Tuesday 16 May 2023

Another Prostate biopsy, another fortnight of stress - Rog T's cancer blog

 Last Friday was the day for my latest medical adventure. I had to make my way to UCLH for 9am for a trans perinneal prostatate biopsy. This is the fourth or fifth biopsy that I've had since I was diagnosed with prostate cancer in 2010. This was performed under sedation, so I was sparko for the duration, which was just fine by me. Of all the elements of treatment that I've had during the journey, biopsies are the one I like least. Although the Hifu I had in 2016 had many more unpleasant effects (thankfully temporary), at least I felt that it was doing something useful. Biopsies simply tell you the extent of the bad news. Not only that, there is a period of uncertainty between the procedure and getting the news. For me, this is mentally tough. It is hard not to speculate on what may or may not happen. 

The day did not start well. My normal journey would be to take Thameslink to St Pancras and have a leisurely walk up the Euston Road, getting my head ready for the stresses of the day. Unfortunately, the trains were on strike. Thank you Mr Sunak and your incompetent transport secretary. Sooner or later, this will be sorted, when you decide to sit down with the Unions. In the meantime, people suffer the consequences. I have no issue with key workers being well paid. My problem is with people thinking they should be pauperised. The reason train drivers are well paid, is because it helps the industry retain people who it takes months, if not years to train, and who can devastate the economy if they are unavailable. The chaos we see with Trans Penine Express is caused by a lack of drivers. If it really was so cushy, this would simply not be the case. 

As a result, I had to get a bus and a tube. This wasn't too bad, but it added 20 minutes to my journey and was not as pleasant a journey. I arrived and was checked in. As my surname is late in the alphabet, I was the last chap to go down for treatment. I've already mentioned how I earwig'd on the other chaps getting a breifing about the process. When you are told "you may experience blood in your urine for a week or two, and in your seman for a couple of months, as well as incontinence and erectile dysfunction" it doesn't fill you with joy. As they take the core samples via the perinneum, there is little chance of infection, compared with the anal biopsy's I've had before. 

When the time came to have the procedure, I noticed one change. I walked down with the anaesthetist. Previously they'd insist on wheeling you, even though you were fit. Then they hook you up to various monitors. The anaesthetist said "I'm going to give you something that may make you feel drowsy".  I was completely sparko in seconds. 

The next thing I knew, I was in recovery. I'd been having a lovely sleep. I was given a cup of tea and a sandwich. I was the given some water. I was quite hungry as I'd not eaten since the previous evening. Then I needed a pee. I was given a cardboard receptor. I found it hard, but not impossible to pass water, but soon managed the required 200ml. I was taken back to the main ward and they checked my blood pressure, which was good. They then called my wife, who came to get me. 

We took a cab back. By the time we were in Mill Hill. I was desperate for the loo. As predicted, there was an amount of blood in the urine, but not too much. A couple of hours later, I needed a poo. When they perform the biopsy, they put an ultrasonic probe up your back passage. They had clearly given a strong local anaesthetic, as my bum was completely numb. It was strange and I wasn't expecting it. 

By Saturday, the blood in the urine had all but stopped. I felt absoluetely shattered, but other than that, I was fine. I did notice that my flow is weaker than it was, but I put this down to bruising and I am not worried. The advice is to refrain from sexual activity for 3-5 days to allow healing, but I don't have any concerns at this time about side effects,  other than blood in the semen. This has persisted for quite a while on previous biopsies. It is visually unpleasant, but not a problem. 

I more or less feel back to normal today. Now it is the wait for results. I am more or less resigned to having some sort of invasive procedure. MRI scans are pretty accurate. The only real question is the timing of it. I am supposed to be going to Lourdes in late July, with our group and I do not want to be suffering the after effects of an operation. Having said that, I'd like whatever it is dealt with ASAP. 

Decisions, Decisions. I am going to try and think about anything but this between now and the 24th when I get the results. I will probably fail miserably.

--- About this feature
For those of you who are regular readers and have read the previous posts on Cancer, there's what this is all about. I write this blog because knowledge is power and if you know what you are dealing with, you have more weapons in the locker to fight it. It is a personal view, I'm not medically qualified. This is for the sole purpose of information for those who are interested.This is the latest installment in my occasional series about how I'm adjusting to living with a big C in my life.  For those of you who aren't, here's a quick summary. I'm 59 years old and in October 2011 I  had a prostate biopsy following two "slightly high" PSA tests - 2.8 & 4.1. The biopsy took ten tissue samples and one of these showed a "low grade cancer" which gave me a 3+3 on the Gleason scale. I was put on a program of active monitoring.  In early February, I got the results of the a PSA test - down to 3.5 and an MRI scan which found absolutely nothing, two more tests in 2012 were at 3.5 and 3.9, in 2013 my test was 4.0, Jan 2014 was 3.8, August 2014 was 4.0,  February 2015 it was  up to 5.5  and my latest in August 2015 was down again at 4.6. In October 2015 I had a transperinial Prostate biopsy, that revealed higher grade cancer and my Gleason score was raised to 3+4 (Small mass + more aggressive cancer). On 22nd Jan 2016 I had HIFU (Hi Intensity Focused Ultrasound) treatment at UCHL). My post procedure PSA in May was 4.0 which was down, followed by 3.7 in August, and 3.5 in October  which means that the direction is positive . However in January the follow up MRI revealed "something unusual which requires investigation" After a follow up biopsy, it appeared this was nothing to worry about. My two most recent PSA tests were Ok (3.7 and 4.6) and an MRI scan in March was very positive. A  PSA in October 2019 was 4.6, so stable and good news, the last in May 2020 was 5.45 a small rise, so worrying, however after a review against the most recent MRI, it was decided that this was fine. My two latest ones in February 2022 was 6.7 and October 2022 was 6.6 was stable. My MRI in March 2022 showed 'a change' so I am now awaiting a biopsy. I had a PSA test in late March which also showed a marked increase to 10.3.
 I've no symptoms apart from needing to wee quite regularly and sadly for a few people, if I'm gonna die soon, it won't be from Prostate cancer. Got the picture?

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