Still disappointed with the quality of service I had been receiving at Group Health, I made an appointment at Urology Northwest after a thorough Internet search. They appeared to have some of the best recommendations. My appointment was pretty standard for a Prostate exam. We discussed past test results and chatted about possible Prostate Cancer Treatment. The doctor performed a DRE and ran a Urine Analysis to check for any infection. Based on my Prostate history and lack of urinary infection, the doctor recommended I have a Prostate Biopsy. He was ready to do one at his office in a matter of days. I left with the very words I didn’t want to hear echoing in my ears.
About this time the lab results from my Bastyr tests came in. Medically I was sound. Everything looked good with the exception of my PSA tests. My PSA Total came in at 6.83, a substantial increase. My PSA Free came in at 13%, again another slide in the wrong direction. Both of these were a shock to me because I'd experienced much better results directly after the cessation of the Cipro. This was not good news. As mentioned before, the specter of Prostate Cancer can be a really scary thing. The unknown possibility can be even worse than the known quantity. At least if you are diagnosed with Prostate Cancer, you can decide on a form of treatment and move on with your life. With these latest results my wife began lobbying for a Biopsy just to get the question answered. Of course she was hoping for good results.
I began to toy with the idea of having a Prostate Biopsy. Sure there was risk but I reasoned certain physicians and facilities may present less risk than others. It also appears Prostate Biopsies can be uncomfortable to very painful. I found that some doctors use a surface acting anesthetic first on the rectum wall, and then a needle anesthetic to numb the prostate. Some doctors do not. While the anesthetic appears not 100% effective, the studies seem indicate it may reduce the pain of the procedure by an average of 30-40%. In some other settings doctors are even using a general anesthetic, knocking the patient out prior to the procedure. Then there was the risk of spreading of any potential Prostate Cancer cells as a direct result of the Biopsy. I was already taking Pectasol-C to prevent this from happening. Additional studies indicated taking Cimetidine (Tagamet at 800 mg daily) may modulate the body’s immune response (immunomodulation), interfere with tumor growth, and inhibit tumor cell migration and metastasis. I was wondering about this as an additional option, but didn’t want to damage my ability to absorb healing nutrients.
I started to make a list of pre-Biopsy questions to refine my search for a Prostate Biopsy physician. They included:
Question 1: What is the number of prostate biopsies you have performed, and what is the number of cases you have had where there have been serious antibiotic resistant infections as a result of the procedure?
Question 2: Is Cipro the only antibiotic you use prior to, and/or after the biopsy?
Question 3: Have you read about Dr. Schaeffer’s new protocol at Northwestern University Feinberg School of Medicine, Chicago, of targeted antimicrobial prophylaxis that has significantly cut the incidence of prostate biopsy infections?
Question 4: What processes(s) do you use for pain management during, the procedure?
Question 5: Is it acceptable for me to be taking Pectasol-C and/or Tagamet prior to, and after a Biopsy?
Question 6: Are there any other ‘supplements’ I should consider taking, or not taking, before, during, or after a Prostate Biopsy?
Then too, should a Biopsy find I have Prostate Cancer what would be my next step(s)? I began this process by looking at all the standard forms of treatment currently available. Then I sought out alternative forms of treatment. My research led me to one conclusion. Should I have Prostate Cancer that needed some form of ‘radical treatment’, the da Vinci® Robotic-Assisted Prostatectomy is the only form of treatment I would accept. This form of treatment appears to have significantly better long-term results when compared to Open or General Laparoscopic Surgery and Radiation Therapy. (More on this to follow) With this conclusion, I decided to keep my search of potential Prostate Biopsy physicians to those qualified with, and having local access to, the da Vinci® method of treatment. Lo and Behold, this led me back to Group Health, and I made an appointment for a Prostate Biopsy 'discussion' with Dr. Jerome Zink in Seattle.
Next installment: The Dreaded Prostate Biopsy