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My First Biopsy - Whee!

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Prostate Cancer
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firsttimer
New Member
Joined : Nov 2007
Posts : 4
Posted 12/14/2007 11:53 AM (GMT -8)
Well, I just got back from my first biopsy. Was it as bad, or as good, as they say?

My doctor doesn't do intrvavenous sedation. He prescribed two 10mg Valium (enough to "stun a horse" in the words of my primary care doc), and I took both! So by the time I went in I was high as a kite! Just perfect!

After a few minutes of my nodding off beside the fearsome ultrasound probe, everyone bustled in and we got down to business,

I have to say that the positioning of the probe, and the injection of the lidocaine, was the most uncomfortable experience I have ever had in my life. Not as painful as tearing my knee meniscus, but more painful than the meniscus surgery. As I tensed up, the doc would just say "relax, you're only making this harder."

But once that was done the "clicks" of the biopsy were painless and I felt nothing. I said (or it was the 20 mg of Valium talking - "just take out the whole gland this way!" The doc said "that would take a long time! :-)"

I was quite incontinent all over myself on the ride home, so bring a towel or diapers.

The post op pain is building, but I have half a bottle of vicodin left over from my knee surgery standing by, and a hot bath has already helped. And I can start taking ibuprofen again, which I actually found more effective than vicodin after my knee op.

Bottom line: I don't understand why docs don't do "twilight sedation" for this. My wife had a colonoscopy a few months back and felt, and remembers nothing, and suffered no anxiety.

Bottom line #2: If your PSA is over 4 (mine was 5.5 and I am only 51 yrs), you probably should get biopsied (my doc biopsies PSAs over 2 at my ago), but there are very effective safe drugs on the market to block your anxiety, and of you are anxious seek out more options.

I am very needle phobic, and I had not slept for three weeks in anticipation of this. IMHO not being willing to use deeper sedation is inconsiderate of the need of the patient and borderline butchery. I doubt I will go back to this doc for further treatment beyond the followup. Certainly if there is any cancer I will seek help elsewhere unless he answers my anxieties in a considerate manner.

Post Edited (firsttimer) : 12/14/2007 1:11:49 PM (GMT-7)

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RTR
Regular Member
Joined : Oct 2007
Posts : 29
Posted 12/14/2007 1:40 PM (GMT -8)

I'm sorry you had such a painful experience.  My dr. gave me the option of "in office" or "out patient".  I chose outpatient & knocked me out.  I experienced no pain & was back at work the next day.  Reading your story I really glad I made that choice.

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Tim G
Veteran Member
Joined : Jul 2006
Posts : 3052
Posted 12/14/2007 2:00 PM (GMT -8)
Congratulations on surviving your biopsy!  Everyone's different in how they react to it.  I had the biopsies done in the urologist's office and I didn't need any meds prior to or after the 12-biopsy procedure. He did numb the rectal wall with lidocaine.  I had some blood in the urine/semen for awhile, but that was it. 

He said he used to biopsy 6 areas, but the new guidelines recommended twelve to have a better chance of catching any cancers in one area only.

Bingo! One of my biopsy samples was positive for prostate cancer and life changed for me at that point. 

Take care and hang in there...Tim

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firsttimer
New Member
Joined : Nov 2007
Posts : 4
Posted 12/14/2007 3:23 PM (GMT -8)
Thanks for the support! I should say that I just had a little bit of incontinece, just afterwards, and might not have peed myself if I'd had one more opportunity to go just before the procedure (I was kept waiting 20 min or so.) All of us with BPH know the feeling.

It is now 4 or 5 hours after the procedure and I am fine, incontinence wise, peeing normally and without discomfort, and not much pain at all.

Now once he had the lidocaine in, he could have taken 100 cores for all I cared. But I didn't appreciate being made to feel like a sissy for not tolerating the initial pain.

My knee doc and his fine OR nurses were much more considerate.

Docs need to think about this. There are lots of fine, safe, cheap meds out there, and preventing the apprehension that keeps people from getting prompt, thorough biopsies will save lives.

Post Edited (firsttimer) : 12/14/2007 4:37:15 PM (GMT-7)

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CaPCa
Regular Member
Joined : Aug 2007
Posts : 118
Posted 12/14/2007 4:53 PM (GMT -8)
There is no reason one should experience any significant pain, even if surgery is part of the journey. I also took Valium for both biopsies in my past and am glad I did. Unfortunately, there are a lot of docs who become inconsiderate of emotions after having done so many procedures. With the prostate biopsy in particular, younger men generally feel more pain, as I have been told by a urologist. This may have to do with more nerves, which we all gradually lose as we age.
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wiggyann
Regular Member
Joined : Apr 2007
Posts : 171
Posted 12/14/2007 8:52 PM (GMT -8)
I read a story once abut a man who had a prostate biopsy and due to the pressure caused by the ultrasound proble, he uriniated all over the bed while the procedure was being done. This happened without him having any control over it and he was very embarrassed. So, evidently something must cause this to happen. Also, I had a urologist tell me that a prostate biopsy could be quite painful. Yet, many men have no pain and it's just uncomfortable for them.

The urologist should always give the patient the option of having it done in the office or in the hospital under general anesthesia. Some urologists just go the outpatient route anyway. I wish my husband's urologist had done his that way.

Pain management should be the number one priority for doctors.
Some men need sedation in addition to a local, patient stress and
other factors should always dictate what a physician does. It should
come down to what is best for the patient.

Wiggyann

Huband diagnosed December 2007. PSA 7.3, eight out of twelve
cores positive. Gleason 7, Stage t1c (found due to elevated PSA)
Treatment 25 IMRT and a 90 seed Pallidium implant. PSA three months
afterwards was 1.67 or 1.7, next PSA in January.
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spinbiscuit
Veteran Member
Joined : Apr 2006
Posts : 818
Posted 12/15/2007 5:38 AM (GMT -8)
I have experienced many painful and uncomfortable procedures, but would have to put the biopsy close to the top of the list. I agree that all who need to undergo a biopsy seek out a doctor that is willing to offer several pain management options. We all feel pain and discomfort differently, and to different degrees. No one should have to endure unnecessary pain just because a doctor thinks it's bearable.

Glen
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Tony Crispino
Veteran Member
Joined : Dec 2006
Posts : 8160
Posted 12/15/2007 3:32 PM (GMT 0)
I barely remember the biopsy. What I do remember is blood in the seman and the positive test. Sitting in the examination room with my wife and the Doc coming in and saying "well there's a little cancer down there". He may just as well said was huge cancer. All I heard was the big "C". But it's the story below my signature that has this part in the distant memory. You have my prayers that it isn't cancer.

Tony
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IdahoSurvivor
Veteran Member
Joined : Aug 2007
Posts : 1015
Posted 12/15/2007 3:50 PM (GMT -8)
Hmmm... since we're sharing experiences....

My biopsy experience was not too bad, but different than most.  I had my biopsy in my surgeon's office.  She had me take a sedative the morning of.  The probe movement was uncomfortable at times, but for me not as bad as taking the samples (the "clicks").  Some of the clicks were quite painful.  I was so glad when it was done.

 

However, for some reason, my blood pressure dropped significantly when they laid me on my back again.  My doctor had left the room by then and the nurse quickly another doctor had to be called in to help and advise.  I was about to black out.  Those attending gave me some juice and 7-up to drink.  It took about 10-15 minutes for me to stabilize and then I was on my way home.  I think I may just have been low on fluids in general.

 

I had no incontinence afterward and a pleasant day of rest after the procedure.  The worst was the 1 week wait until the pathology was complete to find out I that had the big "C."

 

All in all, most of my friends here in Idaho go through the biopsy with very few issues.

 

I don't think any of you with a biopsy ahead of you should have undue concern over the procedure.  It is certainly the only way to prove a PSA result as being a positive or negative indicator of cancer.

 

Kind regards,

Barry

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