Anesthesia

[Poppyof6]

i’m receiving radiation treatments by CyberKnife radiation treatments. Five treatments over 5 days. This involves installing gold markers at the cancer locations. I received anesthesia for the biopsies but will not for the marker procedure. What is the experience of any of you other men of having biopsies or marker placement while awake? Thank you for sharing your experiences.

[mac-12]

I had biopsy, 12 cores, no anesthesia, no pain, barely felt anything, we were talking about investments during procedure, a little dizzy sitting up but went away in bout 10 min, plus I could hear as they were pinpointing needle with MRI/ultrasound, presently AS, 4 cores1%/40%/50% gleason 6's, and last 60% 3+4, decipher 43, taking naturaly testosterone lowering flaxseed/licorice root/curcumintumeric/Dutersteride.

[Poppyof6 in reply to mac-12]

Thank you, Mac-12. I appreciate your feedback.

[MrGreenJeans]

Is that your choice or the docs? I actually had my fiducials implanted yesterday at MSK and was not given a choice, it was done under anesthesia, which I preferred. The way it was explained to me, they use both a catheter to identify the urethra and an ultrasound in the rectum and I'm glad I was out for that. I had a lot of pre-op consultations with nurses to allay any concerns about my reactions to anesthesia.

[Poppyof6 in reply to MrGreenJeans]

The doc’s choice. I was out for the biopsies and I’m surprised at this because, I think, it’s a similar procedure except there’s insertion instead of removing material. The same doctor did the biopsy work so I guess I trust his judgement since it’s obviously his normal procedure. Also, I have no negative reactions to anesthesia. Thanks for your feedback.

[Mpaddler]

Last year I was diagnosed with 4+3 in June 2023 and I had SBRT last December at The Cancer Center of Hawaii. Dr. Lee implanted 3 gold fiducial seeds using local anesthesia of my perineum. I was totally awake and honestly didn't feel anything. Then Barrigel was implanted to add seperation between the rectal wall and the prostate. For me, this hurt like heck. I could barely hold still with my bottom hanging off the edge of the table and feet in stirups. Using rectal ultrasound he checked to see how everything but to me he did not sound totally confident that the right side of the prostate was isolated. I insisted that he be 100% sure and told him to add more Barrigel. He gave more local anethesia and that did the trick for my discomfort while adding the Barrigel.

Now its coming up on 11 months since my last treatment. I just turned 76. I did not want to have hormone therapy due to adverse side effects. My PSA was 9.8 at the start of my first SBRT session. After 3 months the PSA was 2.7 and in early September it was 1.2. My RO said this was normal.

I am having almost no side effects. Never experienced fatigue from the radiation but did have swelling of prostate which made it difficult to urinate. That was solved using a Flomax for about 6 weeks. Now I take nothing.

[Poppyof6 in reply to Mpaddler]

Mpaddler, thank you for your response. I'm almost 78 with initial PSA of 4.7, Gleason 3+4=7. No symptoms at all. Genome testing indicated aggressive cancer so the decision to radiate was made instead of checking every months. I appreciate the feedback from this community. It is certainly interesting with the many treatments for this cancer. As all us men know, get in a group of guys our age and say the word "prostate" and it's like telling fish stories all of a sudden.

I think I'm satisfied with going with a local for the implantation of the gold markers, as my doc calls them.

[Mpaddler in reply to Poppyof6]

Are you having Barrigel ? You're right about the fish stories....

[Odnad]

Had my mine placed at UNC Chapel Hill and was completely out. Doc said due to the precise placement of the markers and Barrigel she did not want to take a chance of me moving. Glad I was out when she explained the procedure to me. I am halfway through my 28 treatments of IMRT.

[climb4blue]

The gold fiducial placement was very painful for me, however, it was over in about 1 minute. Personally, I would have chosen sedation, but I can see how some might want to avert the risks of anesthesia and/or the grogginess afterwards from the 1 minute procedure. UCSF was where I had them placed and they did not offer anesthesia for it at the time but maybe that has changed since. UCSF said I tolerated it well but I just about jumped off the table every time they did a placement; it was just about the most painful experience I can recall.

[cybertreated2019]

I had anesthesia for both the guided transrectal biopsy and fiducials/SpaceOar placement prior to SBRT in 2019. Never occurred to me that going without was an option and was more concerned about discomfort or pain than risks from anesthesia. No issues with the biopsy but was pretty sick after the fiducial procedure. Attribute it to the anesthesia as it passed pretty quickly.

[jazzy53]

Based on my own experience with a perineal prostate biopsy, I would ask the doctor for at least a sedative to get you through the procedure. Personally, I would request twilight anesthesia. There are plenty of men who say they had no problem with the biopsy, but I did and would never again accept the doctor's refusal to give me anything. One caveat: I have no idea if the the procedure you're having is comparable to a regular prostate biopsy.