Men: tell me about getting a prostate biopsy

In My Humble Opinion
1

As I am expecting to have to have one, maybe.

My PSA test (yes, I am familiar with the new fed guidelines, but I took the test before they published) has gone up from 4 to 5 in the past 6 months, so my PCP has given me a referral to a urologist. It seems the best I can hope for is active monitoring of the prostate, which probably will include a biopsy once a year (!)

I cannot imagine a universe in which getting a prostate biopsy is anything but painful. I assume they have to punch through my flesh into the prostate to take a sample.

So, share your comforting stories (or otherwise, if absolutely necessary).
Roddy

2

Sorry nothing good to share. You will be numbed up.

3

Threads of medical opinions and anecdotes go in IMHO, so let me move this thither for you.

twickster, MPSIMS moderator

4

I wasn’t numbed, but didn’t experience what I would consider pain. I certainly did notice a kind of shock when the urologist pushed the button or pulled the trigger or whatever he did to take a sample.

The worst part of the whole procedure (to me) was the utter lack of dignity. If it goes like mine, you will be asked to disrobe from the waist down and lie on your side with your hindquarters projecting off the table. The urologist will place an ultrasound unit where the sun don’t shine, thread the sampler past that, and get on with it. Afterwards you will be free to go about your business pretty much immediately.

No especial post-procedure discomfort, and no inconvenience except for bloody urine which cleared up in a few days.

Was it worth it? Considering that I had a high-grade tumor that would have killed me within ten years if not detected and removed, I would say yes.

Good luck.

5

My father just had one…he’s pretty much a wimp when it comes to procedures, and he didn’t say anything especially bad about it.

I’ll echo what OttoDaFe said…if you look back on the downside of NOT finding that tumor…it’s a walk in the park. I know that doesn’t help before having it done…but it might help keep perspective.

Good luck. May yours turn out to be nothing.

-D/a

6

Thank you very much for the information. I don’t care much about dignity, I gave that up years ago.

Since they go in from the back, did you have to prepare or anything, a la a colonoscopy? Or do they just take their chances?
Roddy

7

Sort of colonoscopy-lite, probably because they’re not interested in the plumbing except as a route to the prostate. Mine was close to three years ago, but IIRC the prep involved a liquid diet the day before, and enemas the evening before and morning of. No drinking massive quantities of Drano, thank Og.

Of course, that’s assuming your urologist uses the same technique mine did. YMMV.

8

The collector device punches from the rectum through into the prostate. Sound germy?

They will typcally give you preventive antibiotics to take BEFORE the procedure. Commonly used are Ciprofloxacin (aka Cipro) or levofloxacin (aka Levaquin or something like that). These are industrial-strength antiobiotics of the fluoroquinolone family. Be sure you know what antibiotics they are before you take them. Fluoroquinolones have a reputation of being SERIOUSLY DANGEROUS! and should be used only for life-and-death situations, yet doctors prescribe them way too freely.

There are many fluoroquinolone drugs. Most of them have the syllable “flox” in their generic names, though not in their brand names.

These meds have a very high incidence of causing permanent damage to tendons, which may not be apparent until years later, when your tendons (Achilles, most commonly) mysteriously start to break. This is said to be common. Much less common, but much more dangerous, a SINGLE DOSE can sometimes cause severe and irreversible brain damage. In the medical literature, this is euphemistically described simply as “CNS compromise”. Those unlucky patients who have this happen to them literally have the rest of their lives utterly ruined.

Cite: Book Bitter Pills by Stephen Fried.
http://www.stephenfried.com/bitter-pills/bitterpillsbook.html
Page includes a link to another page where the entire first chapter is there on-line.
Read it, and you might conclude that risking death by prostate cancer is the better choice.

Anecdote: Friend went for biopsy, got the evil Rx, I told him not to take it, he asked doc for different pill, got prescribed Keflex instead (which I have used, with no ill effect). He took the evil med anyway and didn’t get his brain scrambled.

Contrasting anecdote: I suspect this happened to my father about a year before he died. Went into hospital for septicemia, got pumped full of antibiotics for several weeks, became delerious, disoriented and had hallucinations, never really recovered from that afterward. I don’t know what meds they pumped into him, but I’m guessing it was Cipro, that being commonly used in that way.

9

Mr. Femm, I see you are a guest in this forum (like me). Therefore, are you seeing context-sensitive advertisements at the bottom of each page? I am seeing various ads relating to prostate issues. Maybe, just maybe, for once, this is a case where some of those ads might be useful.

Here is one in particular I just noticed. It’s ad for a free booklet you can send for:

Prostate Biopsy Understand Your Prostate Biopsy. Johns Hopkins Biopsy Guide - Free.

ETA: Looks like the ONLY thing they ask you for is your e-mail address. So I’m guessing they send it to you by e-mail?

10

I have had a fairly recent experience with this. In May a blood test showed reason for concern and I had a prostate biopsy in June. The proceedure was clearly explained beforehand and that explanation left me pretty apprehensive, but it wasn’t as uncomfortable as I expected. There is a pinching sensation each time the device is used (12 in my case) but it’s not intolerable. The biggest problem I had was being left alone in the room beforehand with the equipment in plain sight. It’s not a good thing to see if you have an active imagination.

I was one of those cases that developed a bad infection after the proceedure. About a week after the test I suddenly found urination to be very difficult and ended up spending three days in a hospital bed on antibiotics. I don’t believe I’ve ever felt worse in my life.

In my case the hassle was worth it since 11 of 12 biopsy samples showed cancer. I had my prostate removed in August. If my GP had not badgered me into getting the biopsy I’d be carrying around a pretty serious case of cancer and be none the wiser.

11

Even though this thread pretty much guarantees results in the TMI spectrum I’m still going to spoiler my response. This concerns activities after the procedure that the prostate is known for having a role in.

TMI

[SPOILER]You were warned.

Since the prostate is punctured during a biopsy and it supplies a significant portion of the ejaculate during sex, there is a very good chance that there will be blood in it.

A. Don’t freak out. It’s normal.
B. When you feel like getting back to business, you might want to take care of the first few rounds solo so you don’t freak out partner.[/SPOILER]

12

I had one. The doctor numbed it up with lidocaine first.

I’d describe it as more than a mosquito bite, but less than a bee sting.

And, what Projammer said above is absolutely correct.

PS- They gave me Cipro. No ill effects.

13

Thanks for the many useful responses.

Projammer, that makes sense. Someone else mentioned blood in the urine, which doesn’t make as much sense to me. Anyway, forewarned and all that.

Curate, I understand from my reading that most prostate cancers are slow-growing and don’t actually even need to be treated, especially if one is over 60 (i.e. it grows so slow that by the time it might become a problem, you are already dead 10 years). Did your doctor determine that your cancer was an aggressive one, before you had your prostate removed?

Senegoid, thank you for the referral to Johns Hopkins, I have actually already registered with them and I have received a document on understanding the PSA test and what to do about it. I am looking at other documents as well.

As for your other post, I will be looking at the drug information with some skepticism (but I will be looking). Screeds along the lines of “these medicines are dangerous but doctors prescribe them all the time anyway!!11!!eleventy!!” always strike me as making no sense.

OttoDaFe, one of my fears was that the doc would want the biopsy right then at my first appointment. Sort of like “Hi, I’m Doctor Finger, oh my god look at these numbers, turn around, drop your pants and bend over!” I’m glad to see that this is even more unlikely than my fervid imagination would expect.

Again, thanks for the considered responses, all good information.
Roddy

14

In my case the doctor advised being pretty aggressive because I’m only 50 years old and my cancer appeared rather suddenly. He said that if I had been 70 he probably would have advised simply watching it for a while or possibly starting radiation treatments.

15

This is pretty close to what my urologist told me (except for the age — I was 62). What hastened the process was a sudden, sharp rise in PSA* that didn’t respond to antibiotics.

RF, should the biopsy come up positive (and it goes without saying that we all hope it doesn’t), I presume you will have a long talk with your urologist about options. And I further presume that you’ll do your own research. One thing that I discovered was that one of the options presented me had many of the same potential side effects as surgery, with a couple of extra added detractions of its own.

*Don’t get me started on the current debate on PSA testing, or at least the way it’s being presented in the media. While I concede that those who want to cut back on testing have a point, I see it being hijacked by the “antivax” mentality.