From Chapter 3 – How little is little?
Many men I’ve spoken with about the prostate cancer diagnosis routine wonder about the biopsy.
For one thing, they figure it means they have cancer. This, of course, is nonsense. It no more means you have cancer than having your car brakes checked means you need to replace them.
For another, men ask how one biopsies the annoying gland. Is it just another DRE but with a needle glued to the end of the digit? Is the needle poked through the lower abdomen right into the prostate? Or, in the worst pain scenario, is a long thin foreign object passed through the penis? The very thought makes me shudder.
I suggest they think of it this way. Pretend you lie on your side on a hockey rink in the fetal position. You have a pillow under your head. You are not wearing underwear nor an athletic supporter or cup. Not far away and facing your posterior, a doctor with a better-than-average slapshot lines up ten pucks. To ensure a sterile environment, he wears a surgical mask.
Then he fires away. Each shot strikes you with stomach-thundering discomfort. Not pain. Just not a happy feeling. You sense your testicles will disintegrate and your stomach contents will explode up through your throat. Your eyes strain and bulge and your head jerks just short of hard enough to inflict whiplash, which explains the pillow.
A prostate biopsy doesn’t take long. Mind you, lots of things don’t take long. Being guillotined doesn’t take long. Apparently neither does circumcision. Do we see a theme here?
There’s very little preparation apart from emptying your gut. It’s deceptive that way. They make you think there’s nothing to it for the patient. Afterwards, you come to realize the extent of the deception.
I had three biopsies before my cancer was found. For the first one, when Auntie Jeanne was at 5.25, the doctor took eight core samples (or blasted eight slapshots). Apparently that was the standard, though now it’s ten and sometimes 12. More isn’t necessarily better. While they could puncture the smallish prostate all day long (not recommended), a tiny tumor still might not be discovered.
“You might feel a little discomfort,” he’d uttered.
I was about to ask how little is little when he pulled the trigger and the first puck scored. There was a delay of a few seconds, then another shot. While my eyes rolled up into my forehead and my upper lip twisted, he counted up, got halfway, then counted down. He said this would make it feel as though it was nearly over. Deception, remember?
“Just three to go…you’re doing fine…SNAP!…two more…SNAP!…”
The post-biopsy is relatively easy, too. At first I thought I’d have to waddle from the hospital like I’d just climbed down from a brahma bull. I also feared I might have sprung a leak, what with eight prostate punctures. Instead, I left walking mostly normally and as dry as when I’d arrived. It was then I recalled the hunched men in the waiting room on previous visits. Had they just undergone this misery, too?
A year later, with Auntie Jeanne’s number at 5.05 and urination more like the lawn sprinkler than the hose, it was time for biopsy two.