Possible cuts to cancer and cardiac care.

New Topic Post Reply Printable Version
[ << Previous Thread | Next Thread >> ]

jacketch
Regular Member


Date Joined Apr 2009
Total Posts : 179
   Posted 9/16/2009 6:29 AM (GMT -6)   
I was unaware of this and am still researching it.
 
V10.46 Dx Feb-09
RRP 5-5-09
No adverse SE
PSA 6-19-09 -0-
 
Thriving, not just surviving!
 


JoeyG
Regular Member


Date Joined Jul 2009
Total Posts : 162
   Posted 9/16/2009 6:46 AM (GMT -6)   
All of us American's need to prepare for a future America where expectations will need to be adjusted downward a bit. That goes for health providers too. The physicians who complain and say they will not treat those with Medicare are only fooling themselves because MOST of the elderly cannot afford to pay out of pocket and if they limit their clients to only those who can pay, those doctors will be going out of business.
 
To be frank, there isn't a healthcare provider who will suffer with lower reimbursements. The cost of healthcare MUST be controlled. that is the bottom line. However, I will point out one thing that the Republicans want that does make sense and that is limiting lawsuits to only those that are due to gross negligence and result in significant pain and suffering. Doctors ARE human and there are risks to everything they do.
Age -57; Diagnosed 10/05 PSA 13.4 GS 9 Organ confined (T2B)
Cryoablation 4/06 Allegheny Hosp-Dr Ralph Miller (Cohen/Miller)
Post Cryo Nadir 8/06 0.2
Rising steadily to 0.7 4/09 :-(
Steady at 0.7 (7/09) (Pomegranate???)
Looking to take next steps soon
Hoping to qualify for salvage cryo or radiation


Geebra
Regular Member


Date Joined May 2009
Total Posts : 476
   Posted 9/16/2009 7:04 AM (GMT -6)   
This will lead to further segregation of the society into those who can afford to pay for the best service and those who have to rely on government. What's great about our healthcare system today is that most insured people have access to the same care, regardless of income.

Father died from poorly differentiated PCa @ 78 - normal PSA and DRE

5 biopsies over 4 years negative while PSA going from 3.8 to 28

Dx Nov 2007, age 46, PSA 29, Gleason 4+4=8

Decided to participate in clinical trial at Duke - 6 rounds of chemo (Taxotere+Avastin)

PSA prior to treatment on 1/8/2008 is 33.90, bounced on 1/31/2008 to 38.20, and down at the end of the treatment (4/24/2008) to 20.60

RRP at Duke (Dr. Moul) on 6/16/2008, Gleason downgraded 4+3=7, T3a N0MX, focal extraprostatic extension, two small positive margins

PSA undetectable for 8 months, then 2/6/2009-0.10, 4/26/2009-0.17, 5/22/2009-0.20, 6/11/2009-0.27

Salvage IMRT + 6 Months ADT: Casodex started 6/12/2009, Lupron 6/22/2009, PSA 6/25/2009-0.1, T=516, 7/23/2009-<0.05, T<10, IMRT to start mid-Aug


Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 9/16/2009 7:13 AM (GMT -6)   
Great quote from a doctor about what's wrong with our (the U.S.) current health care system...and what's not.

"One real problem is that we somehow need to separate the two issues within the "health care argument. That is, the business of U.S. health care is catastrophically broken. However, the sophistication and quality of U.S. health care is high and continually improving. We somehow need to focus on the the former and fix this issue of how we pay for health care in America, while improving on the great quality."
Husband diagnosed in 2/2008 at age 57 with stage T1c. Robotic surgery performed 3/2008. Stage upgraded to T3a due to minuscule extraprostectic extension in posterior left. Margins, bladder neck and SV clean. Gleason 3+4 (no change from biopsy). PSA of 0.0 every 3 months since surgery. In August 2009, PSA reading of 0.1 - urologist will retest in 4 weeks. Hoping this is a blip. Incontinence good to excellent but still having issues with leakage. ED is a work in progress (with the help of Viagra).


lifeguyd
Veteran Member


Date Joined Jul 2006
Total Posts : 686
   Posted 9/16/2009 7:54 PM (GMT -6)   
Sephie said...
Great quote from a doctor about what's wrong with our (the U.S.) current health care system...and what's not.

"One real problem is that we somehow need to separate the two issues within the "health care argument. That is, the business of U.S. health care is catastrophically broken. However, the sophistication and quality of U.S. health care is high and continually improving. We somehow need to focus on the the former and fix this issue of how we pay for health care in America, while improving on the great quality."

Excellent quote, this is the fact that the opponents of healthcare reform refuse to acknowledge.  Without a better way of paying for our healthcare we will destroy our economy.  I think the opponents have a few good points, but they lose me completlely when their arguments are filled with paranoia about illegal immigrants and socialized medicine.
 
We need to fix the way we deliver medicine so that everyone can afford it.  It's that simple.
PSA up to 4.7 July 2006 , nodule noted during DRE
Biopsy 10/16/06 ,stageT2A
Very Aggressive Gleason 4+4=8  right side
DaVinci Surgery  January 2007
Post op confirms gleason 4+4=8 with no extension or invasion
no long term continence problems
Post surgery PSA continues to be "undetectable"
One side nerves spared
Bi-Mix for ED 
born in 1941


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4268
   Posted 9/16/2009 8:55 PM (GMT -6)   
No one has addressed how technology has added to the increase in medical costs. Sofisticated drugs to treat cancer and alieviate side affects from chemo are very expensive. New machines like robotics, MRIs and Proton cost money ($100 million for a proton machine); it's got to be a few million for a robot.
I think it is pie in the sky to think that we can reduce medical costs as long as technology keeps driving it. How many on this site chose robotic even though the cost was more?
Treatments for pancreatic cancer costs hundreds of thousands of dollars even though the life expentancy is less than 5 years. These are tough questions and as long as these expensive treatments are available people will demand them.
JT

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.

2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G7, 4+3, approx 16mmX18mm.

Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.

25 treatments of IMRT 6 weeks after seed implants. No side affects at all.

PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.

JohnT


Mavica
Regular Member


Date Joined Jun 2008
Total Posts : 407
   Posted 9/17/2009 9:24 AM (GMT -6)   
Maybe the most relevant quote from the linked article - given the headline for this particular topic:
 
"If enacted as scheduled on Jan. 1, 2010, policy changes recommended by the federal Centers for Medicare and Medicaid Services (CMS) -- the government's insurer for the elderly and disabled -- will severely cut current Medicare reimbursements to cardiologists and oncologists for critical care services that are provided to patients in physicians' offices or other out-of-hospital setting, such as chemotherapy to treat cancer, and various cardiac procedures to monitor and treat heart disease, such as nuclear imaging and heart catheterization. " (emphasis added).
 
It's the reimbursement/payment for out-of-hospital settings that may be adjusted, not all such care - across the board, but odd-ball websites such as the one to which is linked seems to me to be engaged in the "let's scare 'em" game.

Age:  60 (58 at diagnosis - June, 2008)

April '08 PSA 4.8 ("free PSA" 7.9), up from 3.5 year prior

June '08 had biopsy, 2 days later told results positive but in less than 1% of sample

Gleason's 3+3=6

Developed sepsis 2 days post-biopsy, seriously ill in hospital for 3 days

Dr. recommended robotic removal using da Vinci

Surgery 9/10/08

Northwestern Memorial Hospital, Chicago, IL

Dr. Robert Nadler, Urologist/Surgeon

Post-op Gleason's:  3+3, Tertiary 4

Margins:  Free

Bladder & Urethral:  Free

Seminal vesicles:  Not involved

Lymphatic/Vascular Invasion:  Not involved

Tumor:  T2c; Location:  Bilateral; Volume:  20%

Catheter:  Removed 12-days after surgery

Incontinent:  Yes (1/2 light pads per day)

Combination of Cialis and MUSE (alprostadil) three times weekly started 9-27-08

Returned to work 9-29-08 (18-19 days post-op)

PSA test result, post-op, 10/08: 0.0; 12/08: 0.0; 4/09: 0.0; 9/09: 0.0

 

New Topic Post Reply Printable Version
Forum Information
Currently it is Friday, September 21, 2018 3:24 AM (GMT -6)
There are a total of 3,005,365 posts in 329,228 threads.
View Active Threads


Who's Online
This forum has 161774 registered members. Please welcome our newest member, Audreyli.
232 Guest(s), 2 Registered Member(s) are currently online.  Details
bluelyme, fdgdfhdff8801