Deeper sedation during biopsy

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New Member

Date Joined Nov 2007
Total Posts : 4
   Posted 11/5/2007 5:59 PM (GMT -6)   
I've been scheduled for my first biopsy in a few weeks. I'm 51 and my PSA was 5.5 recently, and I have some BPH symptoms but nothing showing from a DRE. I am extremely doctor-phobic, and just reading about the biopsy procedure on the web caused me to vomit and hyperventilate.

My doctor, who has only spent about 10 minutes with me, seems to think a local will be just fine. Based on recent arthroscopic knee surgery, I know I'll need at least two snorts of Versed to calm down and stop hyperventiliating. I told him this and he was unconcerned, and just prescribed some oral valium.

Is this procedure commonly performed under deeper sedation than just a couple of valium? It is worth shopping around for a different urologist at this stage? I'm worried I'm going to have a heart attack just thinking about it. Maybe I should start hoarding the valium now!

Post Edited (firsttimer) : 11/5/2007 4:08:11 PM (GMT-7)

Regular Member

Date Joined Sep 2006
Total Posts : 187
   Posted 11/5/2007 6:29 PM (GMT -6)   
I told my doc I was a real chicken and he gave me a script for valium--- I told him that wasn't enough so he gave a another script for a demirol.....between the two they could have driven a truck up there for all I cared----worked just fine!

Age 47
Open Radical Prostatectomy 6/9/2006
Pathological Stage T3a, Positive Surgical Margin
Gleason 3+4
PSA rose to .24 in November of 2006
6 month hormone therapy initiated December 1. 2006
36 sessions of IMRT Ended Feb 1, 2007
PSA as of May 25, 2007 undetectable
Next PSA November, 2007

Veteran Member

Date Joined Jun 2007
Total Posts : 789
   Posted 11/5/2007 6:45 PM (GMT -6)   

Hi firstimer, I am in a different country, but when I had my biopsy, I had a local cream applied to the area by a nurse, and then was given a intravenous sedative....did not feel a thing! If I was you I would request a sedative or find a doctor that will sedate's YOUR body my friend!

Regards Mal.

age 67 PSA 5.8 DRE slightly firm Rt
Biopsy 2nd July 07 5 out of 12 positive
Gleason 3+4=7  right side tumour adenocarcinoma stage T2a
RP on 30th July,
Post op Pathology, tumour stage T3a 4+3=7, microcsopic evidence of capsular penetration, seminal vessels, bladder neck, free of tumour, lymph nodes clear, no evidence of metastatic malignancy, tumour does not extend to the apical margins.
Post op PSA 0.5 26th Sept. next PSA 26th Oct. seeing Radiation Onocologist 31st Oct. PSA 0.5 23rd October.

Regular Member

Date Joined Jul 2007
Total Posts : 242
   Posted 11/5/2007 7:20 PM (GMT -6)   
Firstimer, maybe I'm in the minority, but I had absolutely no discomfort at all during my biopsy. I was given a local and the only thing I felt was a little "pinch" whenever a core sample was taken, and I had 12. I had no pain afterwards either. The only thing that was freaky was the blood that was in my semen for approximately two, three weeks. I don't know, maybe it's the doctor and his skill, but, good luck.
Age: 49
Diagnosed: March 25, 2007
PSA: 3.0
Biopsy: Gleason 6. Five of twelve core samples positive with <5% each. No perineural invasion seen.
DaVinci Surgery: May 21, 2007 at Florida Hospital, Orlando, Florida. Surgery took one hour and 45 minutes. According to my surgeon, everything went textbook and the prostate peeled away nicely.
Post-op Pathology Report: Upgraded to Gleason 7 (3+4), negative margins, negative capsular penetration, negative seminal vesicles, lymph nodes left intact, multifocal perinural invasion, 15% of prosate involving cancer in both lobes.
Continence: Out of the pads at five weeks. Still have some very minor stress incontinence at times but it's not an issue. Still Kegel every day and will continue to do so.
Erections: Yes! With the assistance of Cialis.
1st Post-op PSA: <0.1 2nd Post-op PSA: <0.1
Family history: My Father had his prostate removed at age 67 in 1997 and has had a <0.1 PSA for the past 10 years. I was diagnosed at a much earlier age and had a more agressive cancer than my father. Go figure.

Veteran Member

Date Joined Jun 2005
Total Posts : 528
   Posted 11/5/2007 8:28 PM (GMT -6)   

When my first urologist/quack proposed a biopsy and I was concerned, his reply was "it's no big deal". I then asked him if he's ever undergone one, and his answer was "no". I didn't realize he was a quack at the time and I let him do the procedure. He injected some lidocaine first, but obviously didn't wait long enough for it to start acting. The first six "punches" were excruciating. By that time the lidocaine must have kicked in, because I barely felt the rest.

Just by the fact that this guy has spent a total of 10 minutes with you, and is not concerned about your concerns, leads me to say - find another doctor. You're in charge of this ship, not them.

1/2005 Dx PSA 26.5 Gleason 7 (4+3) @Age 61
1/2005 Start Casodex and Zoladex
7/2005-8/2005 5 weeks of IMRT and then HDR brachy
1/2007 Rad Oncologist orders CT scan of pelvis
because of complaints of pain in both thighs
MRI confirms pain not caused by cancer BUT
1/2007 CT scan of pelvis picks up a nodule at bottom of left lung
5/2007 CT scan of lungs shows 1/2007 nodule has grown and
there are numerous nodules on both lungs.
6/2007 Thoracic surgeon removes wedge of left lung for biopsy
6/2007 Path report says 95% chance of metastatic PCa, but she's
never seen cells like this before.
7/2007 2nd opinion at M.D. Anderson in Houston.
They confirm: mutated PCa, very rare, but seen there 2 or
3 times. Recommendation: have CT scans every 6 weeks
and watch for change. At that point start chemo and will
survive for 22 - 24 months thereafter.

Veteran Member

Date Joined Oct 2006
Total Posts : 626
   Posted 11/5/2007 10:28 PM (GMT -6)   


At the time of my biopsy I also had a phobia for needles.  I had not joined this forum at the time and was told by my urologist that it would not be a big deal.  I took the Valium as I was going out the dorr to the appointment but then sat in the waiting room for 30 minutes and another 15 minutes laying on the table before he came in.  By that time the Valium had worn off.  To my surprise the pain was minimal.  The only needle pain I had was when the lidocaine was given.  I had 10 samples taken and all I felt was pressure.  If I had known then what I know now and with my paranoia about needles I would have insisted on something stronger before the procedure.  Your urologist should be sensitive to your anxiety.


Diagnosed 7/6/06, 1 of 10 core samples, 40%,Stage T1c, Gleason 3+3
Da Vinci on 11/01/06, Catheter out on 11/13/06
56 Years Old
Post Op Path, Gleason 3+3, Approx. 5% of prostate involved
Prostate Confined, margins clear
Undetectable PSA on 12/18/06
No more pads as of 1/13/07
Began injections in April '07
Undetectable PSA on 6/25/07

Veteran Member

Date Joined Jul 2006
Total Posts : 681
   Posted 11/5/2007 11:56 PM (GMT -6)   

I am alway surprised when a urologist does a biopsy without first making his patient as comfortable as possible.  As I have stated here before I had a full IV valium which put me comfortably to sleep.  I had a guided biopsy that I never felt.  I had some minor bleeding after, but no pain. Any doctor who does other than this is , In my opinion, not practicing good medicine.


You decide.  If your doctor does not agree.  Get another doctor.

Biopsy 10/16/06
T2A,  PSA 4.7
Gleason 4+4=8 right side
adrenocarcinoma of prostate
DaVinci Surgery 01/16/07
Post op report,confirms Gleason4+4=8
no extra extension/invasion identified
age 65
no continence problems
Back on the golf course...
90 day PSA  less than 0.01 (undetectable)
Six Month PSA still undetectable
Dealing with ED problems with Caverject/Viagra

New Member

Date Joined Nov 2007
Total Posts : 4
   Posted 11/6/2007 12:39 AM (GMT -6)   
Thanks to all for the responses.

Yes, it's quite a contrast to the orthopedic surgeon who did meniscus surgery on me last June - even though he was very busy he made good use of the limited time we had in advance.

I think I'll make one more phone call and let him know, unambiguously, how much anxiety I have. Doctors can be so rushed, it's hard to know whether you managed to communicate effectively during the brief times you meet.

Tony Crispino
Veteran Member

Date Joined Dec 2006
Total Posts : 8128
   Posted 11/6/2007 1:58 AM (GMT -6)   
o.k. sterd...LOL
I only needed the local. No orals, no problems, and no trucks...
hi Firstimer
Sorry but I couldn't resist responding my buddy sterd82.  Take it easy on this.  I wasn't a doctor friendly person, but they are my best friends now.  I hope you get through the biopsy ok.  And by that by that I mean kickin' and screamin' will do instead of a positive test.  My experience was wierd but normal.  I did have a day or so of discomfort.  And I did have some blood in ejaculations.  But I had to do it and it wasn't too bad.


Age 45 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007
Post-Op Pathology was poor: Gleason 4+3=7, 4 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
My PSA did drop out after surgery to undetectable.  It has not returned and I will continue HT until January '08.
My Life is supported very well by family and friends like you all.

Post Edited (TC-LasVegas) : 11/6/2007 12:19:10 AM (GMT-7)

Regular Member

Date Joined Jan 2007
Total Posts : 102
   Posted 11/6/2007 5:26 PM (GMT -6)   
Hi firsttimer:

I guarantee that you are not as much of a weenie as I was on my biopsy.

I walked out of my first biopsy because they were not going to give me lidocaine.

Fortunately I found another doctor in the area who did administer lidocaine and it wasn't bad. And I'm a definite weenie.
51 Year Old DBA by profession; amateur pianist by passion.
June 2006:  PSA 4.6.  DRE prostate enlarged.  
Aug  2006:  Second opinion confirms first.  Biopsy suggested.
Sep  2006:  Biopsy results positive one lobe.  Gleason 3+3.
Nov  2006:  RPA performed at Fletcher Allen in Burlington VT.
Nov  2006:  Pathology report: Stage T3a and Gleason 3+4.
Dec  2006:  PSA 0.1
Feb  2007:  PSA 0.0 (under 0.1)
May 2007:  PSA 0.0 (under 0.1)

Regular Member

Date Joined Oct 2006
Total Posts : 444
   Posted 11/6/2007 11:36 PM (GMT -6)   
Hi Firsttimer
I had a 29-core biopsy on September 27, 2006! 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. I did feel one big pinch perhaps before the sedative took hold. 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 number of samples taken, but it gives 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. Having too few biopsy samples may not give you the best indication of your stage of prostate cancer which is critically important in selecting your treatment.
If your urologist gives you adequate sedative in your prostate you should be fine.  That's why it is so important to question your urologist beforehand as to the exact procedures he will follow and what you should expect.  Adding a valium should relax you overall.  You are very normal to feel some anxiety before this procedure.  I put off my biopsy for far too long becaue I didn't like the thought of having someone snip off pieces of my prostate.  It was only when my PSA got too high that I was quickly motivated to get the biopsy done.  I will never know if I lessened my chance for eradicating my PCa by waiting longer than I should have to determine if I had PCa and start treatment.  Live and learn.  Good luck to you!

68, 29-core biopsy 9/27/06, PSA 7.1, Stage T1c, Gleason 7 (3+4) [less than 20% in one area],  Gleason 6 [less than 5% in two other areas], negative DRE, bone scan and Endorectal MRI. Completed 39 Proton radiation treatments 2/22/07-4/18/07.  First PSA test 7/19/07 (3 months after treatment) was 2.1 or a 70% reduction in my PSA before treatment (this was better than the average expectation of a 50% reduction in PSA at this juncture, according to my radiation oncologist).  The following is a link to My Journey With Prostate Cancer -- Proton Radiation Therapy.

Regular Member

Date Joined Mar 2007
Total Posts : 237
   Posted 11/6/2007 11:54 PM (GMT -6)   
Firsttimer, I can echo JCL's and PCDave's experience. The initial lidocaine injection felt like a pin prick -- not too bad at all. After about 10-15 minutes, the dr started the biopsy procedure. I had 10 samples taken and can honestly say there was no pain at all. A little pressure and a "snapping" sound when he clipped the sample. I watched the whole thing on the video and chatted with the dr as he was taking the samples. Afterwards, I had blood in my semen for about two weeks. I'm not too phobic about procedures like this, but really no pain at all.
60 years old
Dx March 2007
Pre-Surgery Gleason 3+3 = 6
Clinical Stage: T1c
Biopsy: 1 in 10 positive
Da Vinci: June 7, 2007 
Post-Surgery Gleason 3+3 = 6
   Clear at margins
First Post-PSA Sept 07 = <.01 (Hooray!!)

Veteran Member

Date Joined Aug 2007
Total Posts : 1015
   Posted 11/7/2007 2:22 AM (GMT -6)   

Hi ~  firsttimer & Loved Ones…


Welcome   to…   ~ HealingWell ~




A   Special   Warm Welcome  to  You !


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Click  on  link  below for important information that will help you ~ help us!!


Welcome New Members ~ to HealingWell


The information (link) listed above is to help you get started on your journey.

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Veteran Member

Date Joined Aug 2007
Total Posts : 1015
   Posted 11/7/2007 2:23 AM (GMT -6)   

Hi  ~ firsttimer,


Welcome to the Forum!


You have made a great choice to reach out to others in this forum.  Members of this forum have the ability to help your journey to healing become a little better and brighter.  In turn, your discussion and comments help all of us further develop our personal understanding and compassion. 


HealingWell will always be here for you…!  You are now part our forum family ~ a group of wonderful individuals who are willing to share and to care.


We’d like to hear and respond to anything you’d like to express.  So please, keep posting. 


My thoughts and prayers will be with you, as you make important, personal choices toward healing.


Kindest regards

Idaho ~ Barry

"Idaho" ~ Barry


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

1st PSA 0.04 (undetectable) 9/11/2007

My web site:

common man
New Member

Date Joined Aug 2007
Total Posts : 13
   Posted 11/7/2007 12:59 PM (GMT -6)   
I know how you feel. I had my Dr put me out before the procedure as I am a chicken as well. He told me that I was the first that he had " put under". Remember that it is your body and you have hired him to do whatever. People have a tendency to do what ever the Dr wants with questioning them
age 66 , pc discovered 2005, psa 9+, did radiation and psa went down to .4, psa apr07 3.4 aug 07 went to 7+ gleason is 8

Veteran Member

Date Joined May 2006
Total Posts : 2542
   Posted 11/15/2007 2:00 PM (GMT -6)   

  tongue Hey ~ firsttimer,

Just a little note to welcome you to HealingWell... Continue to reach out!  That's what makes this forum so powerful.  We hope you've taken time to click on the link Idaho provided in your welcome posting above!   It has a lot of "great" information.  Please ~ touch base and let us know how you're doing.  In New Friendship ~ Lee & Buddy


mama bluebird - Lee & Buddy… from North Carolina


v          We invite you to visit our personal thread:  Click Here:  “Our Journey” ~ Sharing is Caring 

April 3, 2006  53 on surgery day

RRP / Radical Retropubic Prostatectomy

PSA 4.6   Gleason  3+3=6    T2a   Confined to Prostate

3rd PSA 08-07-2007 Less than 0.1 Non-Detectable :)

Regular Member

Date Joined Feb 2007
Total Posts : 27
   Posted 11/17/2007 7:24 PM (GMT -6)   
My first biopsy was very painful, and came out negative, but I believe because the Doctor did not take enough samples because he knew I was in pain. A few years later my PSA jumped and the same urologist said I needed to have another biopsy. My answer was that I would do it under sedation only. He refused so I switched to another that would. The second biopsy showed malignant cells and a Gleason 7 (3+4).
Age 75
January 2007 PSA 14.2
February 07 Gleason 3+4=7
March 2, 07 TUR-P+HIFU Munich Germany by Prof Chaussy and Team
April 30, 07 PSA Undetectable 0.05

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