Friday, December 23, 2011

Why I'm Not Getting a Prostate Biopsy



A few months ago, the results of a routine blood test showed that I had a high PSA count.  My doctor suggested that I should see a urologist to "discuss" further test to see if I had prostate cancer.

I made arrangements to see a urologist and he did a digital test which did not indicate prostate cancer.  However, he did another blood test which again indicated that I had a high PSA count.  He told me "If you do have prostate cancer, at your age (what, I'm old art 70?) you will probably die of something else before you die of prostate cancer."  He then asked "Do you want to continue?" 


I asked him what my options were.  He said he would take a biopsy of my prostate gland which would be twelve pieces of meat from my prostate gland. I wasn't too thrilled about this procedure because of the risk of infection.  When I was seventeen years old I almost died of a staph infection that I contacted through a routine hernia operation.  I was in and out of the hospital for six months.  Three surgeries later I was finally free of the staph infection.  Since that time I have always been leary of hospitals.  The risk of infection is just so great.  That was especially brought home to me when an older cousin of mine died of a staph infection she contacted at the hospital.

I reluctantly agreed to the biopsy procedure.  However, a few days later I called and cancelled the appointment.

I started to ask around.  My cousin was diagnosed with prostate cancer.  He was going to have his prostate removed until he found out he didn't have prostate cancer when he took his X-rays to "Dr. Magic Hands" to get a second opinion.  That doctor told him that he didn't have prostate cancer but had prostatitis, which was not cancer but just an infection of the prostate gland. He went back to his original doctor, who was none to happy that he went to a second doctor.  His original doctor, upon further examination of my cousin's X-Rays, reluctantly agreed that they had misread the X-rays.  EXCUSE ME?  Man oh man.

I talked to other people who have had successful treatment for prostate cancer with minimal or little side effects.  Then I talked to my uncle who doesn't have control over his peeing since he went through the seed implant treatment.

So you see folks, it's a mixed bag.  I've been struggling with a decision whether or not to have the biopsy and what flows from that or else just let this thing go and either die of "something else", prostate cancer or just plain Old Age.  I just haven't felt comfortable with the track I was on to getting the biopsy.  I was getting a bad feeling about it.  My intuition (which has ALWAYS BEEN RIGHT IN THE PAST) was saying "DON'T DO IT!"

As the days crept closer to my appointment for the biopsy procedure on January 6th, 2012; I'm dreading that I'm going to get myself snared in the same trap I was in back in 1959 when I couldn't get rid of that staph infection.  I had to make a decision so I could go on with my life.

Last night I made that decision.  I'm not going to do it and here are the reasons why:

This is why I have decided not to get a prostate biopsy:


Prostate Biopsy Side EffectsBecause Prostate cancer is common in men, many doctors recommended testing for it even in the absence of clear symptoms. Screening is usually done to most men at the age of 40 and above. However, many experts disagree whether this screening is helpful or not.








In theory, screening offers the advantage of finding prostate cancer early. But prostate cancer is a slow growing cancer; it often never causes symptoms or death. Often times, using conventional methods to treat early cancer can prove more damaging than leaving the cancer undetected.






Even though biopsy is regarded as the major way to detect cancer, prostate biopsy side effects far outweigh the benefits of this detection. And above all, it’s not 100% reliable in detecting cancer because it takes a very small sample of your tissues.






To begin with, biopsy is invasive and damaging. The biopsy procedure involves needles, scalpels (knife) and other such instruments to remove a small piece of your living tissues from the prostate gland for microscopic examination and evaluation. Tissue injury occurs because an excision made in the prostate.






Bleeding is a regular, well-known side effect experienced after the procedure. You may see blood in the semen, urine or stool. In some cases it lasts for weeks, but at other times it can take months to stop. But prostate biopsy side effects don’t stop at bleeding.






Another common downside is urinary problems. Since the prostate gland is located and related to the urinary tract, there is a good chance something may happen that will affect your urinary system. Common urinary side effects of prostate biopsy include incontinence and dribbling.






And if it gets worse, you may also end up with a catheter or in diapers for a long time. Afterward, removal of the catheter will depend if you’re able to recover well. Patients are also advised to refrain from any heavy lifting and vigorous activities to prevent an increase in pressure. Ambulation (walking) should also be minimal after a biopsy so as to prevent further pain and discomfort.






One of the most annoying side effects of prostate biopsy is how it affects your sex life; most men are advised to refrain from any sexual activity for several weeks, sometimes months. Erection is difficult for some because of damage in the tissues.






Another major problem with biopsies is that each time you have a biopsy, it tends to increase the level of your PSA so it’s very easy to get into a spiral of biopsies, ever-increasing PSA and worry. Plus multiple biopsies can do you serious harm.






Prostate biopsy is an invasive procedure, a number of side-effects and symptoms would always occur after the procedure. Some clients are able to cope up well after the procedure, but some will not.






Please feel free to get in touch with us using the Question Form and ask any question specific to your prostate health. Our prostate experts will reply soon with a specific response tailored to your conditions.

37 comments:

  1. Sounds like you've done the research and asked yourself the important questions. Congrats on making a decision, especially one that makes you less anxious!

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  2. Sounds like you'd be crazy to have the biopsy. Who knew?
    My mom had one on her lung to determine the stage and type of lung cancer she has and it was very simple. The radiation and chemo treatments have been successful but very debilitating. Instead of surgery to remove the now cold tumor, she'll go on a chemo maintenance program. She's a few months older than you.

    I hope making this decision makes you sleep better again.

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  3. anne marie in philly10:51 AM

    OMG, the side effects are worse than the biopsy!

    if I were in your shoes, I would JUST SAY NO (thank you, nancy reagan) to the biopsy! go with the gut feeling!

    you and I are both curmudgeonly enough to make it to 100 anyway! without medical intervention!

    have a great weekend, and I am happy you took the weight off!

    (why yes, I happen to have some spare exclamation points about today!!!!!!!!!!)

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  4. Walt,

    Yes, I've done my research and the decision I made does make me a less anxious. I just wasn't feeling right about getting a biopsy.

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  5. Sean,

    Too many things could go wrong with getting a biopsy.

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  6. Anonymous11:29 AM

    Wholeheartedly agree with your lastest decision (not that I have a say - LOL)
    I've been biting at the bit for a while to say I don't think you should put yourself thru this for many of the reasons you already stated.
    Merry Christmas and a Healthy New Year, Ron.
    ARF

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  7. Ron,

    It sounds as though you thoughtfully and carefully have made the right decision for you.

    Now that is behind you. Go forward and love and enjoy life.

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  8. Anne Marie,

    You're right, the side effects are worse than the biopsy. I may or may not have prostate cancer but the doctor said that even if I did have prostate cancer I would probably die of something else. I don't like living with the knowledge that I could have a cancer growing within me but I just didn't feel comfortable with the path that I was going down with the biopsy and the possible treatments that would leave me off worse than if I did nothing at all. I made it this far (70) so anything extra is a bonus. Of course I don't want to die anytime soon. Maybe I would have made a different decision is I was twenty years younger but this feels like the right decision for me at this time of my life. I don't need any more complications.

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  9. ARF,
    Thank you for agreeing with me. I just didn't feel right the direction I was going. I'm of that generation that is brainwashed to do whatever the doctor says to do but sometimes that isn't the answer. This time didn't feel right. I'm not against having procedures. I totally believe in colonoscopies although there are risks involved in that procedure too. But this one? There were just too many negatives, My gut feeling was saying "NO! NO!" I may have prostate cancer and I may die of it but at 70 years of age I think the doctor was right when he told me I would probably die of something else before I would die of prostate cancer. If I was younger, maybe I would have made a different decision. However, at my age I feel comfortable I made the right decision. Thank you again for your comment and opinion.

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  10. Will J

    Yes, I have put a lot of thought into the final decision that I made. This has been on my mind for a couple of months now. I didn't feel right the direction I was going. Now this feels right but of course there will always be the nagging worry "Did I make the right decision?" That I will have to live with. Won't be the first time I wasn't 100% sure about my decision but I'm 95% sure. So far I'm batting pretty good in making Life Decisions.

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  11. Ron, I think you made an excellent decision.

    My 52-year old brother had surgery for prostate cancer three weeks ago. He was home on day 4. By day 6, he was readmitted for a day due to serious bleeding.

    After 2.5 weeks, he developed a fever of 103, abdominal bloating and pain. He is now back in the hospital with some drain tubes installed. He is on antibiotics again as it is most likely a post-operative infection.

    It is a terrible, invasive, debilitating surgery and you are very wise to avoid it, if at all possible.

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  12. Anonymous12:50 AM

    Hi Ron
    I've been following/enjoying your blog for a few months now and because of the topic feel compelled to add my 2 cents. Both my Dad and 2nd Dad and an Uncle were told in the early to mid 70's that their PSAs were high. My Dad died at 89 in his sleep after a bout with pneumonia. My Uncle passed this year (age 96) of CHF. My 2nd Dad is 81 and still going strong though his PSA still remains high. All received basically the same info you have - slow growing and would probably die of some other ailment. None of them ever had biopsies.

    Like you I would be more afraid of infection than the possibility of cancer. Sounds like you have made the right choice ~ Judy

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  13. You made a thorough process and came out with a decision - be at peace now with the choice.

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  14. Judy,
    Thank you very much for your comment (or "two cents"). After receiving several comments like yours I"m even more sure that I made the right decision. If I was 50 or even 60, maybe I would have made a different decision about getting a biopsy but now that I'm 70 I don't see where it is worth the risk of infection and getting on that downward spiral of prostate cancer treatment should I even have prostate cancer. The way I look at it now every day I live past 70 is a bonus anyway. No need to add further risk to my life. Thank you again for adding your "two cents." I appreciate it.

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  15. Dr. Spo,

    As usual, excellent advice. I will take it.

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  16. Buddy Bear,

    I am sorry that your brother has developed complication from his prostate surgery. This is exactly what I am trying to avoid. I probably would get the biopsy is I was 15 or 20 years younger, but at my age (70) I don't think it makes a whole lot of difference if I even have prostate cancer because I'll probably die of something else anyway. Even if I do die of prostate cancer, I consider myself ahead of the game already having reached 70 years of age, and having outlived most of my contemporaries. Thank you for your thoughtful and helpful comment.

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  17. Tommy Boy5:21 PM

    Just read this thread (albeit almost a year after it was created). I'm 51 years old and have had a couple of high PSA readings recently, with the most recent one noticeably higher than the prior one. My urologist wants to perform a biopsy. However, despite my relatively young age, after lots of reading on the web (including your site), I've pretty much decided that I'm not going to go through with the biopsy.

    My reading indicates that PSA readings are a very inexact science, so I think I'll have my prostate examined the "old fashioned" way in the future, maybe have PSA readings once a year to see if there's a trend of higher and higher readings.

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    Replies
    1. Tommy Boy,

      Thank you for your reply. Last year I decided not to get a biopsy. However, this year (like right now), I'm having prostate problems (always having to pee) and I went back to my urologist. He suggested before he consider any other treatment, first make sure that I don't have prostate cancer. So I have decided to get the biopsy which is scheduled for January 29, 2013. I've thought long and hard about this decision. I hope there is no evidence of prostate cancer. However, if there is then there is another whole roller coaster that I have to go on which I am not looking forward too. One of my friends did have prostate cancer and underwent through fifteen weeks of radiation therapy five days a week. Guess what? His PSA score is still high. He thinks all he did was damage his prostate by the radiation. I just hope I don't have prostate cancer because I don't want to be face with making any other choices.

      Ron

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    2. Anonymous1:49 PM

      I just stumbled onto this blog while researching this topic because of my husband's elevated PSA results, with a family history of prostate cancer. I was wondering how your biopsy turned out? I hope in this case, no news is good news?

      Lori

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    3. Lori,

      I got my prostate biopsy a few months ago. I do have prostate cancer. I undergo brachytherapy on May 2nd. I am not looking forward to it but it is something I must have done. I will post about it on my blog. I hope your husband has better results should he decide to get a biopsy, which, by the way is no picnic. Make sure he asks for anesthesia.

      Ron

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  18. Anonymous3:07 PM

    Ron, Sorry to hear that you had to go through with your biospy and that you, indeed, have the prostate cancer. I sincerely wish you God's blessings for a full recovery. My husband has been urinating quite a lot for a number of years (he is now 55). Over the last 2 years his PSA has been increasing - now it is 5.1 and peeing on average 3 times per night - he also have an enlarged prostate. Apart from having to go often he has no other symptoms. His PCDoctor recommended a Urologist whom he saw on Friday. He did a DRE and said the prostate is very enlarged but no nodules were felt, but recommended a Cystoscopy and Ultrasound/Biospy. The Cystoscopy was done today (the procedure took less than 5 mins.) The doctor told us the prostate had inflamed, but everything else seemed fine. Yet, he wants him to do a biospy. We decided to do a search and came up on your blog. We have decided against the Biospy. May I ask you what symptoms you had before your diagnosis? Thank you and again, God bless you.

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    1. Anonymous,

      I didn't have any symptoms. However, I did have a slight bladder infection that I went to my urologist for because it was painful for me to urinate and I didn't feel like I was emptying my bladder. When I saw my urologist he said he didn't want to start any kind of treatment until he was sure I didn't have prostate cancer. That's why I decided to get a biopsy which, as you know, I found that I did have prostate cancer. By the time I had my biopsy the bladder infection had gone. But I was glad that I did go to my doctor. As painful, humiliating and uncomfortable as this whole procedure is, I am glad I am having it done. I have a followup visit tomorrow with my oncologist. Good luck in whatever decision you and your husband make.

      Ron

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  19. Anonymous8:45 PM

    hi ron... hope you are feeling better.... some things bother me tho... you put up a good fight about NOT getting a prostate biopsy but ultimately .. you did... right now i am on "the fence" about getting the procedure done. so you went to "no way" ... to getting it done. big conflict there my friend. from "no way" to "i am glad i am having it done"... please watch what you write as people are reading...

    chuck

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    1. Anonymous,

      I changed my mind because living with it the knowledge that I possibly had a cancer growing within me for a year just didn't go away. I didn't want to live the rest of my life that way. Plus, when I went back to my urologist with a mild bladder infection, he didn't want to start any treatments until I had a prostate biopsy to make sure I didn't have cancer. As it turned out, six of the twelve specimens were cancerous and I did have prostate cancer. While the biopsy procedure itself was horrible and the surgery not much better, I don't have that cloud hanging over my head any more. This is what worked for me. I can't say my decision necessarily will work for others. You will have to make the choice of what you can live with. Good luck!

      Ron

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  20. Anonymous10:33 PM

    Today June 5 I had a biopsy done and to my suprise no blood in the urine no blood in stool it really hurt about an hour after leaving the Doctor Office but i took some Tylenol and presto the pain was gone so i will return to work tomorrow and see how it goes. I am 61 years of age Black male with a family history of prostate cancer my two older brothers had theirs removed. So the biopsy was the first walk in the park I will just have to wait and see how and what will follow
    B.C from Bucks County Pa.

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    1. B.C.,

      You're very lucky not to have more after affects from your biopsy. As you know I've had a biopsy and last month had seed implants. I am now recovering (or more accurately enduring) those after affects. I hope your biopsies come back cancer free.

      Ron

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  21. Anonymous5:01 AM

    Hi Guys. My beloved father passed away less than 2 weeks ago from Sepsis. My Dad had the seed implants done in November, had another biopsy in mid-December and had been in pain ever since. He was admitted to hospital 2 weeks after his biopsy and never came home. After doing lots of research on the internet (probably not the most helpful thing for me to do) I've discovered that Sepsis is a possible outcome of a Transrectal ultrasound-guided prostate biopsy. I'm absolutely devastated that the complications weren't identified during the several visits my Dad made to the hospital in the weeks between his biopsy and his death. What the hell is going on? Are the doctors still experimenting in this area or do they know what they're doing? I feel like my Dad was stolen from me a lot sooner than he should have been. He was 73 and thought he still had some time to organise things. It just doesn't make sense and I'll have questions relating to this til the day i die. I do hope that you are responding well to your treatment and value each day you have with your family.

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    1. somsorrynto hear about your dad. The prostate approach, especially with the seeds is like russian roulette. Ask around. You will find one success out of 10 failures.

      Delete
    2. Anonymous,
      My sincere condolences for the loss of your father. I had one biopsy which was very painful (and bloody). I had the seed implants May 3, 2013. My PSA went down after the implants but now my PSA is creeping up again. I have decided no more biopsies for the specific reason of what happened to your father. When I was 17 years old and had a routine hernia operation (that turned out not to be necessary), I developed a staph infection that nearly killed me. I was in and out of the hospital (three operations) until I got rid of that infection. Ever since then I've had a healthy wariness about hospitals. I only go when necessary and I question all routines, if they are necessary. I am 73 also like your father, and if my prostate cancer comes back, then I'll deal with that. I'm stepping off of this medical treadmill. Again, I am so sorry for your loss.
      Ron

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  22. Anonymous1:45 PM

    I am 67 years old my psa level has gone from 4.3 to 3.8 to 4.8 to 4.5 to 5.0 over the last two years my doctor also wants me to have a biopsy from the information I have received a normal psa level for men between the ages of 60 to 70 are 4.5 to 6.5 . I just have to wonder if 5.0 is a normal psa level for my age and to pass on the biopsy.

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    1. Anonymous,
      Based on the information you stated, I wouldn't get a biopsy. Mine shot up to 8.4, that's why I finally decided to get a biopsy.
      Good luck.
      Ron

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  23. Anonymous11:38 PM

    Hello all, 47 YO. PSA 5.7,9.1 , then 6.2 no signs of BPH or prostatitis per urologist.
    Scheduled for biopsy on 2/9/15
    Total anxiety attacks since I made the appointment.
    Married with a perfect 8 year old daughter.
    Thanks. D.S.
    Any advice ?
    Thanks all.



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    Replies
    1. Good luck on your biopsy. I hope it comes out negative for you. Let me know.
      Ron

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    2. Anonymous12:46 AM

      Got the results, PC in 2 out of 12 biopsies.Gleason score 6 (3+3)
      Going to schedule DaVinnci surgery for late march/early april.2015
      I'll let you know how it turns out....good luck everyone
      DS






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  24. Anonymous8:58 PM

    I wouldn't have a biopsy done unless I had a high resolution MRI done first to make sure I have a growth and this gives the doctor the precise location of the tumor so it can be hit with one poke instead of blindly poking needles into it.

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  25. I am 55 and have recently been sent to the urologist by my primary care based upon a single elevated psa of 4.75. Primary care did no digital rectal exam. Upon doing research I became quite anxious, and still am. I am leaning toward a "Hell no" on the biopsy. My urologist was terrible. He did not want to offer me any other treatment besides a biopsy first approach. He did a digital rectal exam and said he could not feel the prostate, but was ready to go with the probe to get 12 samples with just the guidance of the ultrasound. Based on what I read there is a great possibility that I could show no disease but psa could remain stable or get worse, which would usher in more poking and proding, etc. What a racket. Upon examination it was shown that I empty my bladder completely while having frequent urination with past urethra issues. Upon literature search found that hemmeroids, and an irritated urethra can also cause elevated psa. In fact I saw some peer reviewed literature that reported that constipation can cause elevated psa. I have constipation, I have hx of urethral stricture, and bladder issues. I know this does not mean it is not cancer, but I have decided that they need to treat my symptoms first, then and only then will we revisit the elevated psa level. After the visit with the failed digital rectal exam I was told to get another psa. I did that same day and it went down form 4.75 to 3.5? What the hell. I am decided to not do the biopsy at this time. In the future maybe a t3 mri first and then if there is reason to biopsy a particular area, then maybe. I am not interested in a shot gun approach to my health.

    Mark

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    1. Mark,
      Each situation is different. My suggestion is to do what you feel comfortable with. Don't let anyone pressure you into doing something you don't feel comfortable with. Good luck!
      Ron

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