preventing biopsy complications

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compiler
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Date Joined Nov 2009
Total Posts : 7205
   Posted 11/25/2009 9:21 AM (GMT -6)   
I have my biopsy scheduled for Monday at a place 150 miles from home. I plan to stay over Monday night and maybe Tuesday night.
 
Is there anything I can do to prevent biopsy complications? I have BPH and one concern is an additional prostate swelling preventing urination. I guess that, excessive bleeding, and infection are the possible complications. I assume I chould drink a lot of water after the procedure?
 
Mel
PSA-- 3/08--2.90;  8/09--4.01; 11/09--4.19 (Free PSA 24%), this after 45 days on cipro!
 
History of BPH/prostatitis.
 
Awaiting results of my PCA-3 test which will determine whether a biopsy is in my immediate future. Just in: BAD NEWS: PCA-3 = 75.9! Cut-off is 35. Biopsy scheduled for 11/30


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 11/25/2009 9:43 AM (GMT -6)   
Mel

Excessive bleeding after a prostate biopsy is extremely rare, nothing to worry about in advance. Infection is rare, only can remember a couple of cases being discussed here since I have been at HW. Yes, after, drinks lots of water.

The "pain" factor is so varied and so subjective. I had 3 biopsies done total. The last two were 6 weeks apart. I had 1 done with pain med injected via needles, and 2 with no pain meds. I had the least trouble with the 3rd one, with no pain meds. The 2nd one was done with pain meds, and the injections hurt me more than the procedure, so I told my dr, no more like that.

BTW, I was more afraid during the 2nd one, because I had already been through one a year before and knew what was going on, lol.
The 3rd one, it was almost like I was getting use to it.

After, you may or may not see some minor bleeding in your first stool or two. You may see a little pink tone to your urine, and the first time or two that you ejaculate (Gee, I use to be able to do that) it is a bit unsettling to see blood in the ejaculate. But you have to tell yourself, all of that is normal, none of it will hurt you.

I would tend to be sore after for a day or two, but only when I was sitting. My dr. gave me 5mg Loratabs in case there was pain, because he didnt want me using aspirin, advil, etc, - the types of pain meds that can cause bleeding while you heal from it.

All in all, my opinion, is that thinking about the biopsy is worse than having it. With a good dr and team, they make you as comfortable as possible, and its over before you know it. We had a lot of good natured joking going on when I had mine done, which broke the ice.

You will do fine. I say this jokingly, so please take it this way, but I suspect you read every word of the drug info sheet when you pick up a med. With side effects and complications, they are required to list them, even if only one person ever reported a sympton and they sell the med to 10 million people.

When I am put on a new med, I always ask the dr why? and are there any major side effects I should know about? And if I am on any meds that could interfere, I flash the dr/ memory on what I am on currently.

The results of your test is what is important here, and I am hoping that you get an all clear signal. We are ready to welcome you as a brother of the PC, but would rather have to turn down your membership request.

Enjoy the holidays.

David in SC
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence:  1 Month     ED:  Non issue at any point post surgery
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out  38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - began IMRT SRT - 39 sess/72 gys cath #8 33 days, 11/2- SP Cath #9 in place


compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7205
   Posted 11/25/2009 9:54 AM (GMT -6)   
What about tylenol for pain?
 
(I rarely take pain medications and I don't anticipate taking anything too substantial).
 
Oddly enough, despite my posts, I am generally not a worrier.
 
There is something about the CANCER thing that really gets to you.
 
Mel
PSA-- 3/08--2.90;  8/09--4.01; 11/09--4.19 (Free PSA 24%), this after 45 days on cipro!
 
History of BPH/prostatitis.
 
Awaiting results of my PCA-3 test which will determine whether a biopsy is in my immediate future. Just in: BAD NEWS: PCA-3 = 75.9! Cut-off is 35. Biopsy scheduled for 11/30


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 11/25/2009 10:00 AM (GMT -6)   
Mel, and I mean this with respect, if you had no fear of the word Cancer, i would think you were a fool. So no foul there, until you know and if you know, it is a serious thing. Won't downplay that.

Tylenol type products are good for mild pain, make sure the dr writes you a script for something stronger in case you need it, you probably wont, but be nice to have just in case. No one says you have to fill it.

Advil type would be better, because it works on inflamation and pain. Down side, it can cause bleeding.

Got to ask, where do you live, that you have to drive 150 miles for a biopsy?
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence:  1 Month     ED:  Non issue at any point post surgery
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out  38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - began IMRT SRT - 39 sess/72 gys cath #8 33 days, 11/2- SP Cath #9 in place


Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4106
   Posted 11/25/2009 10:10 AM (GMT -6)   

Mel,  Good luck on the porcedure.  From my point of view there was very little pain during and after.  You should do fine, probably able to go home the dame dayt but  nice to be safe.  I would bet that the next day you will be ready to head home.

Best wishes

Jeff T

Cajun Country


Jeff T Age 57

9/08 PSA 5.4, referred to Urologist
9/08 Biopsy: GS 3/4=7
10/08 Nerve sparing open RRP- Path Report: GS 3+3=7 Stg. pT2c, margins clear
3 mts: PSA .05 undetectable

10th month PSA <0.01
1year psa <0.01
ED- 5 mg Cialis daily, pump daily, going to try MUSE next. Next step injections.


compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7205
   Posted 11/25/2009 10:54 AM (GMT -6)   

Purg:

I could have had the biopsy locally, but I decided to go with the Umich physician.

I live in mid-Michigan

 

Mel


PSA-- 3/08--2.90;  8/09--4.01; 11/09--4.19 (Free PSA 24%), this after 45 days on cipro!
 
History of BPH/prostatitis.
 
Awaiting results of my PCA-3 test which will determine whether a biopsy is in my immediate future. Just in: BAD NEWS: PCA-3 = 75.9! Cut-off is 35. Biopsy scheduled for 11/30


GarthK
Regular Member


Date Joined Feb 2009
Total Posts : 74
   Posted 11/25/2009 11:19 AM (GMT -6)   
Hmm... Not to get too distracted from the *real* topic but I'm doing mental geography in my head. :-) I grew up in "central" Mich which I define to sort of be the triangle from Lansing to Grand Rapids to Mt. Pleasant and back. Now if I imagine an arc crossing the state 150 miles from Ann Arbor where UMich is located, it puts you maybe on the west side of the state somewhere above Muskegon crossing eastward and northward to Grayling and ending up near Alpena. Or, you may live in the far southeastern corner of the state.

Am I close?

BTW, you're in Good Hands at UMich even tho I went to MSU. Good luck!
Garth
Vitae:
DOB: Q4'46, HT: 5'9", WT: 180
PCa:
PSA: <2.5, DRE: Slight enlargement, one node
Biopsy: 12/08
Cores: 4 of 12+ positive, Gleason: 3+3
Surgery: RRP on 1/21/09
Catheter: 15 days
Pathology:
Adenocarcinoma occupying 5% of prostatic volume (right posterior aspect)
Gleason: 3+2, No extraprostatic extensions, Perineural invasion within prostate only
No angiolymphatic invasion, No seminal vesicle invasion, Clear margins
AJCC: pT2a
Post-op PSA's
3/10/09 < 0.014 (undetectable by machine)
6/10/09 < 0.014 (undetectable by machine)
9/8/09 < 0.014 (undetectable by machine)


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4227
   Posted 11/25/2009 11:24 AM (GMT -6)   
Take a Vicodine before and after; You wll have about 4 hours of discomfort so there is no need to spend two nights.
JohnT

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.

2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G7, 4+3, approx 16mmX18mm.

Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.

25 treatments of IMRT 6 weeks after seed implants. No side affects at all.

PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.

JohnT


compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7205
   Posted 11/25/2009 11:24 AM (GMT -6)   

Garth:

 

I said 150 as a nice round number. It's more like 120 miles. Either way, you are not close. I am NW of AA. Try again!

I did my graduate work at MSU. My daughter went to Umich and my son went to MSU.

 

Mel


PSA-- 3/08--2.90;  8/09--4.01; 11/09--4.19 (Free PSA 24%), this after 45 days on cipro!
 
History of BPH/prostatitis.
 
Awaiting results of my PCA-3 test which will determine whether a biopsy is in my immediate future. Just in: BAD NEWS: PCA-3 = 75.9! Cut-off is 35. Biopsy scheduled for 11/30


GarthK
Regular Member


Date Joined Feb 2009
Total Posts : 74
   Posted 11/25/2009 11:43 AM (GMT -6)   
That puts you near my old stomping grounds and no need to get more specific. As to the biopsy, my uro gave me a fairly potent pill to "relax" me which I took on the way to his office. By the time I got there (my wife drove), he could have removed my head and I would not have protested. Then a painless pain killer shot to the "affected" area and the worst was over. There was very little discomfort during or after and I was up and about the next day.

BTW, any "intimacies" for the first few weeks after the biopsy will yield strange-looking results as the prostate heals so it is best to live the celibate lifestyle for awhile. Not to get too specific.

Again, good luck and here's hoping for only the best of results.
Garth
Vitae:
DOB: Q4'46, HT: 5'9", WT: 180
PCa:
PSA: <2.5, DRE: Slight enlargement, one node
Biopsy: 12/08
Cores: 4 of 12+ positive, Gleason: 3+3
Surgery: RRP on 1/21/09
Catheter: 15 days
Pathology:
Adenocarcinoma occupying 5% of prostatic volume (right posterior aspect)
Gleason: 3+2, No extraprostatic extensions, Perineural invasion within prostate only
No angiolymphatic invasion, No seminal vesicle invasion, Clear margins
AJCC: pT2a
Post-op PSA's
3/10/09 < 0.014 (undetectable by machine)
6/10/09 < 0.014 (undetectable by machine)
9/8/09 < 0.014 (undetectable by machine)


Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3732
   Posted 11/25/2009 11:47 AM (GMT -6)   
Mel,
The only prep work I can recommend is vigorous and frequent emptying of the prostate contents with a willing partner.
Tell your wife it's Good For Men's Prostate Health (GFMPH) and enjoy. ;)

After the biopsy, your ejaculate will be discolored - mine was black - so you'll want to use a condom. Take advantage of the situation while you still can.
Jeff
DX Age 56. First routine PSA test on April 8th: 17.8.
May PSA: 22.6, 3 weeks later: PSA: 23.2.
Biopsy 6/10/09: 7/12 scores positive, Gleason 6=3+3. Bone scan and C/T scan negative.
RP DaVinci -7/21/2009 @ Univ of Roch Medical Center
Left nerve gone, right partial spared.
Catheter removed - 7/31/2009 Pathology report received:
Gleason 3+4=7 Tumor size: 2.5 x 1.8 cm location: both lobes and apex. No Malignancy in Seminal Vesicle, vasa deferentia, lymph nodes 0/13
Extraprostatic extension present; Perineural invasion: present, extensive
Prostate mass 56 grams. Pathologic Stage: pT3aN0MX
Post Surgery Status:
Potency - 10/31 3 months, Still no activity, nada, zip
Incontinence - 8/20 4 full pads per day
. 9/7 3-4 full pads per day (I'm going to try cutting down on fluids. Bad idea. I know.)
9/27 2 months: Still 3 pads per day.
11/14 4 month: Still 3 pads per day. 420ml/day, 91 um leak. At this rate I'll be fine in 2012.
Post Surgery PSA - 9/3 6 weeks- 0.05, 10/13 3 months- 0.04 undetectable.


compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7205
   Posted 11/25/2009 12:15 PM (GMT -6)   

Garth:

 

Nice chatting with you. Looks like you and I are the same age (even the same weight, but I am an inch or two taller than you!). It also looks like you had a very good path. report. I guess your doctor just found a nodule that led to your biopsy?

 

Mel


PSA-- 3/08--2.90;  8/09--4.01; 11/09--4.19 (Free PSA 24%), this after 45 days on cipro!
 
History of BPH/prostatitis.
 
Awaiting results of my PCA-3 test which will determine whether a biopsy is in my immediate future. Just in: BAD NEWS: PCA-3 = 75.9! Cut-off is 35. Biopsy scheduled for 11/30


geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 11/25/2009 12:36 PM (GMT -6)   
As people have said, reactions to the biopsy vary widely. Mine was no problem. Local injection of anesthetic, then no fun, but I didn't find the pain hard to take. Worst was when the doc said "half done" because I was ready for it to be over. I had a female urologist and a female nurse manipulating that probe up my a@@ and that was a distraction.

My biopsy was at two and then I took the commuter train home and went to work (desk job) the next morning. No pain worth treating. Of the over the counter pain relievers mentioned Tylenol is the safest when bleeding is an issue, but ask your doctor
Age at diagnosis 66, PSA 5.5
Biopsy 12/08 12 cores, 8 positive
Gleason 3+4=7
CAT scan, Bone scan 1/09 both negative.

Robotic surgery 03/03/09 Catheter Out 03/08/09
Pathology: Lymph nodes & Seminal vesicles negative
Margins positive, Capsular penetration extensive Gleason 4+3=7
6 weeks: 1 pad/day, 1 pad/night -- mostly dry at night.
10 weeks: no pad at night -- slight leakage day/1 pad.
3 mo. PSA 0.0 - now light pads
6 mo. PSA 0.00 -- 1 light pad/day


Ziggy9
Veteran Member


Date Joined Jul 2008
Total Posts : 981
   Posted 11/25/2009 12:58 PM (GMT -6)   
After my two 12 needles biopsies I played golf the following day. It's uncomfortable but no big deal with some lidocaine gel.

Now my 45 needle 3d saturation biopsy was another thing altogether.
Diagnosed 11/08/07 - Age: 58 - 3 of 12 @5%
Psa: 2.3 - 3+3=6 - Size: 34g -T-2-A
 
2/22/08 - 3D Mapping Saturation Biopsy - 1 of 45 @2% - Psa:2.1 - 3+3=6 - 28g after taking Avodart - Catheter for 1 day -Good Candidate for TFT(Targeted Focal Therapy) Cryosurgery(Ice Balls) - Clinical Research Study
 
4/22/08 - TFT performed at University of Colorado Medical Center - Catheter for 4 days - Slight soreness for 2 weeks but afterward life returns as normal
 
7/30/08 - Psa: .32
11/10/08 - Psa.62 - Not unexpected bounce after the 80% drop the quarter earlier. Along with urine flow readings, an acceptable amount left in bladder measured by sonic. Results warrant skipping third quarter tests, and to return April, 2009 for final biopsy scheduled to
complete clinical research study 
 
April 2009 12 of 12 Negative biopsy
10/12/09 - Psa .30
 
 
 


Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4156
   Posted 11/25/2009 1:17 PM (GMT -6)   

Mel:

As I recall from your earlier thread, you chose the biopsy under anesthesia...so you will have no pain during the procedure.  Afterwards, a couple of tylenol should do the trick...but, as JT said, you could ask for a Vicodin prescription if you are concerned.

Depending on time of day for your biopsy, staying over the first night might be advisable.  This is especially true if you plan to drive as you should not drive after the anesthesia.  Staying a second night is overkill as you should be pretty much back to normal on the day following the biopsy.  If you have concerns about your BPH, you should by all means discuss that with your physician...most of here are not doctors, we only play them on the internet!

Finally, as others have said, be prepared for some blood in your urine for a couple of days and some nasty looking ejaculate for a few weeks.

Most of all, good luck...I hope your test shows NOTHING and you can relax.  In any case, please come back and let us know what happens...

Tudpock


Age 62, Gleason 4 +3 = 7, T1C, PSA 4.2, 2 of 16 cores cancerous, 27cc
Brachytherapy December 9, 2008.  73 Iodine-125 seeds.  Procedure went great, catheter out before I went home, only minor discomfort.  Regular activities resumed, everything continues to function normally as of 9/1/09.  6 month PSA  1.4 and my docs are "delighted"!

GarthK
Regular Member


Date Joined Feb 2009
Total Posts : 74
   Posted 11/25/2009 3:28 PM (GMT -6)   
First, I have an older brother named Mel that lives NW of AA by about 120 miles and who also got his graduate degree at MSU. Is there anything you've failed to mention to me? Like sharing the same parents? :-)

Anyhow, my personal physician had his lab draw for the PSA immediately after doing the DRE and that's not a good thing as that can artificially raise the PSA level. It came back elevated and he was unconcerned but I pushed for a visit to a uro given that my other older brother had brachy about ten years ago. The uro did a couple of follow-up PSA tests and two really thorough DREs and each time he detected a slight enlargement/firmness. That prompted the biopsy and away we went. I never complained to my personal doc since, if he hadn't done that, I might never have found out about the PCa. Such is life.

That's my story and I'm sticking to it!

See ya,
Garth
Vitae:
DOB: Q4'46, HT: 5'9", WT: 180
PCa:
PSA: <2.5, DRE: Slight enlargement, one node
Biopsy: 12/08
Cores: 4 of 12+ positive, Gleason: 3+3
Surgery: RRP on 1/21/09
Catheter: 15 days
Pathology:
Adenocarcinoma occupying 5% of prostatic volume (right posterior aspect)
Gleason: 3+2, No extraprostatic extensions, Perineural invasion within prostate only
No angiolymphatic invasion, No seminal vesicle invasion, Clear margins
AJCC: pT2a
Post-op PSA's
3/10/09 < 0.014 (undetectable by machine)
6/10/09 < 0.014 (undetectable by machine)
9/8/09 < 0.014 (undetectable by machine)


riverbend
Regular Member


Date Joined Mar 2009
Total Posts : 39
   Posted 11/25/2009 5:38 PM (GMT -6)   
did not see anyone else post this....your uro should have prescribed an antibiotic for you to take prior to the biopsy...I was told to take mine an hour before the biopsy was scheduled
Dx T1c in April, 2009 at 45 years old after recent PSA tests ranged from 2.93-3.25
2 of 14 cores positive at 5% and Gleason 3+3... 2 cores taken from a "protuberance" were "ASAP"
Proton radiation at LLMC May-June 2009


Paralleli
Regular Member


Date Joined Jul 2008
Total Posts : 123
   Posted 11/25/2009 6:22 PM (GMT -6)   
Mel:

Everybody’s different I guess. I had a twelve-core biopsy and it was no big deal. It was over in minutes and I felt, maybe, a slight sting once or twice. That was it. Others have likened the sting to being flicked with a rubber band. I would say it wasn’t as sharp as that. Like Riverbend, I was given an antibiotic. If I remember correctly, I had one dose that a.m.

Before reading Purgatory’s comment, I hadn’t heard of anyone preparing for pain relief after the fact. I got up the next morning, made a six-hour drive to Kansas, and then spent the next four days chasing pheasant and quail. Yes, they told me to drink plenty of water afterwards.

As they say these days - "No worries, dude....."
@ 53 yrs PSA 4.8
T1c – Gleason 3 + 3
IMRT 1/07 thru 2/07 (42 treatments)
PSA 6/07 – 0.76
PSA 12/07 – 0.36
PSA 6/08 – 0.72
PSA 12/08 - 1.06
PSA 6/09 - 1.02

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