PSMA PET Scan

Hello, GeetarMan ---

Sending supportive thoughts your way.

I hope the treatment center starts getting proper reimbursement from the insurance companies, so this new scan can be used to its full potential ---- helping additional patients.

Meanwhile --- you are taking that next proactive step.

My doctors always emphasize the importance of scans and imaging --- and it has helped them stay on top of my case, all along the way.

If a new treatment is needed --- now or down the road --- there's a lot of weapons in the castle armory these days.

Stay the course --- your doctors will lead you forward --- good luck with the scan --- and let us know how things go.

No one here fights alone ----

"The power of the wolf comes from the pack ---- and the power of the pack comes from the wolf."

Support sent your way!

Handshake, fellowship, camaraderie ~~~
CYCLONE --- # Iowa State University

GeetarMan - Not good PSA news obviously but that fact that your PSA is in the range of newer PSMA scans is the silver lining in an otherwise grey cloud. Best to think positive going forward.

Like Stephen, I wish you the best and hope that the scan shows a nearby source of the PSA that can be targeted. The insurance part is terrible when this scan is clearly indicated in your case, no doubt. The pricing seems to be all over the place and there appears to be a backlog at some places so it is great you are getting it done so quickly.

Not sure if you care about details but I found the linked documents on the Pylarify website

https://www.pylarify.com/coding-and-billing.pdf
https://www.pylarify.com/access-and-reimbursement.pdf

My PSMA Pet scan experience is as follows:

After RP in spring, 2013, my psa started rising to a high of around 8 and then dropped down to a low of 1.17, 5 years ofter surgery. No one knows why my psa was so wacky but a fellow on the forum (TA) suggested I take a clinical trial using one of the new Pet scan tracers which are much more sensitive in identifying hot spots for PC in your body. Had the test done August 2018. 2 small lymph nodes in the presacral area identified as hot spots. Started 6 months of ADT in September and RT starting December pin pointing the 2 hot lymph nodes and also the general prostate area. Have had 6 psa tests since Feb.2018, all undetectable.

I am sure there are millions of PC cells merrily floating through the rivers in my body looking for a nice cozy environment to start a family but it has been almost 3 years since RT and no sign yet of an insurrection.

These new PET scans are only going to get better at identifying small lesions in your body before they mastisize giving you a second chance to pin point radiate these little groups of PC therefor giving you a better quality of life.

Dave

Post Edited (slapshot) : 10/25/2021 8:47:20 AM (GMT-6)

As best I can tell Medicare still has not issued reimbursement guidance. Until they do there will be a period of pricing and reimbursement uncertainty between the providers and the payors. As Mumbo points out the reimbursement codes are there as Medicare issues these on a quarterly basis and did so in the second quarter of this year. Issuing the codes often precedes reimbursement advice 6-9 months later.

Well: well done, @Geetarman fighting your corner. Most people in the industry are being restrained in their views but reading behind the medical caution, it looks like this technology will revolutionize the treatment of people EXACTLY like you. I know I breathe easier knowing the most likely negative outcome for me (that I have micrometted or gone N+ over the 5y) just got a LOT less dangerous. I am genuinely thrilled for you in that dreadful PSA news has at least some sugar on it. Good luck and keep us posted.

Well, with everything taken together from your PCa history, I would indeed say it's good news and close to a best case scenario.

I think you are wise for using Lupron with RT to give you the best shot at knocking it out.

Good luck!

BillyBob@388 said...
And hopefully in a few years, we will even have some sort of targeted treatment where the PSMA thing ma jiggy will be used to carry some sort of killer straight to the PC cells and the PC cells only! Go, Go, PSMA! (hopefully all of that won't take 10 or 20 years to be developed and become available)

Bill

I heard that this will be approved next year:
https://www.cancer.gov/news-events/cancer-currents-blog/2021/prostate-cancer-psma-radiopharmaceutical-vision

GeetarMan said...

BillyBob@388 said...
And hopefully in a few years, we will even have some sort of targeted treatment where the PSMA thing ma jiggy will be used to carry some sort of killer straight to the PC cells and the PC cells only! Go, Go, PSMA! (hopefully all of that won't take 10 or 20 years to be developed and become available)

Bill

I heard that this will be approved next year:
https://www.cancer.gov/news-events/cancer-currents-blog/2021/prostate-cancer-psma-radiopharmaceutical-vision

..............................................................................

I admit I found that to be a bit disappointing, compared to what I was hoping for in the near future. Over all survival increased by 4 months(from 11 months to 15). Progression free survival increased from 3 months to 8 months. Every little bit counts but my hopes for using the PSMA seeking drug to carry radiation directly to the cancer cells wherever they might be were for either a cure, or at least a long term remission. Oh well, it is what it is. Maybe there will be even more to come from this or other advances.

Great news Geetarman, all things considered, as you said.

Just keep in mind my friends, there is no Dr. Epstein for getting a second, expert read, of a PSMA PET Scan, that will be new to most all radiologists.

I had one almost five years ago, in Bethesda, at the NIH clinical trial. It uncovered a one inch tumor on my empty prostate cavity wall, that a superstar Johns Hopkins trained prostate surgeon with a MSK fellowship added on oncologist missed. Easy to happen, I guess, because it was in a difficult apex location, but....

Adding insult to injury, said 2018 PSMA PET Scan clearly showed a small tumor between my lungs, that was noted as "Not of concern, and probably benign. No action recommended." I guess the radiologists were focused on my groin area, and not my chest. Well, I should have known better.

Four and a half years later, the tumor is the size of a football, encapsulating one lung, and pushing on my trachea, esophagus and heart. Still no obvious symptoms, BUT given it's size and location it's untreatable, and terminal. It's called Dedifferentiated Liposarcoma.

Just highlighting that the read of an 'expert' radiologist or pathologist is more important than whatever that latest cool scan it. Take nothing for granted, be your own advocate, research like crazy, continue to challenge so called 'experts', and good luck counts for a lot. Live long and prosper!

Garyi: WOW!................

Geetar - “Welcome back, my friend, To the show that never ends”

It takes a while but you will eventually be done. Hope the Lupron treats you favorably and the next few months goes well.