Need help asap

[Pops78]

Changed doctors but at same place. Had ct scan and bone scan in June, MRI with coil and probe in July, many labs, all at this place but the new MO wants more scans before seeing him. Had one Degarelix just before the MRI and a surgical castration since. Seems like after each test, his dementia is worse. Should I ask he wait on the scans until a treatment is in place?

[Tall_Allen]

What is his current diagnosis? How many metastases? Where?

[Pops78 in reply to Tall_Allen]

Stage 4 with mets to bone. From biopsy.....PROSTATIC ADENOCARCINOMA, GLEASON SCORE 7 (3+4), GRADE GROUP 2, WITH 10% GLEASON PATTERN 4, 2.5 MM FOCUS. This is from MRI......Bone lesions: Multiple T1 hypointense lesions are present of the left femur, bilateral ilium, and sacrum, in keeping with metastases. The large left sacral metastasis extends into the left S1 and S2 neural foramina. Is that what you asked? New to all this.

[Tall_Allen in reply to Pops78]

Yes, that helps. So he needs a follow-up scan to determine whether those lesions on the MRI are indeed from prostate cancer. If they are, the castration will shrink them. Alternatively, he could have a bone biopsy, but that is more intrusive.

If all of those are metastases, he will need more than the castration. The advanced hormone therapies that are approved are abiraterone, enzalutamide or apalutamide. But because of his dementia, there is a different hormonal medicine called darolutamide (Nubeqa) that may be preferable because it doesn't get to the brain. He will have to convince insurance to pay for it off label.

[Pops78 in reply to Tall_Allen]

Thank you so much. Are these meds given at the facility (MDAcc) or are they scripts? We don't have coverage for out of plan A or B (no plan D) so will be paying out of pocket anyway.

[Tall_Allen in reply to Pops78]

They are all pills by prescription. Very expensive. Nubeqa costs $12,000/mo on GoodRx.

[MateoBeach]

You will need to contact the patient financial assistance dept for Nubeqa at Bayer. Letter from your doctor explaining these circumstances will help.nubeqa-us.com

[j-o-h-n]

As we age memory is no longer memory.... Give your Pops lots of love and conversation...God Bless him.....

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 08/31/2021 7:15 PM DST