Cost of c-11 choline pet/ct

Just get a different PET scan - you can get better scans for less money elsewhere. Sometimes insurance or Medicare will pay for it if it's done within a clinical trial. Sometimes clinical trials are free.

My current favorite is the Ga68-antiPSMA-PET, which you can get on a clinical trial in Houston. Call them to see what they're charging, and please let us know:
68Ga-PSMA PET-CT Scan for Diagnosis and Management of Prostate Cancer

NIH is offering an excellent one for free and they even pay all the travel expenses to Washington DC:
18F-DCFBC PET/CT in Prostate Cancer

Emory is running a trial of FACBC PET/CT:
FACBC Outcomes for Post Prostatectomy

The least expensive price I've seen for a C-11 Acetate PET/CT (pretty much the same as a C-11 Choline) was $2,300 at UCLA. contact:Johannes Czernin (Most others cost $3,000)

- Allen

Mel,

You told me Medicare always covers it. Apparently not.

- Allen

At the time you wrote: "Mayo indicated that it is FDA approved, also that MediCare covers it, and also that many insurances now cover it (as does mine apparently)." I think your insurance is unusual, and Mayo was making misleading remarks to you. That's why I asked you to get a list of MACs that cover it. It bothers me that not everyone is as savvy as jpgr and they can wind up with a huge unexpected medical bill.

- Allen

Before he shut his clinic down temporarily for an equipment upgrade, Dr.Fabio Almeida at Arizona Molecular Iamging charged me $2,500 since I was also having an F18 sodium test. Without the F18, it would have been $3,000.

Tall:

Thanks for finding that quote! Yes, that's why I thought MediCare covered it: Mayo said so! For me, that was just an academic point, because I had my own group insurance.

It looks like other respondents also indicated MediCare covers it. (I am considering a 20% or even 30% co-pay to mean that MediCare "covers" it).

But I am confused. One person here indicates that it is not covered by MediCare. I am not familiar (YET) with the ins and outs of MediCare. Is it possible that MediCare covers it in some states and not in others??? I thought MediCare was MediCare, regardless of where you lived.

Note that I am assuming the individual already has a PC dx. and is using the C-11 to try and get more information.

If I retire this year, the effective date might be 8/16/15. I think my employee insurance ends at that time, so I will be on MediCare plus a supplement.



Mel

Tall:

Thanks for the information. I did not know this. I thought MediCare either covers something or does not.

Are the regions many states, or does it vary by state?

I am not looking forward to having to learn these minute but crucial details!

Mel

So each region makes their own rules??

Michigan seems to be in two different regions. I guess that's temporary and due to consolidation?
Mel

I am a little shocked after reading TA's post. Actually, I you could knock me over with a feather anyway. Here's what just happened and I am feeling a little shaky at the cost. A US PCa specialist kindly contacted Dr. Kwon as Don's not doing so well and all that is being treated is his bones (plus degarelix). He has become incontinent, looks and feels awful, and I am constantly asking someone to see what is going on with his prostate and urinary system. We just got in with Dr. Gleave at the end of the month. Meanwhile, I just heard from Mayo setting up an appointment for a Choline PET (which I had mentioned we would like to get) AND an MRI with coil. Spoke at some length and then they mentioned the cost. In US dollars: $8,600 and $4,000 respectively. I feel like I am letting the person who referred us down as he went through hoops to get us an appointment. We cannot afford this and the flights as Don isn't working. On the other hand, if this will help maybe we could extend the mortgage... but it seems as if TA is saying this is not the be-all and end-all. I know nothing about scans and am spending hours as it is just trying to get some action from SOMEONE around here regarding the actual prostate. All the oncologist did was to refer us to palliative care. We have had DEXA BDS and regular (non coil) MRIs done here. This isn't a very helpful post for you all, but at least it confirms the cost...

Post Edited (Moonlitnight) : 4/16/2015 1:10:17 PM (GMT-6)

Mel...haha to the last sentence.

Being a Canuck, we are not covered for treatments in the US. We do have something happening in Edmonton with a new scanner but I will have to check to see what kind it is, and when it will be operational. The addition of lab tests would finish us off I think. With the way the drugs have worked so far, and the fact Don is now radioactive, weak, and has higher risk for breaking a femur, we are considering just going on a very long, medicationless trip (I only half jest). An associate of mine with glioblastoma m. did this. Told the doctors she was going on a drug-free walkabout for three months and took off with her husband to the Andes. You of course know the ending of this story (which took place for years ago, when she was told she had at best three months). It's tempting I tell you and Don would do it in a heartbeat.

Great idea about discussing this with Mayo. I will ask with whom I should speak when they call back with our appointment time. Will also ask Dr. Myers his opinion, but I find that they all differ in opinion. (ETA sorry, I realized after posting that you were probably not responding to my comment.)

All,

Can anyone of you, gentlemen, tell me whether my line of thought herein is correct or incorrect?

I understand that Choline C-11 PET scan is a non-specific cancer detector, that, as such, will detect any hidden cancer tumors anywhere in the body, including metastatic cancer originated in the prostate. That is, it will detect cancer that "traveled" to, for example, the lungs. Of course, the lungs do not produce the prostate antigen Kallikrein-3 (KLK3). which is the product of only the epithelial cells of the prostate, which the PSA number is a measurement of. So, a low or zero PSA won't tell me that I don't have cancer anywhere else.

My particular interest on a Choline C-11 PET scan is because the prostate cancer I was treated recently by brachytherapy was a cancer that had been growing "silently" (relatively low PSA) for years. My concern --supported by 2nd and 3rd opinion-- being that during those years undetected (I had to "drag" the urologist to give me a biopsy, which, naturally found the tumor), the slow growing cancer might have metastatized... the current PSA level (1.4; my urologist says it will eventually go down to <.1) notwithstanding.

I am scheduled for C-11 at Mayo for some time in July, hopefully by then my PSA will have gone further down, but with my long history of chronic bouts of bacterial prostatitis, the PSA will surely never go to zero, and any increase will most likely be attributed to new bouts of bacterial prostatitis,, although it could be either recurrent of residual prostate cancer. I don't want to face such risk.

I reason that with the Choline C-11 PET, primarily, I will have any metastatic cancer hiding anywhere else detected, and treated properly; and, secondarily, I will have any recurrent or residual prostate cancer detected as well, in this latter case I will go for a full prostatectomy.

Thus, my primary concern is metastasis. Recurrent or residual prostate cancer is secondary to me.

What do you gents opine?

Jack-

C11Choline is a very specific prostate cancer detector - bones and viscera.

Prostate cancer in the lungs or anywhere else will produce PSA. It has nothing to do with the organ it happens to be in - it's prostate cancer no matter where it is, and it produces PSA.

If your prostatitis is known to be bacterial, that's useful in terms of PSA because a round of the right antibiotic ought to bring it down.

It would help if you'd put in your signature details of your Dx and Tx and your PSA pattern. What was your risk level when you had brachy? How long ago was it? It could not have been all that high or you wouldn't have had monotherapy. If you have a local recurrence, there are a lot better salvage treatments than surgery.

Allen and Mel,

Thank you very much for the explanation.