This conversation rang a bell for me, as I recall a conversation with my Uro (the one that diagnosed me and was predisposed to Cyberknife
After diagnosis, I met with him to discuss my options. When I brought up BRachy, he told me that hardly anyone in the Long Island area does Brachy anymore., in fact he only knew of one Dr.
I pressed and asked why that is the case, son em ve seen studies showing really good data. His response was pretty much these words... "As embarrassed as I am to say this, as a medical professional, a big reason is that the reimbursement rates are so much lower than other treatments."
Rising PSA from 2008 through April 2013
PSA 2008 - 2012 .7 TO 2.2
Dec 2012 - Biopsy, 14 core, nO PCA, one core HGPIN
4/13 PSA 2.8, FPsa 11, PCA3 13, 10/13 PSA2.7 fPSA 15
4/14 PSA 3.1 fPsa 16, 10/14 PSA 4.3 fPSA 12 PCA3 26
11/14 BX 3/12 cores + G610%, G6 20%, 3+5=8, 70%
2nd opinion Johns Hopkins, all G6 10%, 20% 80%
3rd opinion MSKCC all G6 10%, 15%, 70%
RALP scheduled January 6th 2014
Final pathology stage pT2c, upstaged to Gleason 7 (3+4)
ECE, Margins, SV, Lymph nodes (9) all negative, PNI present.
5% involvement of Prostate by tumor.
My story, at tinyurl.com/qgyu3xq