How do they identify prostate cancer? Pt 2
As before, note I am not a medical doctor!
Once the MRI shows that your prostate is misshapen then the next step is a biopsy, where they take physical samples of your prostate & analyse them for cancer cells. This is where it starts to feel real because the biopsy is a surgical procedure with the chance of side effects. There are two main types of biopsy -
- Transrectal. This is done through the rectum and generally does not require a general anaesthetic. Apparently it is a fairly quick & painless but uncomfortable procedure.
- Transperineal. The samples are taken through the perineum - the skin between the scrotum and anus, also known as the scranus. An ultrasound can also be inserted into the rectum to aid in precision.
There are pros and cons to both methods and lots of material on line, but the reality is that you don't get to choose. You will get whatever your doctor thinks is best. For me it was a transperineal biopsy, and for that I needed a general anaesthetic. As far as I can remember (it was 6 months ago) my day went like this -
- A few days before the surgery I gave a urine sample and also stopped taking fish oil tablets (apparently they can impede blood clotting)
- I had to fast for 6 hrs before the surgery due to the use of the general anaesthetic (apparently if there is anything in your stomach it can lead to choking issues), so was up at 5am to have a coffee and some breakfast. I also had to use a couple of mild laxatives to empty my bowel.
- After a few hours of pacing we drove to the hospital to check in at 9am. There was a bit of concern because I had caught COVID the previous month so despite having a negative RAT I had to have my temperature checked again & a review by a COVID nurse - I could have done without that. Anyway it turned out OK and soon I was met by a volunteer and waved goodbye to my wife. I then changed into a surgical gown and spent the next few hours sitting around reading & waiting for my turn. It's amazing how the lack of food & drink, the boredom and the environment turn you into a 'patient'. I had to keep reminding myself that I wasn't actually sick!
- When it was time I was lead through to a hospital bed and wheeled into the pre-surgery section. A stent was put into my arm and then there was some more waiting. Then I was wheeled into another pre-surgery section and the anaesthesiologist & the surgeon both stopped by to say hi and check everything was OK.
- Finally it was time to go into the main operating theatre, and I was impressed with the amount of tech they had on hand. They even had a machine that goes 'bing'. They hooked up the anaesthetic and I got to enjoy the brief but intense wooziness of going under.
- I woke up a couple of hours later in the post-surgery section and was checked on by a very lovely nurse & her student. I felt OK and was able to have a couple of sandwiches and some tea, but then I had a trace of nausea that they wanted to keep an eye on & I drifted in and out of sleep for an hour or so. The surgeon stopped by to see how I was doing and had also rang my wife (personally, which was a nice touch) to let her know that it had gone OK.
- Finally I was able to get dressed, have another cup of tea and was discharged. My wife met me at reception and drove me home, which I vaguely remember.
There wasn't a lot of pain after the surgery because the coreholes for the samples were very thin and fairly hard to spot. But I was pretty achey, felt a bit vacant for a few days and was aware that things had been 'messed around' inside me. I urinated blood for a day or so. More alarmingly, I also ejaculated blood when after a few days I checked to see if everything was working. They warn you about this but I was expecting traces of red, not a dark ketchup! It actually took around a month or maybe more before ejaculating felt normal. I was back on a bike about three weeks later once the wounds on my scranus had healed up and I was able to sit on a saddle without pain.
Hopefully anyone reading this who is going for a biopsy has a better idea of what to expect - next I'll talk about what my diagnosis was and then the options that were available to me.
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