Husband just diagnosed with advance prostate cancer.

That sounds good as I was concerned he had an infection from the biopsy. The hormone therapy can upset the system when first administered and until it gets used to the drop in Testosterone. The injection acts on the pituitary in the brain which is also linked to the temperature control mechanism, hence why some men suffer from hot flushes. My presumption is that this is what is causing the shivering. It usually takes 4-8 weeks for the body to to settle down. Try to encourage your husband to get up and move around a little and feed him little and often until he starts to get his appetite back. Fatigue is common for men on HT but the best thing to counteract this is exercise along with possibly gym work to minimise muscle loss. Your husband may also experience some bone and muscle aches and pains initially but again this should improve. 

This is the start of the journey for you both and it is the most difficult time until you get a treatment plan. We can help you understand the options and the effects they will have. Things will get better. Keep us posted.

If you are speaking to the GP ask about calcium and vitamin D supplements as the hormone therapy can cause bone thinning.

Hello Alwayshope, my husband was admitted to A&E via our GP last Wednesday (13th Nov) with infection, he is still in hospital being given IV antibiotics so has been rather poorly.  I now understand from the urology department that the leaflet they gave to my husband which stated antibiotics will be given at the time of your biopsy to minimise the risk of infection, were not given. The hospital procedure and protocol changed several months ago following an audit and antibiotics are no longer given. I have taken this up with the Chief Executive and PALS as they are giving incorrect information to patients.  I would have requested a course of antibiotics for my husband had I known this, it is a disappointing and a poor decision. So I would recommend anyone having a prostate biopsy requests a course of antibiotics if these are not automatically given during the procedure, I am sure it will save a lot of men having to go through what my husband is going though and save the NHS money with A&E visits and hospital stays. Hopefully my husband will be home soon.

Hello Liv88 

I am so sorry to read of your husbands hospital admission, i do hope he will be home soon having made a full recovery.

That's a very interesting point about the antibiotics, I wasn't aware of this. Will you please let us know how you get on with your complaint. 

I thank you for bring this matter to our attention.

Best wishes - Brian.

I have had a reply from PALs saying they will look into this. Will keep you updated.

Looks like routine antibiotic prophylaxis for the transperineal prostate biopsy procedure is being phased out.  I checked the discharge notes to my GP for my biopsy just over a week ago, and antiobotics were not mentioned.  

See below link and conclusion.  Any pre-procedure guidance notes for patients should of course correctly reflect the procedure to be performed. 

Conclusions

The likelihood of septic infections after transperineal prostate biopsy is low with and without antibiotic prophylaxis. The omission of periprocedural antibiotics with this procedure stands to benefit patients by avoiding potential drug reactions. Furthermore, this practice is in line with calls throughout the medical community for improved antibiotic stewardship.

https://pmc.ncbi.nlm.nih.gov/articles/PMC8883190/#:~:text=Conclusions,by%20avoiding%20potential%20drug%20reactions.

Hello Peroni 

Thank you very much for that link - every day is a "school day" on this forum. 

I can appreciate the need to reduce the use of antibiotics but at least make it obvious they are not being prescribed but may be needed.

Best wishes - Brian.

Hello Liv. Sorry to hear that your husband ended up in hospital. It is rare for men to suffer a bacterial infection after a having a transperineal biopsy compared to a greater risk with the transrectal biopsy. Timing is important as the symptoms of shivering and feeling unwell from the biopsy normally start to show within a few hours but also up to several days from the procedure. The current recommendation is that taking an antibiotic with the transperineal biopsy is not warranted due to the low risk of infection. This is also in line with trying to reduce the risk of antibiotic resistance which is becoming a real problem. Another possibility could be from the hormone therapy injection. Very very occasionally the injection can be pushed too far into the abdomen and nick the intestine. The two bugs normally associated with bacteraemia are Escherichia Coli and Klebsiella pneumonia, basically originating from the gut so have they told you which bug is involved as this might give you an idea of where the infection originated from.