (depending how full my bladder gets).
I have been told I am “abnormal” … haha!
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Richard
I have had 3 biopsies. The last one I described about 3 paragraphs up
The last one the Dr did 17 needle insertions. Do it must have looked like Swiss cheese. I have had no lingering pain at anytime except my anis where the Dr dragged out my hemorrhoids. That was 8 days ago. You might be experiencing proctitis. Which is bacteria in the gland. I would go have that checked to see why your still experiencing pain
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I am amazed at all the comments over several years, and still no change in the way the biopsy are performed. I’ve had 4 by different urologists. When nurses told doctors I was in pain, they all replied “he can take.” One nurse asked why I didn’t ask for lidocaine – I was not informed I could ask for it. Another time the nurse said, I guess the lidocaine did not work. I wasn’t told lidocaine was used. None prescribed pain medication after the procedure and left immediately after the procedure before it could be discussed.
I find it hard to believe the doctors are unaware of the pain involved, which leads me to believe it is a time and money decision.
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My partner has got to have a biopsy and Mir scan his pas was 8.2 he’s really stressed and worried now as he thinks he has prostate cancer I’m so worried I don’t no what to do or say to make him feel less stressed,
Thanks Tina x
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Tina: encourage him to get a biopsy right away. I just had one and contrary to many of the experiences reported here it was fairly easy and nearly painless. If it is cancer, many cases are slow-growing, and if it is removed reasonably early, the cure rate is 100% (5 yr survival)! And the chances are very good that he will keep his superpowers. Please get it done soon!
If it is malignant, lots you can do to slow down the growth: Melatonin, coffee, vit D3, pecta-sol, flaxweed (NOT the oil), walnuts, tumeric, lycopene (cooked tomatoes and watermeon.)
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Tina,
Please read the dome 50 comments on this board. Contrary to what the gentleman said about no pain depends. Some 90% experienced severe pain. 2 of mine I had no pain. The third was paid 8 of 10. I almost passed out. So what’s the difference? The pain medication before the procedure. Make sure your partner has gone over pain medication before the procedure. 5 ml of Valium will not cut it. Versaid .5 ml or percaset will do the job. Some Drs have given nothing and tells you “O it’s just a little pain”. Leave this Ds office immediately.
As far as his high PSA it depends on rate of increase. I have had 6.7 for two years. Negative cancer. The MRI overlay is a new procedure that pinpoints and cells that might be malignant. Do not be concerned about pain after procedure. Blood could be in seman for a month and urin for several weeks. Again go over procedure with Dr and DISCUSS PREOP PAIN MEDICATION
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lmfao r u kidding me,, its not a big deal i had no pain other then a bit from the snapping of the gun , god u guys r wimps the wand is lubricated u feel a pinch when he freezes it 4 asreas , BIG Deal,, then its over in like 3 minutes ,, wow if u think this is the worst medical procedure i surely hope u dont have endure anything really serious lol,, i had an endoscopy i found choking on a camera was a bit worse then this
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Fuck you jerk. Everyone has a different experience but we’re all glad you’re such a he-man. Douchbag.
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Once an ass Allways an ass
I’m thinkin he’s used to having something shoved up his ass. :)) As for me some discomfort during the biopsy not bad. Decided I can drive myself home. About half way home then the freezing came out and holy crap. Got home and laid on the couch for about 4 hrs then not so bad. Have a great day everybody, you to tough guy ;)))
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Now now. We actually are all on the same team. Jm
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If that’s the case consider yourself lucky to be in the ten percent that have little pain. What a great big man you are though to laugh at the other 90 percent and berate their experiences. Makes me doubt if your biopsy ever happened.
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I had my biopsy done yesterday. The Dr. said I may experience a little discomfort and needed no pain medication. It felt like the large end of a 34 inch bat with a ten penny nail. I actually screamed 3 times and swore like a drunken sailor. The screams were from the initial ramming of the probe, the lidocaine injection, and the last shot. The ride home was miserable, I felt every pebble my wife ran over. The pain lasted until bedtime. Feel much better today other than my rectum, still feels like it was ruptured. Not sure I could ever do again.
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I just had it done and i had them put me to sleep only slight discomfort that day a good nap and a wrm bath and i felt fine.
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I have had two prostate biopsies, but I insisted up front that I be put to sleep. I got a terrible stomach infection about 10 days after the first biopsy and went septic. Don’t know whether the antibiotics I took killed all my stomach flora, or whether infection somehow spread from my prostate to my gut. Or maybe their was no relation.
My PSA remained high, although it jumped up and down, and so I had my second biopsy. This time he took 14 samples. No cancer, but lots of inflammation. This time recovery wasn’t so great, but I didn’t get deathly sick.
Just decided to visit a clinic that offers prostate MRI. It’s a four-hour drive. The urologist was very nice, but expressed surprise that I had been put to sleep for my first biopsy. He then said he usually has to put people to sleep for their second or third biopsy. All I could think was, “If you know it’s so bad you have to put them to sleep the second time, why don’t you put them to sleep the first time?”
If I had it to do over again, I would never have had a biopsy without first having an MRI. I think random biopsy cores are insanity.
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77 YO in 4 months. vigorous and in good health despite 2002 quadruple bypass surgery, after ‘small’ heart attack 5 years earlier; blood pressure well controlled by minimal medication. First PSA 10 years ago 0.6, varied up and down in low end of range several years. Not sure exactly when but over past 3 or 4 years it got near, then finally over 4.0. Biopsy past January showed 3 Gleason-6 detections, 2 barely big enough to get reported, other fairly large. Due to location near urethra, only treatment option will be personally bankrupting beamed radiation. Knowing my sensitivity to pain the biopsy was done in hospital with full numbing; unless it was just a “you forget after” thing, I literally remember nothing of the procedure. Back home urinated usual number of times rest of that day, every 2-3 hours, no discomfort; likewise once waking during night. Then at morning urination felt like I was passing barbed wire — but only that one time. Few days of noticeably blood-tinged urine but no further real discomfort. However, since then, almost 9 months after the procedure, I continue to occasionally feel a slight rectal sensation, as if I’ve had a bowel movement after eating too many hot peppers. I have no trouble voiding urine or fecal matter, and none of this rises to the level of pain. But the urologist talks as if it’s lock-step that I will have another biopsy in early 2017. My first 3-month checkback after the biopsy, PSA was a 4.0; 3 months later 4.2. After giving me the new score he then added many patients opt for treatment right there. After telling him not ready to go there just yet and another 15-20 minutes discussion, he mentioned a new genetic-predisposition test he could have done on my January samples. That’s being run now. But at the end his summation was something like “You’re doing just fine. We’ll keep watching it.” A bit confused by his mixed signals there, and frankly not sure I’ll opt for treatment if the PSA should start moving rapidly upward. My life has had its ups and downs but overall I’m satisfied; not much I still hanker to do besides reading and visiting with friends. Really don’t want to make same-city Sister her brother’s Taxi/Ambulance, or wipe out my planned bequeath to her grandson for college, for only 2 or 3 more years that might be not only basically broke but also in much less vigorous condition.
Anyone else with a similar situation?
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Johns Hopkins Surveillance program can show you how thousands of others have done with similar situation. Primary factor for you? Quality of life. Jm
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Why would radiation treatments bankrupt you? Assuming you have Medicare, radiation including proton is covered.
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I would like to share my husband’s experience. We were given options, which included, surgery, 40 radiation treatments, nothing (which they didn’t recommend, and the new knifeless (which this doctor did not know much about. He was called on his 70th birthday and told that his biopsy was positive for stage one cancer. We went I the next week and were told of the above options. He chose surgery because it was cancer. We were told that if he chose radiation and it came back, surgery would no longer be and option. So he had the surgery on Sept. 4, 2014. On the two week visit to remove the catheter, the doctor walked in and said that there was good and bad news. So he gave us the good new first. It was that he had had the prostate removed. The bad news was that he didn’t have first stage cancer at all, as the biopsy stated. It was stage three and had done gotten out of the right side of the prostate. We were devastated. He still had to have the very aggressive radiation and forty treatments of it. WHAT WAS THE BIOPSY FOR? He left our doctor and went to Moffitt Cancer Center where we wished we had gone to begin with. He had the radiation treatments and every time he is checked, which is every three months, they ask if he had a pet scan and he didn’t. The doctor never even suggested it but if he had gone to Moffitt, they would have done one. The Medicare programs are very good and do not leave you paying much. I would absolutely get more than one opinion. We wished we had. My husband’s quality of life changed for sure but we wish we had known what we were dealing with before the surgery. The catheter was (we feel) left in too long due to him not being in a cancer center but still if he had gotten a second opinion, we would have known more and would have had the surgery at Moffitt. I know many whose life is much better than my husband’s because they did go to a cancer center and not stay in the city with a clinic. A second opinion is vital. Don’t trust just a biopsy. We never knew that could be wrong.
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Evon, thank you for your information. Didn’t “speed read” but couldn’t ponder it as I went along. Will do tomorrow. Already stressed enough over tonight’s debate plus my Saints playing arch-rival Falcons. Neither, of course, comes close to this in importance but after waiting all weekend, that’s the menu.
Jim, didn’t realize MediCare would pay much. Articles I’ve read about only remedy open to — directed beam — show operation cost 35 to 150-thousand. Low end, I could probable afford my co-pay. No way if only facility available to me is toward the top. Then there are all the ‘incidental’ costs, which have already proved to be a fairly hefty percentages of my primary item.
Can you suggest a site to further check how much these extras might be, and/or to find what MediCare does or does not cover. Thank, you also.
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I’m 47 years old, and I’ve had two prostate biopsies done over the last two months. In both cases, numbing jelly and nerve blocks were used. I didn’t ask for these, they are just part of the process used at each facility. There was still some discomfort in both cases. I can’t imagine having this done without any numbing agent. Tylenol worked for post biopsy discomfort.
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Lonnie, I never have any ‘invasive’ procedure without anesthesia, no matter how minimally uncomfortable it might be said to be. Didn’t have any particular discomfort once anesthesia had worn off, except for first urination next morning — felt like slowly expelling roll of barbed wire, then couple of days of slightly bloody urine, then all OK except for 9 months later, still get very mild irritation from rectum around through part of urethra if wait even minimal time before going when get either bathroom urge. Wondering if anyone else has had experience with this. Will subsequent biopsy be more of same, or worse?
Thanks.
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IMPORTANT INFO…PLEASE READ: As a point of interest, may I direct any and all of you past, current or future posters regarding this topic…that being the actual founder of the PSA Test himself now rebukes it as a means to detect “cancer of the prostate”. READ his book “The Great Prostate Hoax: How Big Medicine Hijacked the PSA Test and Caused a Public Health Disaster Hardcover” – March 4, 2014
by Richard J. Ablin (Author), Ronald Piana (Author). Every year, more than a million men undergo painful needle biopsies for prostate cancer, and upward of 100,000 have radical prostatectomies, resulting in incontinence and impotence. But the shocking fact is that most of these men would never have died from this common form of cancer, which frequently grows so slowly that it never even leaves the prostate. How did we get to a point where so many unnecessary tests and surgeries are being done? In The Great Prostate Hoax, Richard J. Ablin exposes how a discovery he made in 1970, the prostate-specific antigen (PSA), was co-opted by the pharmaceutical industry into a multibillion-dollar business. He shows how his discovery of PSA was never meant to be used for screening prostate cancer, and yet nonetheless the test was patented and eventurally approved by the FDA in 1994. Now, doctors and victims are beginning to speak out about the harm of the test, and beginning to search for a true prostate cancer-specific marker.
*** LINK: https://books.google.com/books/about/The_Great_Prostate_Hoax.html?id=VvTpAwAAQBAJ
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My letter to the New York Times in regards to Richard Albin discoverer of PSA-(Not accepted) | Prostate diaries
https://theprostatedecision.wordpress.com/about/my-letter-to-the-new-york-times-in-regards-to-richard-albin-discoverer-of-psa/
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Hello to all dealing with this odyssey that some of us men are dealt as we move through our lives. As a resident of southeastern PA, I am now 58 and had my third biopsy today after being told I have Gleason 6 PCA last June ’16. My PSA started rising to a concerning levels in 2012 when I crossed the 4.0 reading. In early 2013 I had my first biopsy, 12 cores, out patient at my urologists local surgi center. Results were negative – obviously a big relief so I went on about my days. From that time to 2/16 my PSA rose to 6.5. My urologist recommended (several times) a saturation biopsy – full anestsia 25 cores to find out if I had prostate cancer. That just didn’t sit well at all with me – I had an event with fevers in 5/2014 that put me in the hospital on a Sunday night in Chicago (Nortwestern University ER was excellent) that was believed to be from prostatatis but never confirmed. Needless to say I looked for other alternatives to a saturation biopsy and found that Fox Chase Cancer center part of the Temple university school of medicine near philly offered an MRI of the prostate. If, after analysis found something concerning they would then do a targeted biopsy at the area the MRI eluded to. I contacted them and went through this process. My MRI can back as concerning. So I had biopsy #2 in June. 13 cores. My Dr told me that my biopsy came back positive for a very small, slow growing form of PC and that he believed that active surveillance was the best course of action. Todays procedure, 6 mos later is to see if their is any change. I get my results on 12/28 – that’s where I am….
In terms of biopsies – all I can say is they suck, there uncomfortable ( especially if you have hemies like me) but you’ll get through it. The anxiety leading up to it can get the best of you, the probe is uncomfortable but once they start counting off the core samples as the procedure is in full swing you can focus your mind that each one gets you closer to the end of it. 10 – 15 mins, they ask you to drink some water, take a pee and your outta there. Pee will be dark for few days plus other side affects as stated in this thread.
After reading an scanning many of the previous commenters this disease is confusing and obviously scary. I’m trusting that the science this is based on (as did Ben Stiller) is accurate and putting my self in the hands of the best experts I can find. I believe that MRI gives doctors the best picture of what’s going on far better than PSA tests and will get to the bottom of what’s going on with your prostate. I hope I’m right – and I hope my doctors choice for AS is too.
I hope this helps if your on the ledger for your first biopsy. I will be glad to help if I can if you have any questions hang in there. any suggestions for me always welcome, thanks for your time.
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Very informative. Thank you. Jm
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hello Phil, i’m sitting at the computer, reading comments, and i’m scared to death! I have a biopsy scheduled for this Thursday (Dec. 20, 2018. I’ve been through a lot of surgeries, but for some reason, this biopsy has me worried. Dr found some growths on prostate and PSA went up to 5.68. I guess the only thing getting me through this, is I feel I have no choice. I’m 52
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The overwhelming odds are that you will do fine-short lived post biopsy bleeding (expected), maybe some burning to urinate and acceptable discomfort. It is important to have thingsdone to limit the discomfort and the measures taken to prevent an infection. It is fair to ask for a “pre med” of a sedative like Ativan, and something for pain like Norco. The urologist will also probably do a block and this limits pain as well. Some urologists have a surgery center perform the biopsy with I.V. general anesthesia and in this case there is no pain. In regards to preventing an infection, pre biopsy antibiotics and a rectal culture to know which antibiotics are best to use are sometimes utilized. In patients that are hesitant to have a biopsy, the option of an MRI of the prostate can identify low risk vs. high risk suspicious areas that may help in the decision to have a biopsy. All of this is fair game to ask of you urologist. Again, the most common likelihood is that you will do well and hopefully put the issue to rest with a negative biopsy. JM
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Hat trick Phil: my results showed no change in my PC tumor. My Dr stated the area is small and defined. Says do a PSA in June and possibly an MRI at the end of ’17. Continue with active surveillance. Ran into my general practitioner, told him what was going on with me, he feels I should get radiation treatment and get rid of it now while it small and non aggressive. Any thoughts or advice welcome?
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It hurt Like he’ll, was only given a lidocaine shot and it wore off during the first six of 12 samples taken. I am pretty sure my doctor and the entire building heard me yelling and cussing during the last 4 samples taken. The pain was equal to a pellet rifle being shoved up your rectum and fired. I would welcomed cancer compared to ever having this procedure done again without pain meds.
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Pain Level: 8, where 10 is your leg being cut off.
The “pain block” injection hurt like a SOB, and didn’t seem do to a damn bit of good. The 12 biopsies were worse; I would characterize the pain as “excruciating”. I’m no wuss – played football games with broken bones. I would NEVER repeat this procedure…
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Well to say it was not painful is and understatement. Being 54 and walking on a cracked tibia for a month while younger I can handle pain. Like stated by previous guys procedure started out ok. First 7 samples were not bad but last 3 were very painful. After the procedure while sitting up my blood pressure dropped to 90 over 46 and I passed out. Not sure if it was from pain or the local I received. After a few minutes to stabilize my blood pressure I was of course put in a wheel chair and wheeled out for the next sucker. If I have to do another I will ask for pain medicine or not have it done.
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I had a biopsy at Hopkins Hospital in Baltimore. A well known urology department, where men come from all over the world to be treated.
On the day of my biopsy, a resident did the biopsy and was supervised by a doctor. She inserted her finger into my rectum and it was supposed to numb it
prior to the insertion of the probe and gun. I agree with above, the sound is frightening and it hurts like hell, especially when they do thirteen. Getting up from the table and seeing blood is pretty scary. I went home and the next morning, I awoke to a fever and violent chills. My wife called an ambulance and I spent 8 days in the hospital with sepsis. When I was released, I spent the next 2 weeks receiving antibiotics through a midline. I now have pain and burning and take meds to control that while urinating. It has been 6 weeks and I still am not back to normal. By the way, the biopsy was normal, which is good as aI would never let them get near me again.
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Pre biopsy rectal culture can help prevent what you experienced. Some people have bacteria with limited sensitivities. The culture helps identify theses patients and the atypical bacteria before the biopsy to guide the type of antibiotic given. JM ps It is fair for a patient to request the culture before the biopsy.
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They did do a culture when I made the initial
Appointment with the doctor and they
Prescribed Cipro. 3 prior to the biopsy and
2 after the biopsy.
After spending 8 days in the hospital,
3 weeks recovering with antibiotics diffused
Through a midline, I now have urinary issues
And possibly a abscesses in the prostate.
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Had a prostate mri for elevated psa (6), and they found a pirads 4 1.8cm mass. Went for a perineal mri fusion biopsy (through the spot between the rectum and scrotum, and they use the mri images to precisely place the biopsies) two days ago.
The doctor did 4 shallow lidocaine injections, and then another 3 or 4 deeper in the prostate. Hurt a bit. The actual biopses were extremely painful even with the lidocaine – about like having a sharp knitting needle inserted, and then a smaller knitting needle shooting out into the prostate. The removal was even more painful than the insertion. I was shaking from the pain, and the blood pressure machine gave up trying to take the pressure because my arm was too tensed up for a reading. He gave me another two deep injections about halfway through the series of 12-15 (I lost count).
I’ve had broken vertebrae, put a screwdriver through my finger to the bone, 3rd degree burns, and this was significantly more painful. I am never having another biopsy without a general anesthetic. Period.
Two days later I am still peeing blood and blood clots, very sore, and my whole crotch is purple from the internal bleeding. I have to sit to one side to avoid putting pressure on that area.
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First of all, I am sorry you had a bad experience and I hope that the results are favorable. There is a false positive rate (reported to be cancer on the MRI but it’s not) so maybe all will be well. The nicest thing about the perineal method is the very low risk of infection, so that you did not get that is a positive. The blood that you are seeing will abate with time and is not a concern long term. I wish you the best and thank you for sharing. JM
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