Forgive the title. I want to be clear upfront on the following content. I held off blogging about this until I talked to my mom to give her a heads up. Since she reads this blog, I have to be fucking careful about what I write. A blood analysis last fall indicated an elevated PSA level. I elected to take a second reading a few months later rather than proceed directly to a prostate biopsy. Do-overs are standard policy in my book. Unfortunately, the second test didn’t work out in my favor.
In case you’re interested because you expect a prostate biopsy in the future, the following is my experience. I can tell you this is not some cavalier test. Without even taking medication, simply having the procedure has potential side effects. I find the risks acceptable, major inconveniences though for sure. I can see not every guy feeling the same way. Most of what I read suggests the side effects are temporary over the course of several weeks or months. I find the more I subjugate myself to doctors and the more dignity I relinquish in their offices, the easier it becomes to accept such potential side effects.
I have to compare this procedure to a colonoscopy, mostly because I’ve had one of those too. There’s the obvious rectal component. In that sense, the biopsy is a mini colonoscopy. There’s no prep to drink – so right there the biopsy wins. And we’re talking about a rectal intrusion in terms of inches rather than feet, hence the mini. There isn’t even anesthesia. I was offered Valium but turned it down. I needed to return to work afterward and I’m not exactly clear on IBM’s Valium in the workplace policy. Believe it or not, I’ve never taken any of the popular anxiety drugs so I don’t truly know if there would be cause for concern. Based on performance reviews, I do know that I’m overly transparent as it is at work. I don’t need to be telling my coworkers what I really, really think.
My experience began with the nurse instructing me to undress from the waist down and to lay on my side covering myself with a sheet made from paper. This picked up my spirits a bit as, on some metaphorical level, I found this preferable to having to bend over. If you’re concerned you might get an erection, trust me – you won’t. The experience is overwhelmingly emasculating. I was like a dog with its tail between its legs. She registered my heart rate at 56bpm so I was managing the anxiety fairly well. She then asked for my permission to allow a 3rd party into the room, a woman technician, to train the urologist on their brand new prostate biopsy ultrasound machine and monitor the imaging. Like I was going to say no to that. “No, let the doctor learn as he goes. We’ll learn how to operate this thing together.” While I don’t think of myself as an exhibitionist, I was actually fine with it. The more the merrier.
Dr. Webster was quite good at setting my expectations. The procedure took maybe 20 minutes. While extremely uncomfortable, it didn’t really hurt. The most painful aspect was two needle injections of something to numb my prostate. This hurt on the level of any flu shot to the arm, only it wasn’t to the arm. My online research led me to expect the biopsy pinpricks to feel similar to bee stings. Had the doctor told me this I was prepared to reply, “American bees or African bees?” I’m still a little disappointed I couldn’t reference that Monty Python skit. Reminds me though, I need to erase my search history.
I received 12 biopsies and only two of them hurt a little, but less so than the initial shots. After the fourth biopsy, my penis began to burn – acute dysuria. The sensation was fairly strong actually and maybe hurt more than those two initial shots. Apparently, this is normal, I’m guessing from a dramatic change in the pH balance suddenly streaming through my urethra. In other words – bleeding. I should have asked what causes it because I’m just guessing. Feels better this morning. Dr. Webster told me I would jump at the first biopsy – which I did – but I didn’t overreact to any of the subsequent biopsies. Each biopsy made a clicking noise like a cap gun being fired, or a mousetrap being sprung. It’ll spook you the first time.
I review the results with Dr. Webster in a week. I’m not nervous. Cancer is far from the worse prostate malady from what I’ve read. Everything is essentially treatable at my age. That’s why you don’t procrastinate on health issues. Just ask Steve Jobs. Oh yeah, you can’t. I already know from the exam that I don’t have an enlarged prostate, which is a good sign. The elevated PSA levels are likely from running. I might be a bit preoccupied waiting for the results; considering I’m up at 5:30 am blogging about it. Karen and I are going snowshoeing in a couple of hours though. That’ll take my mind off it.
Sorry to hear about your biopsy. Try as we might there’s nothing dignified about having a procedure – any procedure but I think a prostate biopsy is up there with the worst. I hope the results are ok. Jx
Ed Mahoney said:
Thanks Jules. I know I’m not alone. Pretty much any guy still standing by the time he is 80 will have had a prostate biopsy.
Terry Collier said:
I thought you would be getting a biopsy . Your PSA levels aren’t in the range I generally have seen with malignancy . We’re hoping for a negative report . Dad
Sent from my iPad
Thank you for writing about the biopsy. I know when I had my first scare, writing about it really helped me think more clearly, and most importantly to really educate myself on the issue. One of the most gratifying aspects of the whole adventure was learning that I was far from alone in my worry, that there is an entire brotherhood of people I would never have guessed were, have, or will go through the same thing, and that those men are surrounded by people who care a great deal about them. Best wishes for good results.
Ed Mahoney said:
Jim Carey said:
What were the results? I just had one today and looked up “prostate cap gun” since that’s the noise my doc said do expect, and I wondered just what was happening at the time. I mean, the gland is definitely smaller than a golf ball so how precise are these biopsies?
Prior, I had to do an enema–new to me and in its own way humiliating (how tight was I supposed to squeeze that bottle [SLOWLY] anyway?
(Possible) Differences in our procedures: You didn’t mention a shot of antibiotic (plus a 4 day regimen orally). I did opt for the Valium. I’ve had Xanax but never Valium before. It may have eased my anxiety. I noticed a dulling of equilibrium (not dizziness) while walking. I only received one shot, and that is what I was told would be like a bee sting. Now, 12 hours later I feel…rattled and a bit worn back there, vaguely like constipated feeling (but it’s not)…but it’s not. Biggest difference–the actual procedure (not prepping) took absolutely less than 10 minutes.
I saw a twinge of color in my first urine pass…hoping to not see anymore, elsewhere, though I understand it’s normal. What you said about the pH and blood in the urethra–you apparently know more about the anatomy than I do.
Ed Mahoney said:
I had a one day supply of antibiotics to take the day prior – in pill form. That self-induced enema was my first too, not counting that time I jumped off a 70 foot high dive as a kid. I found it preferable to drinking the prep all day for the colonoscopy. I made up the notion of pH level differences accounting for the pain – hoping someone would correct me with the real reason. I decided to not follow up in this blog with my results because it’s a light-natured diversion for me. I fired up a new blog the other day to capture my ongoing experience. http://prostatechronicles.wordpress.com/
Ed Mahoney said:
Reblogged this on Prostate Chronicles and commented:
Reblogging this post at this site since it is really part of the story, although not chronological.
Prostate cancer screening and early detection does NOT save men’s lives. Let’s do the math. Per the USPSTF (U.S. Preventive Services Task Force): “Only one man in 1,000 could possibly have a life saving benefit from screening” and “A small benefit and known harms from prostate cancer screening”. However about 1.3 to 3.5 deaths per 1,000 from prostate blind biopsies. Also 5 men in 1000 died and 20.4% had one or more complications within 30 days of a prostatectomy. This does not include deaths, injuries and side effects from radiation and other procedures, medical mistakes, increased suicide rate, ADT therapy complications, heart attracts, depression, low quality of life, etc, caused by prostate cancer screening and treatments. Detection and overtreatment of prostate cancer has killed or destroyed millions of men’s lives worldwide from understated and multiple undisclosed side effects. The doctor that invented the PSA test, Dr. Richard Ablin now calls it: “The Great Prostate Mistake”, “Hoax” and “A Profit Driven Public Health Disaster”. Follow the money!
My story: http://www.yananow.org/display_story.php?id=1659
The Great Prostate Hoax by Richard Ablin MD (the inventor of the PSA test)
The Big Scare, The Business of Prostate Cancer by Anthony Horan MD.
Ed Mahoney said:
I’m approving your comment JJ but I was tempted not to. I don’t believe in moderating opinions as that’s what free speech all about.
The two reasons I considered not approving it was one – you clearly either did not read my first two paragraphs, or you didn’t understand them. I also said not everyone agrees with the risk and I also never said it saves lives. Other reason is that there are scores of bonfide studies supporting that early detection saves lives to every one that disagrees.