Assumptions I Made About the Prostate and Prostate Biopsy
Before being diagnosed with prostate cancer, I had little knowledge about the disease. Since no one in my family had been diagnosed with it, the topic had never come up. Prostate cancer was the last thing on my mind, so receiving the diagnosis was both shocking and devastating.
Due to being blindsided by the news, I made numerous mistakes and oversights that I hope others can avoid. In addition to my numerous mistakes, I now realize I also made assumptions. These assumptions could have significantly altered my outcome and even have been life-threatening.
Assuming I was fine
When I was 52, my doctor suggested a digital rectal examination (DRE), because my PSA blood test results were high. Although familiar with the procedure, I wasn't looking forward to it. However, I understood its importance, as it allows the doctor to check for prostate anomalies and irregularities.
The doctor asked me to lower my pants and lean over the examination table. He put on a pair of rubber gloves, lubricated his index finger, and then examined my prostate through the rectum. The procedure wasn't painful but uncomfortable. Thankfully, it didn't last long. After the DRE, the doctor informed me that my prostate felt smooth and there were no irregularities. However, he mentioned I had an enlarged prostate, which is typical as men age, and assured me not to worry.
But this is where I made my first assumption. When the doctor told me that my prostate was smooth with no irregularities, I assumed he meant my entire prostate. However, I later learned that it was physically impossible to examine the whole prostate via the DRE. During the procedure, the doctor examines the back wall of the prostate, which is just a tiny part of it.1 In my case, there were significant anomalies outside the reach of the DRE. Because of my assumption, I trusted the doctor's expertise and didn't seek a second opinion. Looking back, I realize it's important to consult multiple experts before accepting one opinion.
The biopsy that missed my cancer
At 53, my doctor referred me to a urologist, because my PSA levels were increasing. Despite multiple examinations showing a healthy prostate, the rising PSA was worrisome. As a result, the urologist suggested a prostate biopsy.
I had heard about this procedure and was quite worried. However, I knew it was the only way to confirm the presence of cancer. I assumed the urologist knew best and walked into the prostate biopsy uninformed. Ideally, it's good to be intimately familiar with what you are getting into, including understanding the risks and alternatives. Above all, seek multiple opinions before you agree to move forward, especially when your health is on the line.
This or That
Have you had a prostate biopsy?
After the uncomfortable and somewhat painful prostate biopsy, the week of waiting for the results was nerve-wracking. The call reporting negative results was a moment of pure relief. "I'm cancer-free," I shouted to my wife. We hugged and celebrated the good news at our favorite restaurant that night.
I now realize that I had made a significant assumption when I learned the prostate biopsy tissue samples were just random. The purpose of the prostate biopsy is to take tissue samples from different areas to check for cancer cells. However, it never occurred to me that cancer could be present even if the results were negative.2 In my case, a prominent cancer tumor was growing in an area not included in the random tissue sampling.
The importance of regular check-ups
I'm thankful my doctor suggested continuing PSA testing even though I had no symptoms and a negative prostate biopsy. If I hadn't continued testing, I wouldn't have known my PSA was still rising, allowing cancer to keep growing unnoticed.
Because prostate cancer often doesn't show symptoms in the early stages, I likely wouldn't have found out about it until it had already spread and become terminal. So, my assumption that I had a healthy prostate without cancer could have proven deadly, had I not continued PSA testing. Which later led to an MRI.
This experience highlights the importance of regular check-ups and the potential life-saving benefits of ongoing testing.
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