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gtmriviera
Regular Member


Date Joined May 2007
Total Posts : 338
   Posted 5/17/2007 6:08 PM (GMT -7)   
I think that it was Capt. Kirk in the Starship Enterprise who "went where no man has gone before", which brings me to my upcoming biopsy.  Because of other ongoing health issues my biopsy will not be until next month. (the prostate, for other biopsy find me elsewhere)   This may be ancient history to you, but could someone tell me what to expect from the experience?  Just a brief description of the main points of interest would be fine.  Thanks. 

stkitt
Forum Moderator


Date Joined Apr 2007
Total Posts : 32602
   Posted 5/17/2007 6:32 PM (GMT -7)   

Hello gtm,

Here is a very watered down version and I am sure someone who has gone through the procedure will give you better info.

If prostate cancer is suspected, a biopsy is recommended. A prostate needle biopsy is a surgical procedure in which a small sample of tissue is removed from the prostate gland and examined under the microscope by a pathologist, a doctor specializing in identifying disease through the study of cells, tissue and organs.

The procedure takes about 15 minutes and is usually performed in the urologist's office in conjunction with transrectal ultrasound (TRUS), a procedure that uses sound waves to create a video image of the prostate gland. A local anesthetic is routinely used. With the help of TRUS, a doctor guides a biopsy gun — a hand-held device with a spring-loaded, slender needle — through the wall of the rectum into the area of the prostate gland that appears abnormal.

The rectal wall is thin, so it is possible to place the needle more accurately and with less injury to other tissues. When activated, the needle can remove a slender cylinder of tissue (about 1/2" by 1/16"), called a core, in a fraction of a second. Biopsy needles are tiny -- only 1.2 millimeters in diameter and less than 1/2" long -- and very precise. A sliding sheath opens once the needle enters the prostate, closes onto a sample of tissue and the needle is withdrawn.

I hope that helps answer part of your question.
 
 
Respectfully
Kitt

Moderator Prostate Cancer

Depression 25 years, Husband Crohns Disease 30 years
My Father and his 5 siblings all died of Cancer.
______________________________________________________
"If you doubt you can accomplish something, then you can’t accomplish it. You have to have confidence in your ability, and then be tough enough to follow through.” 
~Rosalyn Carter


Izzyblizzy
Regular Member


Date Joined Oct 2006
Total Posts : 411
   Posted 5/17/2007 6:38 PM (GMT -7)   
Ken has had three.

He says no pain with any. His doc does do the "numbing" procedure. Ken says it is like one quick pinch that feels like novacaine. Then can "hear, but not really feel" the punches, he says it is like a paper puncher in his mind. But doesn't really hurt, just the sound, anticipation of it.

I only went on his last biopsy with him because it was a couple days after he sprained his ankle skiing and was on crutches. He did the first two on his own, and did fine driving back and forth with them.

But it depends on whether they just numb the prostate (like they did in ken's) or actually put you under with a mild sedative. ken has had a couple colonscopy's too, and, for those, they kinda semi knock out and there is no way he could drive or function for a few hours.

I would ask your doc what he does for "pain" etc. It can range from everything from nothing, to valium, to numbing shot, to IV pain med which can be pretty strong.
Age: 63
Diagnosed: 10/30/06
PSA: 3.7 (2005: 3.4, 2004: 4.0)
Biopsy: 1/10 cancerous, 5% of one core, right apex.
Gleason: 3+3=6
Da Vinci: April 10, 2007, Denver CO
Path results: 1% of prostate involved. Very small tumors on both right and left apex. Negative margins, negative seminal vessicles, lymph nodes left intact. Gleason upgraded 3+4=7.
1st PSA Results: May 11, 2007 <.01
 


gtmriviera
Regular Member


Date Joined May 2007
Total Posts : 338
   Posted 5/17/2007 8:02 PM (GMT -7)   
Very good explanations.  To be honest I pretty much knew how the procedure is done, but your information is helpful not only to me but anyone else facing this. (How do you face a prostate biopsy anyway?)  I was curious about the amount of bleeding and how long it lasted as well as the residual pain.  Although the doctor doesn't tell you, I'm not planning on going to the office that day.  Anyone wonder why I'm not particularly worried about this situation?  My secretary recently had a double radical.  Now there's someone with a problem.  Her doctor told her she may have five years and she's at work with a smile on her face.      Later.

EB02
Regular Member


Date Joined Dec 2005
Total Posts : 48
   Posted 5/18/2007 2:08 AM (GMT -7)   
In response to your question about bleeding, there is seemingly a lot of blood to clean up right after the biopsy. My doctor left me in the room with a box of tissue to "clean up" and I was initially stunned by the mess. I used a lot of tissue. I don't remember there being any blood leaking from the rectum after the initial cleanup. There will be blood in the semen for a few weeks. My recollection is that the doctor recommended abstaining from any sexual activity for at least 24 hours, but I remember being shocked that the first discharge after that period was a sticky, bright red bloody mess. I recommend using condoms for a while. There was a lot of brownish dried blood mixed with the semen for a few weeks thereafter. I also discharged a major blood clot while urinating four or five days after the biopsy. It initially blocked the flow and I didn't know what was happening until it came out in a gush with the flow behind it. These weren't major things - I just wasn't prepared for them.

You are wise to take the day off work even though you most likely won't be debilitated for the entire day. My doctor told me I could do the biopsy first thing in the morning and then go to work and it would be no problem. I had planned to go home to shower and change clothes anyway, but once I got home decided to lie down for a couple of hours because I was tired and moderately uncomfortable. After a brief nap, I got up and went to work. I did not experience any significant residual pain.

Not to alarm you, but I disagree with the school of thought that there is very little pain during the procedure. Probing around in the rectum is never comfortable. The equipment is a lot larger than a finger and the biopsy lasts a lot longer than a digital rectal exam. The loss of dignity is the worst part followed closely by the lidocaine shot. The sticks themselves were not too bad, although I remember one spot on each side of the prostate was close to nerves that produced the sensation of being kicked in the groin. The sticks are quick and the noise and effect reminded me of a staple gun. The good news is that the whole thing doesn't last long and it is bearable. It would have been nice to have some mild anesthesia similar to what they give you for a colonoscopy. If the doctor offers you anything to calm you or more than the shot of lidocaine, my advice is to take it.

Good luck. You have the right attitude. All you really have to do is show up. It's not the end of the world.

CVK
Regular Member


Date Joined Apr 2007
Total Posts : 66
   Posted 5/18/2007 3:48 AM (GMT -7)   
Hi Riviera,
For me the biopsy was a piece of cake. My Dr. gave me a valium when I got to the office. By the time I got back in the office I didn't give a rat's a**. You lay on your side and pull your knees up and they insert a well greased ultrasound rod that has no discomfort because they numb the area with something like novacaine. Then they gave me a shot in the prostate to numb the prostate. They took 24 samples on me and about half way through I began to feel a little discomfort from the needle biopsy and it started to sting a little bit, but don't be afraid to ask for more numbing medication- they gave me more when I asked for it and I was very comfortable. After the biopsy you will experience blood in your semen. My first ejaculation looked like almost all blood. I would definitely wear a condom for about a month or until it clears up. Later ejaculations contained dark blood. I did not have blood in my urine but everybody is different. Good luck, hope everything works out for you.
Curt
Age 52
Diagnosed 2/19/07
10 of 24 cores positive
Gleason 3+3=6 Changed to Gleason 7 after surgical pathology
PSA:3.3
DaVinci Prostatectomy May 11, 2007 at Univ. of Mich. Hospital
Stage: T2a
Pathology: May 16 - Cancer confined to prostate, Margins, Lymph & Seminal Vesicles all CLEAR!
Father and Uncle had prostate cancer


gtmriviera
Regular Member


Date Joined May 2007
Total Posts : 338
   Posted 5/18/2007 4:47 AM (GMT -7)   
Very, very useful information.  Many thanks to you guys for taking the time to share.  I'll be seeing the oral surgeon today to begin the process of checking out the top end.  At least I'll be getting the Riviera back from the garage this morning so it will be a good day.

jwb187
Regular Member


Date Joined Apr 2007
Total Posts : 101
   Posted 5/18/2007 4:49 AM (GMT -7)   
There must be many ways and procedures to perform a prostate biopsy. I had mine done in a same day surgery center, came in around 7am, got my room assigned to me, put my gown on, had an IV placed on my left hand. In about an hour they came and got me, rolled me to pre-op, dosed me with some happy juice and I woke up about an hour later back in my room. I had no pain at all and like the above poster stated, just some blood residue in my semen for a week or so. Very short procedure so they said.......I knew nothing about it.....which was the way I wanted it. I hope yours works out as well as mine.....good luck. jwb
age: 61
PSA 4.57 - Positive DRE
Biopsy 3-19-07 - Gleason 4+4=8
Negative bone scan 3-20-07
DaVinci 4-24-07
Catheter out 5-01-07
post op pathology:
positive margin left side of prostate
left seminal vesicle involved (both removed)
No lymph node involvement
New gleason score 9
T3B....radiation consult on 5-9-07.


gtmriviera
Regular Member


Date Joined May 2007
Total Posts : 338
   Posted 5/18/2007 5:02 AM (GMT -7)   
Your experience does sound much more like having a colonoscopy.  You may not actually be asleep, but you don't remember anything about it.  Although needles and such don't bother me I would think that the doctor would prefer having a relaxed patient to one who may become upset.  In my case also the parkinsons occasionaly causes some unintended movement so it might be best if I am under a general versus a local.

stkitt
Forum Moderator


Date Joined Apr 2007
Total Posts : 32602
   Posted 5/18/2007 9:10 AM (GMT -7)   

gtm

Good Morning,

Just a couple of things

1.    Your secretary is a very brave woman as I have had two good friends have the bilateral mastectomies. Their  outcomes are excellent so far.  I will keep this lady in my prayers.

2.    Colonscopy in our GILab  = Versed for the drug of choice....your right, you don't care and you don't remember much.  You doze and they ask how your doing.......doing with what?  I am just fine.

Glad to hear you got your car back.

 


Respectfully
Kitt

Moderator Prostate Cancer

Depression 25 years, Husband Crohns Disease 30 years
My Father and his 5 siblings all died of Cancer.
______________________________________________________
"If you doubt you can accomplish something, then you can’t accomplish it. You have to have confidence in your ability, and then be tough enough to follow through.” 
~Rosalyn Carter


gtmriviera
Regular Member


Date Joined May 2007
Total Posts : 338
   Posted 5/18/2007 12:10 PM (GMT -7)   
My thanks to you and to all of my new friends for your support, knowing that you all are undergoing tougher times than I am.  I have been extraordinarily lucky and I won't try to describe my life other than to say that I grew up in extremely modest circumstances.  I goofed off throughout college and my gpa in my class was second from the bottom.  I have been divorced several times and so on and so on.  Today I have a wonderful wife and a life that is the American dream.  I have the greatest secretary in the world and brave doesn't begin to describe her.  If my health goes down from here, didn't MLK say something like "I have seen the top of the mountain"?  Enough already-the oral surgeon today said that he didn't think that it looked like cancer, but we will do a biopsy just to be sure.  Hope that he's right.  The Riviera is home and running great.  If you catch me complaining just bring me down to earth.

mvesr
Veteran Member


Date Joined Apr 2007
Total Posts : 823
   Posted 5/18/2007 6:13 PM (GMT -7)   
Hi reviera.  what model is it?  I am an old car man with prostate cancer.  My biopsy was much trouble, had a local in my backside with the needles. Did not hurt much, and did not have anything for pain before.  Not much blood afterward, but had some in my semen for a month or so that worried me.  The urologist never mentioned this.  It is one of the reasons I got a second opinion about my situation.  Went to my old office down the street from the Dr.'s office stayed too long I guess, so I drove myself and wife an hour back home and by that time my rear was hurting so, I took a couple of oxydones I had left over from my broken arm last year and went off to bed and haven't felt anything since.
 
 
mvesr

pcdave
Regular Member


Date Joined Oct 2006
Total Posts : 444
   Posted 5/18/2007 9:11 PM (GMT -7)   
I had a 29-core biopsy! I must confess that there was not much discomfort. A sedative was injected into my prostate (a little pin prick through my rectal wall into the prostate—then you could feel the sensation of the serum being injected). Then it was 29 clicks and we were done. So don’t be fearful of a biopsy—make sure that your urologist performing the procedure gives you some kind of sedation in your prostate beforehand. I was surprised at the large number of samples taken, but it gave me greater assurance of my stage of cancer. If you have a biopsy, don’t settle for less than 12 samples; a minimum of 20 would be preferable--discuss this with your urologist beforehand. Having too few biopsy samples may not give you the best indication of your stage of prostate cancer which is critically important in deciding on your treatment. Because I had so many biopsy samples taken, I had blood in my semen for several weeks thereafter. Good Luck!

Dave
68, Biopsy 9/27/06, Stage T1c, PSA 7.1, Gleason 6 [less than 5% in two areas], Gleason 7 (3+4) [less than 20% in third area], negative DRE, bone scan and MRI. Had 39 Proton radiation treatments 2/22/07-4/18/07.
First PSA test to be taken 7/07.


gtmriviera
Regular Member


Date Joined May 2007
Total Posts : 338
   Posted 5/19/2007 12:04 AM (GMT -7)   
We call them boattail Rivieras with a back end that looks like _V_.  I call it my stingray on steroids .  To me it may be the best looking car ever made.  Rally wheels. bucket seats, automatic with shift on the floor, oh man it just doesn't get any better than this.  Cruising with the Beach Boys in the eight track.  Life is good. 

mvesr
Veteran Member


Date Joined Apr 2007
Total Posts : 823
   Posted 5/19/2007 5:56 AM (GMT -7)   

I agree they are cool.  A buddy had one in college.  It was quite a cruiser.

 

mvesr

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