Working on the prostate
October 28th 2008 07:56
Today was one of those days that needs to be remembered. For the second time in a few years I had an appointment at the hospital to have a prostate check. Can’t remember how long ago the previous one was, but it must have been at least two or three years.
Doctors keep an eye on the state of prostates by using blood tests that give them a PSA reading. PSA means Prostate Specific Antigen, if that’s any help to you. Apparently it’s something that the prostate exudes into the bloodstream as a matter of course. The blood test can tell whether it’s normal or not.
As guys get older, the PSA number goes up. For my age, around 63, it should only be around 4 or 5. Mine is 10, and has been climbing slowly for a few years. At my previous prostate examination, the hospital doctor decided not to do a biopsy, for which I was grateful. The examination itself is invasive, though short. Basically the doctor sticks a finger up your rear end and fiddles around, finds the prostate, and determines its rough size. (Prostates grow as you get older, just to make things tricky. If they get irritable about life, they can start cutting off the uretha, which passes through them.)
Anyway, the examination was okay, but the doctor I had today said that because of the high number on my tests, I should now have a biopsy. Didn’t really give me a lot of choice about the matter, and mentioned the word, ‘cancer’ a few times, just to make sure he was going to get his way.
So I’m due for a biopsy sometime in the next few months.
I rang my doctor when I got back to work, and asked if the number my blood tests were producing was necessarily indicative of cancer. She said, No. It can also indicate a benign prostatic hyperplasia (PBH, of course), which, according to Wikipedia, means the following. (I’ve edited it to make it a bit more comprehensible.)
BPH “refers to the increase in size of the prostate in middle-aged and elderly men. It is characterized by the formation of large, fairly discrete nodules in the periurethral region of the prostate. When sufficiently large, the nodules compress the urethral canal to cause partial, or sometimes virtually complete, obstruction of the urethra which interferes the normal flow of urine. It leads to symptoms of urinary hesitancy, frequent urination, increased risk of urinary tract infections and urinary retention. Although prostate specific antigen levels may be elevated in these patients because of increased organ volume and inflammation due to urinary tract infections, BPH is not considered to be a premalignant lesion.”
Which means, basically, that it’s not necessarily cancerous, just annoying. As it happens, I don’t have much in the way of urine flow problems. In fact this area seem to be currently better than it used to be, possibly as a result of a tablet I’ve been taking for the last few years, which is aimed at keeping things settled.
It doesn’t really pay to start looking up what happens when a biopsy is performed, but here’s what another Wikipedia article says, anyway:
“Prostate biopsy is a procedure in which small samples are removed from a man's prostate gland to be tested for the presence of cancer.
The procedure, usually an outpatient procedure, requires a local anesthetic, with fifty-five percent of men reporting discomfort during the biopsy. The most frequent complication of the procedure is bleeding in the urine for several days, some bleeding in the stool for several days, and blood in the ejaculate for several weeks afterwards.
The procedure may be performed transrectally, through the urethra or through the perineum. The most common procedure is transrectal, and may be done with tactile finger guidance, or, more commonly and precisely, with ultrasound guidance.
About a dozen samples are taken from the prostate gland through a thin needle - about six from each side. If the procedure is performed transrectally, antibiotics are prescribed to prevent infection. In the transrectal procedure, the doctor inserts an ultrasound probe into the rectum to help guide the biopsy needles. A local anesthetic is then administered into the tissue around the prostate, similar to the local anesthetic administered for a dental procedure. A spring-loaded prostate tissue collection needle is then inserted into the prostate, through the rectum (or more rarely through the perineum), about a dozen times. It makes a clicking sound, and there may be considerable discomfort.”
The person who wrote this appears to have a sense of irony: ‘considerable discomfort’, I suspect, is an understatement. The examination I had today caused considerable discomfort, the only consolation being that it was quick. And what’s this about ‘similar to the local anesthetic administered for a dental procedure?’ That’s supposed to be encouraging? I avoid anesthetics at the dentist’s, if I can at all help it. They cause the pain to be prolonged, I find.
I note that the writer says 55% of men report discomfort during the biopsy. What do the other 45% report? We’re not told; perhaps it’s because they pass out in the middle of it all!
Anyway, enough of all this. Just had to write it out in order to get some of the tension it was causing out of my head!
Maybe better still, I should get one of those funny t-shirts made: I survived a rectal examination.
Doctors keep an eye on the state of prostates by using blood tests that give them a PSA reading. PSA means Prostate Specific Antigen, if that’s any help to you. Apparently it’s something that the prostate exudes into the bloodstream as a matter of course. The blood test can tell whether it’s normal or not.
As guys get older, the PSA number goes up. For my age, around 63, it should only be around 4 or 5. Mine is 10, and has been climbing slowly for a few years. At my previous prostate examination, the hospital doctor decided not to do a biopsy, for which I was grateful. The examination itself is invasive, though short. Basically the doctor sticks a finger up your rear end and fiddles around, finds the prostate, and determines its rough size. (Prostates grow as you get older, just to make things tricky. If they get irritable about life, they can start cutting off the uretha, which passes through them.)
Anyway, the examination was okay, but the doctor I had today said that because of the high number on my tests, I should now have a biopsy. Didn’t really give me a lot of choice about the matter, and mentioned the word, ‘cancer’ a few times, just to make sure he was going to get his way.
So I’m due for a biopsy sometime in the next few months.
I rang my doctor when I got back to work, and asked if the number my blood tests were producing was necessarily indicative of cancer. She said, No. It can also indicate a benign prostatic hyperplasia (PBH, of course), which, according to Wikipedia, means the following. (I’ve edited it to make it a bit more comprehensible.)
BPH “refers to the increase in size of the prostate in middle-aged and elderly men. It is characterized by the formation of large, fairly discrete nodules in the periurethral region of the prostate. When sufficiently large, the nodules compress the urethral canal to cause partial, or sometimes virtually complete, obstruction of the urethra which interferes the normal flow of urine. It leads to symptoms of urinary hesitancy, frequent urination, increased risk of urinary tract infections and urinary retention. Although prostate specific antigen levels may be elevated in these patients because of increased organ volume and inflammation due to urinary tract infections, BPH is not considered to be a premalignant lesion.”
Which means, basically, that it’s not necessarily cancerous, just annoying. As it happens, I don’t have much in the way of urine flow problems. In fact this area seem to be currently better than it used to be, possibly as a result of a tablet I’ve been taking for the last few years, which is aimed at keeping things settled.
It doesn’t really pay to start looking up what happens when a biopsy is performed, but here’s what another Wikipedia article says, anyway:
“Prostate biopsy is a procedure in which small samples are removed from a man's prostate gland to be tested for the presence of cancer.
The procedure, usually an outpatient procedure, requires a local anesthetic, with fifty-five percent of men reporting discomfort during the biopsy. The most frequent complication of the procedure is bleeding in the urine for several days, some bleeding in the stool for several days, and blood in the ejaculate for several weeks afterwards.
The procedure may be performed transrectally, through the urethra or through the perineum. The most common procedure is transrectal, and may be done with tactile finger guidance, or, more commonly and precisely, with ultrasound guidance.
About a dozen samples are taken from the prostate gland through a thin needle - about six from each side. If the procedure is performed transrectally, antibiotics are prescribed to prevent infection. In the transrectal procedure, the doctor inserts an ultrasound probe into the rectum to help guide the biopsy needles. A local anesthetic is then administered into the tissue around the prostate, similar to the local anesthetic administered for a dental procedure. A spring-loaded prostate tissue collection needle is then inserted into the prostate, through the rectum (or more rarely through the perineum), about a dozen times. It makes a clicking sound, and there may be considerable discomfort.”
The person who wrote this appears to have a sense of irony: ‘considerable discomfort’, I suspect, is an understatement. The examination I had today caused considerable discomfort, the only consolation being that it was quick. And what’s this about ‘similar to the local anesthetic administered for a dental procedure?’ That’s supposed to be encouraging? I avoid anesthetics at the dentist’s, if I can at all help it. They cause the pain to be prolonged, I find.
I note that the writer says 55% of men report discomfort during the biopsy. What do the other 45% report? We’re not told; perhaps it’s because they pass out in the middle of it all!
Anyway, enough of all this. Just had to write it out in order to get some of the tension it was causing out of my head!
Maybe better still, I should get one of those funny t-shirts made: I survived a rectal examination.
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Comment by Cheryl J
Rhythmatism
Zentertainment
Budget Centsability
I remember my cervical biopsy where they said I would feel a 'slight pinch'.Exactly the way I'd describe having a piece of me cut out with a pair of long handled scissors. Yes it did hurt but after a day or two all felt back to normal and thankfully the biopsy gave me the all clear.
I hope it's nothing too nasty for you and that it will all be a storm in a pee cup.
Be well. Good luck.
Comment by Mike Crowl
Webitz
Work Report