maallyn

Folks:

I am going in for a Prostate Cancer Biopsy in a few weeks here in Bellingham, Washingon.

I don't know if this is the correct part of bike forums to ask this question . . .

I wander if anyone can give me any insight as to how soon I can get back on the saddle after a biopsy. My bicycle is my only transportation here in Bellingham besides walking.

Currently, I have a regular bicycle, not a recumbant.

Should I buy, beg, or borrow a recumbant to use after my biopsy? Or will I just have to bite the bullet and walk everywhere I go for however long I need to recover from a biopsy?

Thank you

Mark Allyn
Bellingham, Washington

Lascauxcaveman 

Ask your doctor?

He'll probably say, "Whenever it feels OK to do it."

BTW, I've been told riding a bicycle naturally overstimulates one of the chemical indicators in your body that point to prostate cancer. I've been told not to ride for at least five days before getting checked, to avoid a false positive.

If you need it, I've got a recumbent trike I'd be happy to loan you, but you'd have to came fetch it here in Port Angeles. Maybe a local shop can rent you one instead.

maallyn

The blood draw for the PSA was about 5 minutes after riding my bike to the doctors office to do it.

Lascauxcaveman 

So you may want to ask your doctor about that, before getting a biopsy. Especially if prostate cancer doesn't run in your family. Maybe you already got a false positive? I imagine a biopsy for that is an expensive and invasive procedure.

OldTryGuy

Currently surviving PCa or Prostate Cancer, mine the Big Daddy being Gleason 10. If you would like a source for plenty of information.....

https://www.inspire.com/groups/us-to...-cancer/about/

Riding a bike, lifting weights, sex, infection....can cause a rise in the PSa number due to irritation so I hope you discontinued such things a week before your PSa blood work. As for the biopsy, if you are having the standard TRUS biopsy, riding following the biopsy can be painful, cause bleeding and infection. I was told to stay off for 1 week. My biopsy was during the week before an IRONMAN 70.3 triathlon so I had to withdraw.

FYI, please, PLEASE, PLEASE do some due diligence researching regarding a prostate biopsy and cancer. The standard TRUS biopsy can be VERY INCOMPLETE resulting in missing cancer that is present in the prostate and lead to a delay in treatment. please, PLEASE, PLEASE research....a word from experience.

I am 67 and was diagnosed at 65. Typically ride 100 milers and currently preparing for a 400 miler in 24 hours my RAAM qualifying race. Any questions you have I will answer for you.

GOOD LUCK. OOPs, just reread and saw you rode before the blood work. What was your PSa number? That soon before might, might not have done something BUT still not good that you rode.

Tony P.

I had prostate cancer 12 years ago (age 57), so I have an idea of what you're thinking.

I'd like to comment on the PSA issue but you didn't say what the PSA level was or why the doctor recommended a biopsy - could be for reasons beyond one PSA test. But, given that prostate cancer is a slow disease and the "few weeks" before the biopsy, I would get a second opinion and a another PSA first.

More important, though, is to get a second opinion after the biopsy.

OldTryGuy

The evil thing with prostate cancer is that many times there is no indication of a problem and thus by the time it is found metastasizing has occurred. My Gleason 10 was supposedly still contained within the prostate so I should have a better chance of making another 5 years without major issues arising. Second opinions are fine unless there is a large discrepancy and then a 3rd opinion and 4th and ????

A low PSA could exist with very aggressive cancer as can the opposite where a high PSA is due to inflammation or infection.

Once again, knowledge is a priority and one must be their own advocate.

maallyn

Folks:

Sorry I was not clear. Here is what came down:

1. Family history (father and one of two brothers)
2. PSA 2 years ago was 6; two weeks ago is 25
3. Yes, I did kayaking, walking, gym, and biking withing days of PSA draw.
4. I biked to PSA draw; it was 2 mile flat bicycle ride from home to doctors office.

From you comments, it seems that it makes sense to stay off standard upright bicycle with narrow seat. What about a recombant or a split seat on my upright?

Barring that, what about walking?

I need to make clear that I have no car. This is my only form of transportation (walking/bicycling).

Also, when you say 2nd opinion on Biopsy results, do you mean 2nd biopsy or do I ask the urogolist to take two sets of samples, one for him and one to send to someone else? If so, who would I send it to? I don't know of anyone else in Bellingham? Would I send it to someone in Seattle? I am guessing Vancouver BC is out as it is in another country and insurance would laugh.

Thanks

Mark Allyn

OldTryGuy

What were your Gleason numbers???

Walking is fine. A thick padded bent seat is better than a diamond frame seat, HOWEVER, if a DF is all you have TO RIDE then the Hobson seat https://www.modernbike.com/hobson-original-easyseat is usable. NOTE--I have used the HOBSON.

A 3T mp MRI will show PCa location far better than a TRUS can and is more current than a 1.5T MRI

Tony P.

Mark, first and foremost live your life. Don't allow this issue to dictate to you. You need to be the one dictating to it. So, bike on and walk as you choose.

On the biopsy, given the PSA skip what I said about the second opinion prior to the procedure and just go forward with the biopsy. In the interim, though, let your doctor know you'll be getting a second opinion on the biopsy which is common. He'll know what's needed. Contact Univ. of Wash. Medical Center Urology Dept. or a similar facility.

There is no Gleason at this point in the process.

Stormsedge

Mark, I had a biopsy followed by a radical prostatectomy 15 years ago at 46yo. Fine now, thanks. Ask your doctor remembering that the biopsy is invasive and your body needs time to heal. Your fitness and resiliency may suggest to you that you are good to go (mine did), but tell your doctor what you want to do for a guess of when to give it a try. Then, go easy until you are functioning normally (pain during certain activities and bloody seminal fluid reminded me I needed to wait a bit longer...LOL, oh yeah, an eye opener).

As for the biopsy itself...no biggie. Tell jokes to the assistant and remind the doctor that your tonsils are checked from the other end.

The actual treatments, if required, are different and better than when I had mine, so "the future so bright."
I liked and still have "The ABCs of Nutrition and Supplements for Prostate Cancer" by Moyad, recommended to me by the head of Urology at Balboa Naval Hospital. It gave me a solid starting place to weed through the diet and pill stories that we get bombarded with.

Someone else said it earlier...you'll likely go through some of the stages of grief (why me, why now) as you step through the diagnosis and, if required, treatment, but continue to live life. God bless.

OldTryGuy

Sorry about the confusion with my question about GL numbers. I should have made it clearer that a second biopsy is not needed, IMO, if a MRI guided biopsy is performed and the numbers are high. However a second opinion on those results might be obtained for self assurance. Anything GL4+3 and higher should be considered immediate action and current thinking is leaning towards results of 3+3 and 3+4 can be considered having a more appropriate treatment of Active Surveillance. Radical Prostatectomy (RP) is a treatment that is becoming less favorable with the more accurate imaging available and improved modalities of treatment as with Breast Cancer.

late

In my case, the biopsy hurt like hell. Agony. They stuck this thing in there and slice and dice.

If it's a reasonable option, I'd go for low dose radiation.

It's new, it works, and it beats the alternatives.

5 days a week, you go to the lab, and they make you glow in the dark. You feel like crap. Maine has a Pot RX program, and that helped me a lot.

One last thing about treatment. They shot me full of girly hormones. This also sucked. I was supposed to be on them for 2 years. But after one year of that, I said no more. Worked out fine for me, YMMV.

This is scary as hell, and about as much fun as taking on an biker bar by yourself. But you can get through it.

Tony P.

It's extraordinary for me to outright challenge someone's posting but given the importance of the issue and the inaccuracy in this post, I feel compelled. Hopefully I won't be hijacking the topic in the process.

Earlier, you asked about a Gleason score prior to getting a biopsy although a biopsy is needed to have a Gleason.

Now, you offer a view that a second opinion is not needed depending on the Gleason then go on to describe how a Gleason can impact treatment options. Ridiculous! It is precisely because the Gleason may impact treatment that a second opinion is needed.

A second opinion does more than just say yea or nay to the overall determination, it can also re-evaluate the Gleason. And, this second opinion adds confidence as options are considered. Thus, a second opinion is recommended.

OldTryGuy

Thank you for calling me out and pointing out my error in thoughts to words. I hope the bolded print correction makes my thoughts a little clearer.

I was trying to say that, IMO, if the biopsy was a 3T mp MRI, the quality of that type of biopsy is FAR SUPERIOR TO A TRUS BIOPSY and a second biopsy need not be done only a second opinion on those results if the individual feels more comfortable in doing so. The issue with a second opinion is that if the results differ from the first, then there is a question as to which one is correct and then a third opinion might be desired.

My TRUS yielded a GL5+4 so I felt there was no need for me to consider a SECOND opinion. In pursuing my treatment, the doctor I used required his own biopsy so I had the second biopsy, a saturation transperineal 3D Prostate Mapping Biopsy which provides an ACTUAL 3D model of the entire prostate since the number of cores range from 50 to 100+ depending on live imaging during the procedure.

Again, thank you for you attentiveness.

maallyn

Folks:

Thank you very much for the great help!

Regarding 2nd opinions, I am assuming that it is best to get a 2nd opinion on both the MP-MRI results and the biopsy together? So, that would me that I send the biopsy slides and the MP-MRI pictures to another place like UW in Seattle (I am in Bellingham, Washington).

If that is the case, then can I assume that I don't have to go to the 2nd opinion facility myself and that everything is done via mail/email?

Also, do any of you know of any facility in Bellingham that can be trusted for the MP-MRI, or shall I plan to have that done at a place like UW in Seattle? I am assuming the Vancouver is out of the picture because it's in another country. Is that right?

Also, if I choose to try for the MP-MRI first and then followed by an MP-MRI guieded biopsy if anything is seen n the MP-MRI, that should be a viable option? Have any of you had problems with insurance with that method; ie; they insist on a TRUS before paying for the MP-MRI?

Thank you

Mark Allyn
Bellingham, Washington

Tony P.

Mark, I will stay clear of suggesting medical advice but here's some comments:

• Make certain you have a good doctor advising you, possibly a surgical oncologist and get specifics from him.
• You mention your involvement in the second opinion process. Speak to your doctor. Second opinions are routine and his office may handle it - some do and some don't.
• There may be reasons why a visit may be needed with the second opinion, but that's not likely. See next point.
• I'm not familiar with the Seattle area but Univ. Wash. has an excellent reputation. However, depending on insurance you may not be limited to the Seattle area. In fact, Johns Hopkins (in Baltimore) has a large second opinion program.
• Insurance coverage varies. Speak to your doctor and the carrier about your coverage and the process.

Having said all that, don't get ahead of yourself. There's a very good chance the PSA rise may be caused by something other than cancer.