Testicular Cancer, PSA Exams, Prostate Biopses and other fun and games

So, I went into Sloan Kettering yesterday for my yearly post-testicular cancer check which involves a chest x-ray, blood work and testicle grab, and all is fine for another year there (11 1/2 years now). However, I have taken PSA's for a while and it was 1.3 in 2008, 1.56 in 2009 and 2.3 this month. I was concerned with the degree of increase, so I figured since I was seeing the best in the field anyway, why not have it checked?

My doctor sends in one of his underlings first. Needless to say, when I told him about the PSA's, I got the highly dreaded prostate exam. He said all seemed ok, but he called in the main doctor, Dr. Sheinfeld. Dr. Sheinfeld also gave me the prostate exam ( I felt like I had cheated on the first guy) and said everything felt normal. He said PSA's can rise for a million reasons and we could check the levels again in a few months or, while I was there anyway, I could get it biopsed and than not have the unknowns.

I agreed, so bring on Dr. Sandha, who performs prostate biopsies at MSK. I went into the room where the procedure is done and got ready. Step 1 was an ultrasound of my prostate by a technician, which is even more unpleasant than the prostate exam. That lasts about 5 minutes (Or what felt like a week to me!). Then Dr. Sandha comes in and injects me, yes in there, too, with Lidocaine to numb the area. There is a slight burn and pinch, but no big deal. After waiting about 5 to 10 minutes, still laying completely exposed as to hind quarters mind you, he comes back in and has a device that injects you and removes a sample of the prostate - about 15 times!!! Oh, and the sound and feeling is sort of like a stapler (though not that painful). I asked if he was stapling me shut!

Needless to say, far too many things were being jammed up my ass, especially since I am not a fan of having ANYTHING jammed up my ass!! I want a tattoo now, yes, on my ass, that says, "Exit Only."

After I peed, I was allowed to leave. I had to wear a pad, though, as there could be some bleeding. At this point, fortunately, there has been no blood in my urine, and only minimal, and expected, blood from the rear exit, which stopped by the next morning. I am on Cipro to avoid infections, which also will allow me to open any letters with anthrax.

The bummer is I have to wait a week to find out if I now have prostate cancer!! Didn't I fill my cancer quota already!? Hopefully, the PSA's went up for some unknown reason. Even a good biopsy, though, will likely have me getting PSA's more frequently to monitor it.

Nothing like the cancer specter hanging over your head for a week ... while you bleed out of your ass and wear women's liners.

Oh, and I should note that Dr. Sandha and his staff were fantastic. They were professional, thorough and minimized any pain. It also goes without saying that I trust Dr. Sheinfeld completely and have full faith in how he treats me as a patient.

Update: Today is Tuesday, September 28, 2010, and the doctors both called from MSK with the good news - no cancer. I will continue to monitor my PSA's, but am glad to hear the positive report.

Some interesting additional observations:
1. I do not know if it was the distraction of bleeding for a few days, the high cure rate for prostate cancer, a strong positive attitude now from years of hard experiences, or complete faith in great doctors, Sandha and Sheinfeld, but I was never panicked during this process. There was a relative calm that I would be ok no matter what and could deal with things. It is nice to know I have more inner strength than I had realized.

2. I want to re-iterate what fantastic doctors both Dr. Sheinfeld and Dr. Sandha are. I joked a lot about the biopsy above, and it was hardly a fun time, but Dr. Sandha did a remarkable job. It seems as though there are no complications for starters. Also, while aspects of the procedure were uncomfortable, it was not painful. The stapler stuff mentioned above was more a pressure combined with a creepy sound than anything else. No one should fear the procedure if done by a doctor as good as Dr. Sandha.

As for Dr. Sheinfeld, I can honestly say that I have 100% faith in the man. I trust his judgment, skill and knowledge, and I believe that was a major factor in my remaining calm throughout this process. I knew he would be taking care of me. Both Dr. Sheinfeld and Dr. Bosl, who I originally dealt with, are also great doctors because they talk to you like you are a human, in fact, like you are their friend. This goes a long way!! There are a lot of doctors, I am speaking to you William Kohlberg, who could learn quite a bit from the bedside manners of Drs. Sheinfeld and Bosl.

3. One of the things you cannot do have a prostate biopsy is have sex for two weeks. My thought on that was that it was nice to have an excuse for a change. :-)

4. I posted this entire story, as well as the other three cancer-related postings you can view down the right-hand column for a reason. I hope others read these stories and gain some solace, understanding, knowledge, and, also, appreciation for the necessity of taking care of yourself, seeing doctors when something is wrong and not pretending there is nothing wrong when something is. Here I have posted on this website about testicles, anal bleeding, prostate biopsies, and so forth, so throw the stigmas out the window, would you!? Talk openly about stuff, don't be afraid and get or be well.