Wednesday, April 6, 2011

What To Do

Let me refresh everyones memory about some recent prostate issues that I have been dealing with.
The last time that I discussed my prostate issues and concerns was when my last PSA test came out with a score of 6.7ng/mL This was an elevated level compared to the PSA test that I had prior to this one and I should mention that there was not a long time period that had gone by between those 2 PSA tests.
I also had a DRE...Digital Rectal Exam done by my Urologist and he could find nothing out of the ordinary at all.
Due to the speed that my PSA had elevated to its current level, my Urologist decided that I should be put on Cipro for a month. Cipro is an antibiotic that is used to treat Prostatitis.
Prostatitis is swelling and inflammation of the prostate gland, a walnut-sized gland located directly below the bladder in men.
Prostatitis can be caused by a number of different things. If it's caused by a bacterial infection, it can usually be treated successfully. However, sometimes prostatitis isn't caused by a bacterial infection or a cause is never identified.
After my 30 day treatment period on Cipro, I went back and got another PSA test performed.
I got a telephone call the other day and was given the results of that PSA test.
My PSA level had dropped from a 6.7ng/mL to a 5.2ng/mL.
I was somewhat disappointed that my PSA had not dropped more but after discussing it with my family doctor, it appears that what I had originally expected the Cipro to do was not really realistic and that the drop in numbers that I had was actually good.
So it appeared that the Cipro had an effect on whatever was going on with my prostate.
The next thing to be done was to wait for my Urologist to get a copy of this PSA test and decide what to do next.
Today I got a call from the Urologists' nurse. I was not really prepared for what she had to say. As it turns out, the Urologist wanted to schedule me for a prostate biopsy.

So what is a prostate biopsy and how is it done you might ask. Here is that information straight from a John Hopkins Prostate informational literature that I purchased and downloaded:

   Transrectal Ultrasound and Prostate Biopsy


If the results of a digital rectal exam, PSA test, or both suggest cancer, transrectal ultrasound is performed to determine the size of  the prostate and to identify areas of possible cancer. Ultrasound also is used to direct the needles used for prostate biopsy. A prostate biopsy typically takes about 15 to 20 minutes and is performed on an outpatient basis. Most doctors use a local anesthetic such as lidocaine (Xylocaine) to reduce discomfort during the procedure. ( just wanted to interject that I would not get this procedure done unless they could make me semi-conscious). The ultrasound examination is performed with the man lying on his side. An ultrasound probe (about the size of a finger) is gently inserted 3 to 4 inches into the rectum. The probe emits sound waves that are converted into video images corresponding to the different prostate zones. Small prostate cancers are usually not detectable by ultrasound
examination. Fitted to the ultrasound probe is a biopsy gun with a needle that is fired through the wall of the rectum. The needle extracts small pieces of prostate tissue in less than a second. Ideally, at least 10 to 12 tissue samples (“cores”) are taken from the prostate. A pathologist examines the samples under a microscope to determine whether
cancer is present.
A prostate biopsy usually causes only minor discomfort. Common side effects include minor rectal bleeding; blood in the stool, urine, or semen; and soreness in the biopsied area. All of these side effects disappear with time.

I have had a bone marrow biopsy done in the past and that wasn't something that I would put in the fun category. And then there was the tongue biopsy that showed a precancerous growth and the subsequent cutting out of said growth.....really truly not fun at all...actually downright miserable. I have also had a colonoscopy which when I look back on it...the preparation of the body for that exam was much worse than the exam itself. Of course that is easy for me to say that because I asked them to basically knock me and have me in a semi conscious state and I was "semi" enough that I could not remember a thing after I woke up.
But this prostate biopsy has a different feel to it and I am not getting "good vibes" from the possibility of having to get it done. There are always chances that things can go wrong or the healing process doesn't always go as planned and with my luck the way it is, I am just not sure that I want to take any chances. It really is beginning to be a tough decision...do the prostate biopsy and live with however the results turn out and deal with whatever problems that might result after having it done....or...not worry about it because even if I did have cancer, nothing is being felt on my prostate now so it could be a very slow growing problem...slow enough that I would die from natural causes and old age long before the cancer became any real issue for me to have to deal with.
Definitely a roll of the dice. I guess there is a reason that they call it "craps". 
I was able to talk the Urologist into one more month of being on the Cipro. My logical line of thinking is that if this last month of being on the Cipro dropped my PSA level down 1.5ng/mL then it shows that Cipro had a direct effect on whatever is going on with my prostate issues and it would be possible that after this next 30 days on Cipro, my results could drop another 1.5ng/mL and that would bring my PSA level back down to a more respectable 3.7ng/mL.
And if this newest upcoming round of Cipro has no effect on my PSA levels......
then I am back to making that tough decision again....what to do?????

If anyone out there has gone through the prostate biopsy, please let me know what to expect...both good and/or bad...I need to know both sides of the coin to make a good sound decision.

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