Enduring the Pain

One week had elapsed since he saw the doctor and tomorrow he would arrive at the hospital to undergo the biopsy. The opening of the buds on the trees came on overnight. The flowers of early spring came as if they had been blooming a long while, though there had been no trace of them the day before yesterday. The gravel and pebbles left from the winter season were piled by the side road ready to be collected and preserved for the next winter. Spring was within reach, though it was hard to forecast as it was still April. Rays of sunlight penetrated the scattered clouds giving occasional gleams of silvery sunshine.

During the last few days, he had educated himself on problems relating to prostate cancer and, in particular, the biopsy operation. He learned that a prostate biopsy was recommended when a digital rectal examination (a routine screening test for prostate diseases) reveals a lump or some other abnormality in the prostate.  In addition, if blood tests revealed that the level of certain markers, such as PSA, was above normal, the doctor would order a biopsy.

Prostate biopsy was a surgical procedure that involved removing small pieces of prostate tissue for microscopic examination. This microscopic examination was done to determine whether the patient had prostate cancer. Occasionally, it would also be used to diagnose a condition called benign prostatic hyperplasia (BPH) that causes enlargement of the prostate. He learned that prostate biopsies could be performed in three different ways. They could be performed by inserting a needle through the perineum (the area between the base of the penis and the rectum), by inserting a needle through the wall of the rectum, or by cytoscopy.  (In this procedure, the patient would be given either a general or a local anaesthetic. An instrument called a cytoscope, a thin-lighted tube with telescopic lenses, is passed through the urethra. By looking through the cytoscope, the doctor would detect any blockage in the urethra for removal. Tissue samples from the urinary bladder or the prostate can be collected for microscopic examination.) Needle biopsy would be performed in his case in the hospital operating room, without any anaesthesia.