Tuesday, 25 October 2011

PSA tests and Prostate biopsy - The blog you don't want to read

November the 8th. On that day I will either drink a lot of alcohol to celebrate or my life will presumably fundamentally change. That is the day I get the result of a Prostate biopsy. It has taken me from last Tuesday, when I was told I needed it, until today, to get my head around it. Some of us keep these things private. That was my first inclination, but hey, I'm a blogger - loud and proud. It would be a cop out to say nothing. It's not in my nature. I was in my favourite cafe, having a cup of tea and some advice my Dad gave me many years ago came to me. "Everything happens for a reason, if a bad thing happens to you and you can make a good thing happen to someone else, then you have a moral responsibility to do it". It seems that there isn't a wealth of information on the subject out there. The doctors always say "Do you have any questions" but generally you haven't thought of the most important ones at the time. I'm writing this in the hope that

a) It helps a few people understand whats happening
b) Anyone who has anything useful to add can leave a comment
c) Answers a few of those questions that you forgot to ask

So how did it start? In May I went to see the doctor because I had a problem with my knee and needed a referal for a consultant. He commented that he hadn't seen me for a while and suggested that as I was 49 an "MOT" would be a good idea. So I rolled up and had a plethora of blood tests.

When I went back for the good news, he said the PSA test has come back slightly raised. What is that, I asked. It is a new test which can indicate Prostate Cancer. At your age, it should be under 2.1 and it's 2.8. We discussed it and he advised a trip to the Urology department. He went on to explain that generally people with Prostate Cancer would have a far higher PSA, but it is best to be cautious.

So I went to see the consultant,w ho advised that the usual course of action is a course of anti-biotics and a follow up test. He advised that the test is pretty unreliable and can vary on a day to day basis. So in August I took the Anti Biotics and gave some more blood. The appointment was changed a couple of times and I eventually went back last Tuesday. The consultant said "Well the urine test was clear, but your PSA has gone up to 4.1. As this is on an upwards curve, I'd recommend a Prostate biopsy." We discussed the options and he advised that this was a logical next step. His advice was that it was unlikely given the state of my prostate and the relatively low reading that I'd have anything requiring radical surgery, but the earlier these things are caught, the better. He said that for many people with early stage prostate cancer all that happens is that it is monitored. I must admit I was shocked. I had expected the test to come back as OK. I was phoned later in the afternoon and the procedure was booked for last Saturday.

I'd not given any thought to what it entails and I'd not thought  to ask. I'd had a leaflet that explained "afterwards there may be some blood in stools, semen and urine". I certainly hadn't thought how this might affect me. It also said it would be done under local anaestic (ie I'd be awake). So on Saturday I rocked up for the appointment at Barnet Hospital. I changed into a gown and was told that they were running late. I sat in the waiting room, watching the saturday cooking show. Quite surreal really. A certain gallows humour amongst the other poor mugs pervaded. I suspect that the British have a fundamentally different approach to such problems than most nations. Bad jokes was order of the day and a general mood of mutual support "Don't worry, I've had four of them, it's horrible". I felt like a condemned man.

Into the treatment room. Again, I hadn't realised what the treatment consisted of. They stick something that looks like one of the spark machines that lights gas hobs up you bum and snip bits off your prostate. It makes a similar noise as well. The local anaesthetic is applied first. You still feel something. It is far more unpleasant than it is painful. After the fourth click, I asked "how many do you actually take?" I'd thought they took 1. The answer came back "10". This didn't make me feel happy and I wished I'd been given the option of something to dope me up. I will most certainly ask if that is an option if I ever have to have another one. After the 10th snip, they said "Now we'll adminster an anti biotic suppository". After that I lay on my back and got the good news about the side effects. "You'll be peeing blood for a few days and there will be plenty of blood when you do a poo. You'll also find clots and fresh blood in your semen". How long for? "For some people a few days, for some people several weeks". It's now Tuesday and so far I get a small amount of blood maybe 50% of the time when I pee. The blood in the stools was bad on the first day. As to the semen? I've been too scared to even think about that so far. I didn't ask how long you should leave it before testing the equipment. The consensus on the internet seems to be 3-4 days. I must say so far I'm not ready to cross that bridge as it is bad enough with the blood in the pee (even though it is a small amount).

So what should I have asked?
a) Can I be knocked out or at least doped up?
b) When is it safe to have sex/masturbate?
c) How many samples will they take?
e) What happens if the test comes back as negative. What happens then?
f) How much fluid should I drink (I've been drinking as much water as possible)?
g) What should I avoid?

In answer to g) The doctor told me not to play football or go to the gym for at least a week. If they had told me before, I could have cancelled my training session today a little earlier. Fortunately I had cancelled our Sunday night five a side already, but they should have notified me before.

Whatever happens, I'll be glad I had the tests. The earlier that anything is found the better. If there is nothing, then they have a baseline to monitor my levels going forward. I've found out that approx 1 in 5 people with a PSA between 4-10 have Prostate Cancer. As I'm at the bottom end of that, the odds are not too worrying. The examination said it was normal sized, so again that makes me cautiously hopeful.

If the news is bad then if nothing else, I've caught it far earlier than if I'd waited till  I had symptoms. As I've a family, even if the news is terrible, it means that I can sort things out in an orderly fashion. Sadly many people believe that burying their heads in the sand is the answer. It isn't. It just makes a bad situation worse and reduces any treatment options that may crop up. I hope to God that the tests come back all clear. If they don't then that bridge will be crossed at the time. I'm not worried right now although it is a bit of a black cloud on the horizon.

My advice? If you are approaching (or older than) 50 and you've not been to the doctor for a few years, get yourself an MOT. I really did not enjoy any of what I described above, but statistically you should be fine. I have no symptoms of anything, so don't assume that because you feel OK everything is OK. We live in an age where medical science can sort many things out. We live in a country where sorting it out won't bankrupt us. We are lucky. God Bless the NHS !


Vicki Morris aka Citizen Barnet said...

I'm thinking of you, Roger. Something comes to all of us in the end, not a comforting thought, but a true one! I'm sure you'll be fine. I get some lumps in my neck and groin checked every now and again. So far I haven't had to have anything put up my bum, though... I'll tell you when I do!

Rog T said...

Thanks Vicki,

If the doctor wants to put something up your bum to fix your neck, I'd see another doctor if I were you ;)

MickeyN said...

As the errant Councillors of Barnet and readers of your blog will know already, BarnetEye won't give up without a hell of a fight. So win, lose or draw on Nov 8th, best wishes.

LBB said...


Please be very careful what you do. There is new research that shows the PSA test (not a new test by any means) does more harm than good and is NOT a reliable early indicator of prostate cancer.


I'm a NS subscriber and this is not the only article I've read on this over the last few years. The issue is of particular concern to me as I'm in my mid 40's and there is a history of cancer in my family, albeit not PC. It would seem that there are many reasons for an elevated PSA, not simply as an early cancer index. Many men have had unnecessary surgery and suffered all sorts of serious problems afterwards.
Please don't take any rash decisions but do ensure that the levels are monitored more regularly.

Best wishes


p.s. As an aside, the recommendation as regards your prostate, is that one should, "use it or lose it" so to speak. This means every day; especially when one is getting older and the, ahem, "frequency" of use may not be as much when one is younger.

MS said...

I have read your blog for some time and for several reasons in the past have considered getting in touch - including the fact that you kindly mentioned my mother some time ago! However, this particular posting has spurred me to action (despite my PCs efforts to frustrate me!?). My thoughts and prayers are with you at this challenging time. Very best wishes and I look forward to learning of a positive outcome.

Rog T said...

MS - thanks for the message. I'd be intrigued to know who your mum was? I can't work it out from the initials?

george vietze said...

I am naryears of age and a recent PSA of 16. About 23 years ago I had a PSA of 10.5 and went to the Mayo ar Clinic for a biopsy. The results were negative for cancer and the biopsy test was very uncomfortable and painful. My prostate was enlarged and I have been watching the results over the years, each time around 9 to 11 but when it reached 16 it was time for another biopsy. This time the area was numbed and the procedure was not painful, only a little uncomfortable. The results were negative. My prostate was very large and the urologist want to reduce its size with some type of surgery or laser treatment. I asked for a prescription of Cialis which has been approved by the FDA
to reduce the size of the prostate. Its only been a month since the procedure and I am awaiting the results of whether the Cialis is reducing my prostate. In the meantime the side effects of Cialis is good.
Just because your PSA is elevated does not mean you have cancer, a benign enlarged prostate can raise your PSA level significantly. The biopsy is a little uncomfortable but if the urologist numbs the area and you take a pain pill just
prior there is very little pain, at least that was my experience.

Fine Treatment said...
This comment has been removed by a blog administrator.
Servicing Stop said...

Sorry about that, do anybody have any news of how it went? (Even if I am abit late))