SRT Protocols?

[Ralph1966]

I have problem with my PPO insurance as they partially approved my SRT treatment at "USC Noris cancer center" so I have to pay the "facility fees".

The Blue Shield California said that the same treatment is available at Adventist Health Glendale, and regarding my 6 months Firmagone injections they said they will cover all expenses 100% if I do the whole thing at the local hospital AH Glendale cancer center, otherwise, I have to pay thousands of dollars.

The local MO (not the one who is f/u with me at USC Noris) but he saw me once in 2017 before my RRP surgery said they have a new Radiation therapy equipment received just a few months ago with qualified RO and also he said that SRT protocol is the same everywhere nationwide so I don't have to worry about the machines or the way they will treat the prostate bed with radiation.

Any thoughts?

I am still waiting for the appeal of radiation therapy (SRT) but I can't wait for Firmagon first injection (240 mg), because my last PSA 05/20/2019 was 0.11 ng/mL and I read that nowadays they start SRT for Gleason 9 (4+5) even earlier than 0.10 ng/mL

My PSA will be perhaps 0.15 ng/mL next week, so I am so worried about my treatment delay!

[Fairwind]

Read the fine print in your insurance policy. If you must use "in network" facilities for treatment, you must play by their rules..get the Firmagone shot where they want you to.. Ask your in network RO if the LINAC he will treat you on is a Varien Rapid-Arc or newer. If it's an older machine, tell your insurance company you want to be treated with modern, up to date equipment..The new equipment is MUCH better than the older machines. More accurate dose delivery, less damage to healthy tissue...

[cesanon in reply to Fairwind]

Wow, nice advice. Where/How did you learn about the equipment?

[AlanMeyer]

A firmagon injection should be the same anywhere. It's made in the same factory and should have the same effect whether injected by USC or by the local people. I would schedule it ASAP at the local hospital. It will only take a few minutes to give you the injection so ask them if they can schedule it in without delay to stop the growth of your cancer while you are waiting for radiation therapy.

As for the radiation equipment, Fairwind knows more than I do and I defer to his judgment. As for the doctor however I think it is a good idea to meet with the local radiation oncologist, talk to him honestly, and try to form some opinion of him. Ask him all your questions about the radiation dosage and targeting. Is he thinking about your specific situation seriously and not planning a slam bang off the shelf treatment that he gives to everyone? Does he sound honest and knowledgeable? Does he listen to your concerns and do his best to answer them? Does he give you a reasonable amount of time? Or does he brush you off with thoughtless answers and push you out the door after a short meeting? In short, does he seem like a trustworthy and dependable person?

My radiation treatment was planned by a radiation oncologist but administered by technicians. The technicians in a local hospital can often be very good - people who live in the community, treat their patients as neighbors, and and are proud of their work. USC is a great institution with a great reputation as a cancer research and treatment center, but local people can also be excellent. Give them a visit as soon as you can and see what you think.

I'm hoping that the firmagon will totally stop the advance of your cancer and knock it down for a significant time. That will give you a breathing space to work out the other problems.

Best of luck.

Alan