I had my meeting with my Radiation Oncologist (RO) to discuss my treatment plan now since I had the recurrence cancer after surgery with PSA 0.8. He had me meet him in his examining room, instead of his office so he could sit next to me and my wife. I thought that was unusual because I even asked if he was going to exam me. He said no but he had some important information to tell me. He said we are not going to start radiation treatment right now because he thinks my aggressive cancer is outside the prostate area. I said what made you believe that and he said he reviewed some early CT's that were done before and after my PR surgery and he noticed some changes in my lymph nodes outside my prostate area but directly above in the retro-peritoneal space in the abdominal cavity. That is when he started to mention doing more scans and the one you mentioned, 68 Gallium PSMA PET and a Axumin PET scan - tracer to find the cancer. The bad news is these are not covered by private insurance but covered by Medicaid Insurance if 65 years old or older.....I am 61. So I asked how much these are and he said $6,000. When the surgeon removed my prostate he also removed 22 lymph nodes that surrounded the prostate that looked and felt unusual. The results were: 6/14/18 - Robot assisted laparoscopic radical prostatectomy and bilateral pelvic lymphadenectomy - Gleason 4 + 3 prostate cancer with tertiary 5; acinar type - extracapuslar extension; + lymphovascular invasion; no seminal vesicle invasion; negative surgical margins; 22 negative lymph nodes. Question: What does that + lymphovascular invasion mean??
I am getting another CT on Thursday of my chest, abdomen and pelvis area PO + IV contrast at a Johns Hopkins Imaging Center which I had been at before. They are going to be looking at changes in the suspected area since we will have a 4 month period to review. I also was given another doctors name at Johns Hopkins Oncology dept. that might be able to get me into a clinical trials for this specialized scan and save me a lot of headaches and costs. I meet with them on October 3. I also will be checking my PSA reading again later today or tomorrow for my next readings. The doctor was surprised that I knew about that scan and said you have been doing your homework. He also wasn't afraid or offended that I was getting a second opinion to help me at the Johns Hopkins Oncology dept. He said he has sent patients to them before and that me feel better as well. Can anyone see any major issues that I should be concerned with in the above information?