I had been dreading this appointment ever since it was first arranged.
Of course I had looked on line and seen all the procedure summaries and outlines. What I tend not to do though is read comments or anecdotal stories because you’ll alway get the full range of reactions all the way from “The worst day of my life” to “hardly noticed it happening”, and most people think their own experience should immediately be adopted as the international benchmark.
For my own part what I would say, having just been through it is - if I have to do it again I won’t worry as much in advance.
Having established, by means of DRE and my blood PSA level that this biopsy was necessary, Glen had alarmed me at our last appointment by saying that during this process he would be taking ten to twelve samples of tissue
Subsequent reading provided the rationale for this. Prostate biopsies are notorious for giving false negatives - and that’s not what you want.
Granted, nobody wants to be told they have cancer, but it’s worse to be told you don’t have cancer - when you do. Think of it like this; imagine you have a ball of dough about the size of a tennis ball, and you poke a couple of frozen peas into it. then you give the ball of dough to someone else along with a biopsy needle and say I’ll give you three goes to see if that ball of dough has any peas in it. Chances are you’ll get a false negative. And if your biopsy needle gets one bit of cancer but not another you might get a false picture of the stage and extent of the cancer.
That’s why you have an MRI scan to give your specialist a detailed view of the affected organ, its structure, and the position and extent of any abnormalities which may be present. Then when you go in for the biopsy procedure your urologist wants to get an ultrasound probe as close to the business as possible so he can see what he’s doing and have the best chance of an accurate result.
Unfortunately for the patient - in this case me - this means going into a room with a urologist , a nurse, and my wife (sounds like the start of a joke), removing all the clothes from my lower half, lying on the bed on my left side, drawing my knees up and waiting. Then Glen wanted to get me into a better position so I had to shuffle up and poke my naked bum out towards him until he was happy. My sense of dread and fear were peaking at this point; I had seen the rows of specimen containers lined up on a tray ready to contain the samples of tissue which were as yet happily inside my prostate gland; and the nurse was busying herself preparing something - no doubt something I was soon to be on the receiving end of.
And then I made a mistake. As the shuffling into position came to an end and Nikki was seated by the bed in front of me, and I held her hand, there was a very real sense that the show was about to start and I glanced at the nurse beyond my feet just in time to see her pass to the doctor a syringe which had attached to it a long needle. I remember thinking ‘well, given where it has to go it’s not surprising it’s so long’ - I turned back to face Nikki clasped her hand tighter and closed my eyes. Glen inserted the probe through which the needle was shortly to pass and said “well, time to get some anaesthetic into place,” or some such words, then a pause then he said “bit of a sting here”.
Now, I didn’t know where it was going to hurt, or, in truth, if it was going to hurt at all. As it happens I hardly felt anything, just a sharp sensation somewhere inside, and then another one, and then he said “This one might sting a bit” and it did, and I had the feeling he was going deeper than he had before.
That done he left me to wait for “ten minutes or so” for the anaesthetic to take full effect.
The nurse covered me up for that duration.
While we waited the nurse told us that her husband had himself undergone a similar procedure only the day before although it had had to be done under general anaesthetic.
She had a tear in her eye as she told us, which dispelled my immediate notion that perhaps she tells everyone a similar story to make them feel better. She was lovely though, and clearly a bit upset herself just for a moment. Made me think: Ducks on a millpond every one of us.
Soon enough Glen reappeared and suggested that we get started. I asked him if he was sure he had waited long enough - bet he hasn’t heard that before. So he took his seat at my rear end and the nurse took up a position next to him. He informed me that he was inserting the probe again and I was please to note that it could have been a telegraph pole for all I knew - I felt nothing. The nurse passed him the biopsy instrument and he said he would demonstrate the sound it was going to make just so I knew what to expect. He fired it off into mid-air and it made a fairly innocuous click. At this point I thought I would happily have foregone that demonstration in favour of just getting on with it.
And so to business.
The first biopsy duly clicked and I felt a dull sensation, a bit like someone flicking your arm, only inside your rectum. And so on. Glen had clearly worked out in advance the order of events; some of the ‘clicks’ were a bit uncomfortable, one or two made me wince a bit, but it was the penultimate one which made me jump.He knew it was coming; I can’t remember exactly what he said at that point but it was something like “This one is a bit further up”. Then one more easy one and it was over, within about five or ten minutes.
The specimen jars and various other items were quickly cleared out of sight, and as I put my clothes back on I asked Glen how many of these procedures he might normally do. I was gobsmacked to discover that mine was the tenth one he had performed that day. And judging by the morose looking character we passed in the waiting room on the way out - not the last.