prostate biopsy

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aceguy
New Member


Date Joined Jun 2008
Total Posts : 2
   Posted 6/26/2008 7:12 AM (GMT -6)   
I am due to have a prostate biopsy tomorrow and I am not sure I want to go thru with it.
 
I am just now 70 years old and this invasive biopsy really concerns me.
 
3 years ago I had my first psa and it was 4.8 and my doctor had me go to a uraligist.He did the dre and it was found to be normal and I was put on antibiotics for 2 weeks.After the antibotics my psa came back at 3.6.
 
In December 2006 I had another psa and it was 3.6.
 
In Jan. of this year I had another psa and it was 4.3.I waited three months and had another and it was 4.6.The doctor said I should have the biopsy without the dre and without another psa test.This concerns me.It seems he would do the dre and see what comes from that.
 
Even at this moment I am still undecide as what I will do.
 
Thanks

smilingoldcoot
Regular Member


Date Joined Jan 2008
Total Posts : 338
   Posted 6/26/2008 8:06 AM (GMT -6)   

aceguy

A DRE is only a part of the diagnosis process.  Even a biopsy sometimes I think, misses the cancer.  A biopsy, at least my last one nothing to it.  Doctor used pain meds and I had knew he was back there. 

Good luck

Richard yeah tongue yeah


Retired USAF Richard & Debbie on The Shores of Toledo Bend Lake Louisiana
Biospy 1/10/08 Gleason 10, Stage T1C  8 of 12 samples positive all Less Than 5% 
Jan & Feb & Mar all tests clear
MD Anderson = No surgery and No Proton only Hormone and IMRT
Contacted with Loma Linda and UFPTI in FL
Started Treatment at the U of Florida Proton Therapy Institute in April 2008
May 2, 2008 LUPRON & Casodex
IMRT to started  5/27/2008 Will get 42 treatments 19 IMRT and then 23 Proton
Turn Stumbling Blocks into Steping Stones and Keep Smiling
Our Journey is on WWW.GLEASON10.COM
 


DanmanBob
Regular Member


Date Joined Feb 2008
Total Posts : 467
   Posted 6/26/2008 8:07 AM (GMT -6)   

Each man must decide what he is comfortable with, but do not let the biopsy scare you.

It is similar in one way to penile injections.....the thought of it is MUCH worse than the actual event.  I can honestly say I have more discomfort when I have my teeth cleaned than I had with my biopsy.

A negative DRE means very little.  I had a negative DRE (nothing felt) but had an aggressive cancer.

Good luck with your decision.

DanMan Bob


Danman Bob, Born 1951
Nerve-sparing, open prostate surgery November 13, 2007
Gleason score 9, PSA 14; Biopsy result - 9 of 12 sticks showed cancer
Post-op pathology stated that cancer was confined to the prostate
Unrelated surgery January 2008 delayed incontinence recovery, which is now showing good signs of improvement (fraction of a pad a day as of late April 2008)
100 MG Viagra 3 times a week beginning December 2007
Osbon Erec-Aid Esteem manual pump for therapy beginning mid-February 2008
30 MG papaverine/1 MG phentolamine bimix injections beginning late April 2008
Five week post-op PSA 0.2, five month post-op PSA 0.1, next test August 2008


BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 6/26/2008 8:35 AM (GMT -6)   
As DanmanBob said, a negative DRE is not conclusive. I had a GP do a DRE (felt nothing), followed by a urologist (felt nothing) and when I went to a second urologist he said he thought he could feel something. Of course urologist's #2 opinion was given with the benefit of the biopsy results conducted by urologist #1 which had revealed the presence of a tumour. Unfortunately, I am cynical enough now about the medical profession to believe that this may have been to impress me with his special prowess. The tumour was located on both lobes but to the front of the prostate where it could not be felt. Having said that, doctors would be suspicious and want to investigate a PSA above 4. Reserch everything you can before making a decision but do not allow apprehension about the biopsy procedure cloud your judgement. Light sedation and a little pain killer means you will feel very little.
Bill
1/05 PSA----2.9 3/06-----3.2 3/07-------4.1 5/07------3.9 All negative DREs
Aged 59 when diagnosed
Biopsy 6/07----4 of 10 cores positive for Adenocarcinoma-------bummer!
Core 1 <5%, core 2----50%, core 3----60%, core 4----50%
Biopsy Pathologist's comment:
Gleason 4+3=7 (80% grade 4) Stage T2c
Neither extracapsular nor perineural invasion is identified
CT scan and Bone scan show no evidence of metastases
Da Vinci RP Aug 10th 2007
Post-op pathology:
Positive for perineural invasion and 1 small focal extension
Negative at surgical margins, negative node and negative vesicle involvement
Some 4+4=8 identified ........upgraded to Gleason 8
PSA Oct 07 <0.1 undetectable
PSA Jan 08 <0.1 undetectable
PSA April 08 <0.1 undetectable


phillysub
Regular Member


Date Joined Nov 2007
Total Posts : 64
   Posted 6/26/2008 10:13 AM (GMT -6)   

aceguy,

I guess your decision on getting the biopsy depends on whether you care to find out if you might have PCa.

Since you've been getting your PSA and DRE's done, I would have to assume that you do care to find out. I won't lie to you and tell you that it is 100% pain-free, there is a bit of discomfort.

In my opinion, it's best to go ahead to find out what's really going on with your prostate.

I hope you make the right decision.


Phillysub.

Age: 51
Last PSA before diagnosis: 2.9
Diagnosed: Oct 2007
Gleason: 3+3=6
RALP surgery: Jan 23, 2008 (Dr Costas Lallas @ Thomas Jefferson Hospital in Philadelphia)
1st Post-op appt: Feb 1, 2008 (negative margins, cancer contained within the capsule)
1st PSA post-op: May 23, 2008 - <0.1 undetectable


aceguy
New Member


Date Joined Jun 2008
Total Posts : 2
   Posted 6/26/2008 12:27 PM (GMT -6)   
Thanks to everyone for responding.
 
My problem is not the biopsy as much as the fact that I might be getting one when it is not neccesary at this time.
 
Everything that I have read suggest the biopsy is the last thing you have after having the PSA the DRE and the regiment of antibiotics(500mlg of citro) and another PSA test.This procedure was done three years ago but for whatever reason is not being done at this time.
 
After saying all this I took the first of three levaquin pills that help to prevent infection.So I suppose reluctantly that I have decided to go ahead with the biopsy but then again I still have about 24 hrs before I am due at the doctors office.

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 6/26/2008 12:34 PM (GMT -6)   
  tongue    Hi ~ aceguy and Loved Ones,

 

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Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 6/26/2008 12:38 PM (GMT -6)   
Hi aceguy,
I wouldn't worry about the biopsy too much. but I would recommend it. Even if you choose to wait before doing anything, you are better prepared by being proactive about it. It just might be a non-issue, but it's a gamble to wait. Of course I Hope you are not a club member, but if you are, you are very welcome here and this wonderful site is full of great people to draw from. Good Luck and again, I recommend that you do get the biopsy. It's not the funnest thing you will do in life, but if you have family close by you, you can look into their eyes and know what you should do.

Tony
Age 46 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007 @ The City of Hope
Post-Op Pathology: Gleason 4+3=7, positive margins, Stage pT3b (Stage III)
HT began in May, '07 with Lupron and Casodex 50mg
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (May 9 '08): <0.1
I will continue HT until May '09. 
Years in Remission (3/23/07): 1
Visit my Journey at:
And at:
 
STAY POSITIVE!
 
Prostate Cancer Forum Moderator


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 6/26/2008 12:58 PM (GMT -6)   
aceguy, by almost any standard, there's enough evidence to justify having a biopsy now.  It is the logical next step in the  ladder.  If you don't worry about the procedure but only about the timing, then I'd suggest it is time for it.   Welcome to HW, by the way.  Hope you come back and share the result of your decision, whatever it is...ok?

James C.
Co-Moderator- Prostate Cancer Forum

Age 61
4/19/07 PSA 7.6, referred to Urologist, recheck 6.7
7/11/07 Biopsy- 16 core samples, size of gland around 76 cc. Staging pT2c
7/17/07 Path report: 3 of 16 PCa, 5% involved, left lobe , GS 3/3:6.
9/24/07 (open) Retropubic Radical Prostatectomy performed
9/26/07 Post-op Path Report: GS 3+3=6 Staging pT2c, 110gms, margins clear
10/15/07 ED- begin 50mg Viagra and Vacurect pump nightly, Fully continent
1/14/08 Caverject started/stopped, aching. 2/24/08 .5ml Bimix started-success
5/7/08 ED- Viagra, pump, no response- Trimix .075ml continues
Post Surgery PSA's:  3 mts-0, 6 mts.-0


mvesr
Veteran Member


Date Joined Apr 2007
Total Posts : 823
   Posted 6/26/2008 5:41 PM (GMT -6)   
Hi Aceguy

Life is full of things we don't have to do, but there are some things we have to do. I have never had a positive DRE but the biopsy was positive. My uncle (mid 70's) just had a biopsy and it was positive. The biposy is just one of life's bad moments.

Mika
age at dx 54 now 56
psa at dx 4.3
got the bad news 1/29/07
open surgery Duke Medical Center 5-29-07
never more than 2 pads
wear one for insurance now
ED still a problem
last PSA undetectable
 


durantlion
New Member


Date Joined Jun 2008
Total Posts : 12
   Posted 6/26/2008 6:19 PM (GMT -6)   
Hello aceguy...I'll be 68 in August.  Understand your concerns.  I had biopsy in July '06 - PSA 5; Biopsy in March '07 - PSA 6.6, both negative.  Biopsy in June '08 - PSA 8.  THE BIG C...For me, big baby that I am, it did not hurt other than maybe like a mosquito sting.  At our age old buddy, get the biopsy and find out "aye or nay"...if negative, go fishing; if positive, start fighting...
 
For all of you that responded to me earlier in June when I couldn't see straight after being diagnosed; after so much reading; on the intermet; on the telephone with friends and loved ones; I came to the decision for da Vinci robotic in Phoenix August 7.
 
Mr. Aceguy...you and I have a wealth of information, support and knowlege on this forum...Go do it tomorrow and let's get about our daily lives...and have a peace of mind one way or the other...
 
 
durantlion

Retired
Born Aug. 14, 1940 (dx 6-3-08)
Oct. '05 PSA 3.7; Free PSA 14.3
1st Bio July '06 - negative; PSA 5; DRE Negative
2nd Bio Mar '07 - negative; PSA 6.68; DRE Negative
Feb. '08 PSA 7
Mar. '08 PSA 10.8;  Free PSA 24.1
April '08 PSA 8.2; Free PSA 14.6
3rd Bio June 3'08, one core of 10 (LMid 20% cancer)other 9 cores negative
Stage T1c, Gleason 3+3=6; DRE Negative
 


DanmanBob
Regular Member


Date Joined Feb 2008
Total Posts : 467
   Posted 6/26/2008 7:01 PM (GMT -6)   
durantlion,
 
Good luck with your surgery.
 
DanMan
Danman Bob, Born 1951
Nerve-sparing, open prostate surgery November 13, 2007
Gleason score 9, PSA 14; Biopsy result - 9 of 12 sticks showed cancer
Post-op pathology stated that cancer was confined to the prostate
Unrelated surgery January 2008 delayed incontinence recovery, which is now showing good signs of improvement (fraction of a pad a day as of late April 2008)
100 MG Viagra 3 times a week beginning December 2007
Osbon Erec-Aid Esteem manual pump for therapy beginning mid-February 2008
30 MG papaverine/1 MG phentolamine bimix injections beginning late April 2008
Five week post-op PSA 0.2, five month post-op PSA 0.1, next test August 2008


livinadream
Veteran Member


Date Joined Apr 2008
Total Posts : 1382
   Posted 6/26/2008 7:45 PM (GMT -6)   
please do the biopsy, it just might be the most important procedure of your life.

peace to you my friend
Dale
My PSA at diagnosis was 16.3
age 46 (current)
My gleason score from prostate was 4+5=9 and from the lymph nodes was 4+4=8
I had 44 IMRT's
Casodex
Currently on Lupron
I go to The Cancer Treatment Center of America
Married with two kids
latest PSA 5-27-08 0.11
cancer in 4 of 6 cores
92%
80%
37%
28%
 


corynski
Regular Member


Date Joined Apr 2008
Total Posts : 63
   Posted 6/26/2008 7:51 PM (GMT -6)   
Aceguy

I'm 70 and apparently just a few steps ahead of you in this drama. Puzzling, I would think your urologist would want to know what a recent DRE result would be after 3 years. I suggest you request it, perhaps he can do it before the biopsy. My inner cynic suggests that my biopsy costs over $3000 where a DRE would not be more than a few hundred I'd guess. But you do need that information to make a treatment decision, even if you were to continue with watchful waiting I'd think. More knowledge is better.

Most importantly to me is to know that I am (hopefully) T2a, Gleason 3+4=7, which suggests that the cancer is contained, and that gives me better treatment options. For example, contained disease can be treated non-invasively with Proton Beam radiation which reports a minimum of side effects such as incontinence and impotence, with about the same survival stats. At our age, quality of life is pretty important I think. A great book to read is Bob Markini's, who is a graduate of the Linda Loma Proton Beam program. This is a relatively new treatment that my urologist told me today he had no idea what it was all about, and sent me to another doctor.

http://www.protonbob.com/proton-treatment-homepage.asp

You may have time if your PSA is correct, and not rising rapidly. You can see by my stats that mine started to gallop and I'm up too high really, I should have moved into action a year ago.

Good luck to you

charley/70/east tenn
_____________________________________________________________________________

Pre-Diagnostic PSA record, begun 1995 at age 58..... now 70:
1995 - 1.2, 1997 - 1.7, 1998 - 1.4, 1999 - 1.7, 2000 - 3.4, 2001 - 2.0,
2002 - 4.6 on 6/6, 4.1 on 7/24, 3.5 on 10/1 at urologist's office
2003 - 2.3, 2004 - 2.7, 2005 - 3.2 on 7/15, 2006 - no test????
2007 - 5.8 on 2/5, 5.7 on 6/16
2008 - 10.4 on 2/29, 8.8 on 4/21 --- Scheduled biopsy for 5/6/2008. On a graph, the PSA rise looks exponential, i.e. a growth function.

*****************************************************************
5/22/2008 -- Results of biopsy
4 of 12 cores show adenocarcinoma:
LLM - Gleason 3+3=6, PTI=10%, LM - Gleason 3+3=6, PTI=2%
LLA - Gleason 3+4=7, PTI=25%, LA - Gleason 3+3=6, PTI=20%
Clinical Stage: T2a
Comments:
RLB - There is focal acute prostatitis
LLM - There is focal perineural invasion
LLA - There is focal perineural invasion
Partin Table:
OC - 33%, CP - 52%, SV+ -10%, LN - 4%
No treatment selected yet.....


IdahoSurvivor
Veteran Member


Date Joined Aug 2007
Total Posts : 1015
   Posted 6/26/2008 9:36 PM (GMT -6)   

Hey aceguy,

We're so sorry for the reason you're here, but you came to the right place!  A warm welcome to you!

This is a great place to ask questions and to get support.

Your numbers indicate to me very good reasons to get a biopsy with your PSA rising.  My PSA was 4.3 and I caught PCa early.

Look at it this way.  If your results come out negative, you've gone through a little discomfort.

** but, remember the prostate biopsy is never a test done "for nothing" **

You and I really need to know if we have cancer or not.  There are many on this forum who wish they had caught the disease earlier.  If you do find that you have cancer, then you can take charge and find a way to get rid of it.

No one can force you to do anything, but those on this forum will support you in any decision you make to help ensure or re-gain your good health.


Barry ~ (a.k.a. "Idaho") - Prostate Cancer Forum Moderator

 

Da Vinci Surgery July 31, 2007… 54 on surgery day
PSA 4.3  Gleason 3+3=6  T2a  Confined to Prostate

1st PSA  09/11/2007  <0.04 (undetectable)

2nd PSA 12/10/2007  <0.04

3rd PSA  03/17/2008  <0.04

4th PSA  06/17/2008  <0.04

My web site: http://pca-info.blogspot.com


uncledan
Regular Member


Date Joined Aug 2007
Total Posts : 120
   Posted 6/26/2008 10:17 PM (GMT -6)   
Things to think on. I am 68. I did not have any systems. No going to the bathroom at night, no trouble in voiding urine, no pain. Only a high PSA score. Biopsies were done and the answer was cancer. Luckily I went ahead with them, and the cancer was still encapsulated by less than 1 MM or 37 thousand of an inch. That's less than the thi9ckness of 13 sheets of paper. I was lucky. Tomorrow I will be going for my 10 month check up. The previous three have all been zeros. My biopsies were at 10AM and by 2PM I had more or less forgot about it. I never ebven had the pain prescription filled. My advise go for it. Uncle Dan
Age 68
DRE negative, 10 - 06 PSA 5.44, 01 - 07 PSA 6.47
5 - 07 CT and Bone scans negative, 05 - 07 Biopsies, 2 of 6 positive
Gleason Score (3+4) 7 Stage T1c
08 - 14 Da Vinci RAP, five hours surgery
Some right nerve and all left nerve removed,
8 -16 Negative margins, Encapsulated, 50% left side
Lymph nodes 2 R & 1 L - Negative, R & L seminal vesicles - Negative
Gleason changed (4+3) 7 so it was closer to 8 than 6
Sixth month PSA 0.04 Previous PSA 0.00 Occasional stress drip
Results are improving while using pump. Pills no help


ace06
Regular Member


Date Joined May 2008
Total Posts : 28
   Posted 6/27/2008 5:21 AM (GMT -6)   
Don't waste time. Do it. I am 73, G P discouraged a biopsy because he coun't feel anything. Urologist couldn't feel anything. Biopsy showed a tumor. pre-op 3+3. post-op 3+4. My PSA was 4.5. 

Age 73
PSA 4.1 in Nov 07. 4.5 in March 08 after antibotics
Biopsy 2 Pos out of 12, 1- 70%, 1<5%
Preop Pathology 3+3 contained no postop yet
robotic surgery May 5th 08
Doing good except very wet

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