Medical Tourism vs Us Standard Care- RRP- wife relates experience

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Robin Bertorelli
New Member


Date Joined Sep 2009
Total Posts : 3
   Posted 9/16/2009 9:19 AM (GMT -6)   
I write this as the wife of a recovering prostate cancer patient. Early this year, at the age of 50, my husband Robert’s annual check up showed that he was in great health, except for an elevated PSA of 4.95. Subsequent visits to the urologist, and 12 biopsies followed. The results of the biopsies were that 7 out of 12 samples showed sign of prostate cancer. We were stunned. However our doctor reassured us since they had caught it early, Robert’s chances were good. However our surprise turned to panic because Robert lost his job last year, and with it, went our health insurance. We could not imagine paying for something like this. Of course there was no choice, I wanted to Robert to get better. Our primary care doctor advised us that to go with robotic surgery. They recommended a surgeon in CT, but we knew he would be expensive. I had heard from friends who had gone overseas for plastic surgery and that other procedures were pretty cheap outside of the States. So I started researching this option.

Then I came across this article: www.marketwire.com/press-release/RoboticoncologyCom-1044300.html. It made a lot of sense to me. We could not gamble with my husband’s life, no matter the cost. I appreciated the viewpoint from the doctor in the article, Dr. David Samadi, from Mt. Sinai in NY. He even mentioned in the article that many hospitals work out financial details and payment options with you. I figured it this way. We financed our house, our cars and Robert’s life was much more valuable than any of that. In the end, we did go with the surgeon in CT, and was thankful we did. Had I read this article before our decision, we would have decided even sooner to get him treated in the States.
Robin Bertorelli
Middletown, CT

Robin, I added a Subject to your post, so people can know what it relates to.

Post Edited By Moderator (James C.) : 9/16/2009 9:36:06 AM (GMT-6)


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 9/16/2009 9:38 AM (GMT -6)   
Robin, Welcome to HW and the Forum. Thanks for the post and the subject you discussed. That issue has been a hot topic here in the past, involving other treatments, so your story is interesting, especially with the decision you and your husband came to. Thanks
James C. Age 62
Co-Moderator- Prostate Cancer Forum
4/07 PSA 7.6, referred to Urologist, recheck 6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS 3/3=6
9/07 Nerve sparing open RRP 110gms.- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
24 mts: PSA's: .04 each test since surgery


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 9/16/2009 9:41 AM (GMT -6)   
Hi Robin,
Dr. Samadi makes some great points that I have been aware of in the discussion of taking risk by flying to foreign countries for medical care. It's just not great advice to do it. And you are correct, most hospitals and practices can work out a payment schedule for the uninsured. It is terrible to have to go through this disease without coverage. And for some in this recession, they don't have jobs to make payments anyway.

You did very well on your research. How is your husband doing?

Tony
 Age 47 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Gleason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (May 11, 2009): <0.1
 
My Journal is at Tony's Blog  
 
STAY POSITIVE!


Robin Bertorelli
New Member


Date Joined Sep 2009
Total Posts : 3
   Posted 9/16/2009 10:16 AM (GMT -6)   
He is great! Thanks for asking! His PSA levels have been zero ever since, which is what we were promised. He's had no side effects and he's healthier than ever!

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 9/16/2009 11:06 AM (GMT -6)   
Robin, welcome, and I am glad your husband is doing so very well, that is what we all want in that situation. Did the doctor really promise zeros? Just curious, that would be a risky promise to make to any patient considering the fickled nature of PCa.

David in SC
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20%, Contained in capsule, 1 pos margin
2009 PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/09 met 2 rad. oncl, 7/09 cath #6 - blockage, 8/09 2nd corr surgery, 8/9 cath #7 - out  38 days, 9/14/9 - met 3rd rad. oncl., agreed to start radiation, does not rec. HT at this time, mapping on 9/21/9


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 9/16/2009 11:32 AM (GMT -6)   
Hi Robin...and a big thanks for sharing this article with us all. It will certainly help those just entering this journey. Glad to hear your husband is doing well. Keep us posted with updates from time to time.

Take care,
You are beating back cancer, so hold your head up with dignity
 
Les
 
Age 58 at Diagnosis
Oct 2006 - PSA 2.6 - DRE Normal
May 2008 - PSA 4.6 - DRE Normal / TRUS normal
July 2008 - Biopsy 4 of 12 Positive 5 - 30% Involved Bilateral w/PNI - Gleason (3+3)6 Stage T1C
Robotic Surgery Sept 18, 2008
Pathology October 1, 2008 - Gleason 7 (3+4) Staged pT2c NO MX - Gland 50 cc
Seminal Vesicles and Lymph Nodes clear
Positive Margins Right Posterior Lobe
PSA 5 week Oct 2008 <.05
                   3 month Jan 2009 .06
                   6 month Apr 2009 .06
                   9 month Jul  2009 .08


lewvino
Regular Member


Date Joined Jul 2009
Total Posts : 384
   Posted 9/16/2009 11:48 AM (GMT -6)   
Best wishes to you and your husband and thanks for sharing that article.
Larry
Father treated for Prostate Cancer in 1997 with Proton Beam - Still doing well.
My Stats
Age at diagnosis 54, PSA 5.1
Biopsy 04/08 12 cores, 5 positive
Gleason 3 Cores at 4+3=7, 2 Cores at 3+4=7
Perineural Invasion Noted on biopsy

Robotic surgery 08/12/09 at Vanderbilt, Nashville TN. 
 
Post Surgery - Dr. Spared 100% of Nerves on the left side.
Estimated that 50 - 70% of the nerves were spared on the right side.
 
Final Path report
20% of the prostate Invovled
Tumor graded at T2C
Overall Gleason 3+4 (7)
Lymph Glands Clear
Positive Margin 1.8 cm in length Noted in Right Apex


Geebra
Regular Member


Date Joined May 2009
Total Posts : 476
   Posted 9/16/2009 1:13 PM (GMT -6)   
Welcome to HW! I am so glad that your husband is doing well.

I have a question regarding the insurance, as I might be facing similar problem. When your husband lost his job, couldn't you get the insurance through COBRA?

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


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 9/16/2009 2:25 PM (GMT -6)   
COBRA rules only cover firms with x amount of employees, state regulations vary immensely, from no coverage to 18 months. Here in SC, Blue Cross was forced to carry me for 6 months after I was laid off, and my employer generously paid for the premium, so that I was covered through the time of my surgery.
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20%, Contained in capsule, 1 pos margin
2009 PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/09 met 2 rad. oncl, 7/09 cath #6 - blockage, 8/09 2nd corr surgery, 8/9 cath #7 - out  38 days, 9/14/9 - met 3rd rad. oncl., agreed to start radiation, does not rec. HT at this time, mapping on 9/21/9


lifeguyd
Veteran Member


Date Joined Jul 2006
Total Posts : 677
   Posted 9/16/2009 6:37 PM (GMT -6)   

Thank you for a real life example of what can happen in the USA if you do not have health insurance through no fault of your own.  It cuts through the ugly political tirades and untrue claims.  We in America need to have  access to affordable health care insurance. 

I am glad that you were able to get through this time, but you should not have been forced to make that kind of decision.


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


Robin Bertorelli
New Member


Date Joined Sep 2009
Total Posts : 3
   Posted 9/17/2009 8:50 AM (GMT -6)   
Hi David

Yes we were told to expect zero to near zero levels of PSA post - surgery and so far so good. And just as stated above, we were not eligible for COBRA. But we made payment arrangements that were reasonable. To tell you the truth, I would paid any amount for this outcome so we are thrilled. Thanks all for the well wishes!
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