Urologists Take Note – The Real Truth About A Prostate Biopsy!

November 10, 2008

At first I thought I was just a “wimp.” At the urging of my family doctor I went to a urologist for a prostate check. She (my family doctor) said my PSA was a bit high for my age – 4.58 PSA and I was 47 years old.

Now let me state…I didn’t even know what a PSA was until she forced the test when I was having routine blood work done. Something I hated as I had a fear of needles.

The urologist did the “bend over boy” routine finding nothing with his “DRE” – Digital Rectal Exam. Now I have to be honest, that wasn’t the most exciting exam, but all in all it didn’t cause me any great pain. But, as the urologist said, “Better to be safe than sorry. Let’s schedule you for a biopsy.”

Now let me be frank…I had no clue what to expect other than what my doctor told me. He said there wouldistock_000002146611small be some minor discomfort but mostly I would be annoyed by the sound of the instrument when the sample was taken. “Other than that,” he commented, “most men don’t really feel much.” I do recall asking if there was pain, and again, my urologist stated, “Most men feel very little. Nothing to be concerned with.”

I have been interviewing men from all around the English speaking world who have been diagnosed with prostate cancer. With few exceptions everyone reports the same thing. The damn biopsy hurts! When they report this, I ask a follow up question: “Did you tell you doctor this?” Their response – “Well, no, I just took it like a man.”

GUYS…WHAT A CROCK!

In Dr. Sheldon Marks book, “Prostate and Cancer” he describes the biopsy as follows:

In a biopsy of the prostate, multiple tiny sliver-like ppeces of tissue are obtained for microscopic analysis to see if cancer is present. These pieces are obtained through a long but very thin needle, specially designed to open inside the prostate, take the sample and then close.

For most men, biopsies can be done as an outpatient office procedure without anesthesia and with usually only temporary discomfort. Now we can get a good representative sampling of the entire gland with minimal trauma to the gland.

He is right…it is done outpatient most of the time. Where I beg to differ is on the pain issue. Thus far, well over 70% of the men I have talked with have reported that their urologist misled them when it came to what to expect and the pain. All but two men interviewed would, in retrospect, have desired pain medication before the biopsy. One man reported that had he known it would have hurt as bad as it did…he would never had submitted to the test. (Although the test might have saved his life).

Several men stated that they felt that ALL UROLOGISTS should have a biopsy on their prostate so that they would know exactly what their patient was going through. In that way, the urologist might be willing to volunteer provide some local anesthesia to reduce the pain and trauma.

Urologists…do you get the picture. What is reported to you is inaccurate (men don’t want to admit to their pain) and it (the biopsy) freekin…hurts – SO GIVE US SOMETHING TO TAKE THE EDGE OFF.

WHAT ABOUT AFTER THE BIOPSY? For most men normal functions – exercise, work, activity will all resume as normal either the next day or day after that. Now, when I say normal functions…that also includes sex.

I’ve scoured the Internet and seldom do I see PRACTICAL ADVICE that men need to know – so here’s some. A few days after your biopsy you may engage in sexual activity. Be prepared! When you achieve orgasm your ejaculation will be bloody. Guys I don’t mean a trace of blood, but bright red bloody. And, gentlemen, if you are unprepared for that, it can cause alarm. That alarm may be to you and/or to your partner. Nothing can change the mood of an intimate evening of sexual play than to achieve an orgasm and find that you look like you just hemorrhaged.

GUYS… The biopsy is necessary so in no way take this entry as anything other than solid information. Have it done, and more than once if necessary. My personal advice is – request pain medication.

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Can Sexual Activity Prevent Prostate Cancer? Wishful Thinking or Reality?

November 2, 2008

For those who are following this site, let me begin this article by saying…I wish I could give a perfect answer to the question above.  Frankly, as a guy, I would love to believe the answer is yes.  Perhaps it is wishful thinking, but the question was raised yesterday by a reader who was commenting on diet.

She (yes SHE) pointed out: “There have also been two studies (2003 and 2004) which demonstrate a correlation between a high number of ejaculations per week with a lower risk of prostate cancer. Summaries of those studies can be found here: http://www.plannedparenthood.org/resources/research-papers/sexual-expression-6358.htm Just scroll down a bit.”

I will save you the time as I have copied the relevant parts and they are printed below:

Prostate Cancer

  • A 2004 prospective study of follow-up survey data conducted between 1992 and 2000 found that a history of high ejaculation frequency — = 21 ejaculations per month — was related to a decreased risk of total and organ-confined prostate cancer.  Each incremental increase of three ejaculations per week throughout a lifetime was associated with a 15-percent decrease in the risk of prostate cancer.  Study authors speculate that this relationship could be a result of ejaculations flushing potential carcinogenic substances from the prostate, or that the stress relief associated with ejaculation reduces central sympathetic nervous system activity that can cause cellular division (Leitzmann et al., 2004).
  • A 2003 case-control study of Australian men younger than 70 years of age found no association between the number of sex partners or ejaculations, and an increased risk of prostate cancer.  In fact, men who recalled a high frequency of ejaculation — four or more emissions per week — in their 20s, 30s, and 40s were one-third less likely to develop prostate cancer than men who reported fewer than three emissions per week over the same period of time (Giles et al, 2003).

As part of the research for the book that is in process (Prostate Cancer related of course), I have interviewed many men and one of the questions is sexual frequency before cancer diagnosis and sexual activity following treatment.  Now for the men and women who read…please understand, it is my intent to help men and their families through this process, hence, my focus will be direct and perhaps deserves some reflection time before drawing any conclusions.

First, I have found no correlation between frequencey of sexual activity and cancer, but to be sure, I am not testing that theory so my comments are unreliable.  What I have found is that men are unwilling in the presence of their wives (or partners) to talk openly and honestly about their sexual activity.  With rare exception, men will over estimate the frequency of sexual activity when asked how often with their partner.  I suppose it is a “man thing” to want to tell others it happens more than is real.  The telling question that men will not discuss (generally) in front of their partner – is the frequency of masturbation.

So far, close to 9 times out of 10, a man – interviewed alone – will reveal that he masturbates (yes even as adults) as often if not more often than he has sexual intercourse or activity with his partner.  O.K. – interesting – so what’s the point?

Point # 1 – Assuming that one survives prostate cancer and can call themselves a prostate cancer survivor – it is critical to honestly face ones sexual activity before cancer in order to assess a realistic healing time frame and expectation following treatment.  I was told to masturbate often by my doctor.  Why masturbate?  Well, candidly the doctor told me that my wife would not likely want to make love as often as I needed to exercise my penis and re-educate the nerves that had been disturbed thru surgery.

If a man was relatively inactive before surgery, then he certainly could expect equal or greater sexual function following treatment.  Now I am no physician, but hundreds of men’s stories can’t be that off.  Sexual exercise, for lack of a better way to put it, is paramount to regaining sexual ability following treatment for prostate cancer.

Let me state clearly, that if the nerves are not spared, there will be no renewed sexual function.

Point # 2 – If the studies by Planned Parenthood are accurate, then there is no (other than from other health concerns) reason not to have an active and healthy sex life.  Without offending women readers, ladies, if the frequency that a man desires sex is incompatible with your desire, then by all means encourage him to find release through masturbation.  Better to put past the issues that some raise regarding religion, social morays and the like and focus rather on health.

As always…your comments are welcome and Amy…thanks for the great link to the Planned Parenthood article and study.

Other Links that may be of interest:

http://jama.ama-assn.org/cgi/content/abstract/291/13/1578

http://www.newscientist.com/article/dn3942-masturbating-may-protect-against-prostate-cancer.html

http://health.usnews.com/articles/health/healthday/2008/07/03/lots-of-sex-may-prevent-erectile-dysfunction.html

http://www.nativeremedies.com/articles/prostate-health-sexual-frequency.html