Northern California HIFU: In October... - Prostate Cancer N...

Prostate Cancer Network

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Northern California HIFU

Smallfall profile image
20 Replies

In October, 2017, I was dx'ed with moderate risk prostate cancer. The biopsy, done in Mazatlan, Mx, showed Gleason 3+4; with 18 cores, none on the right side were positive and 6 of 9 on the left side were positive; my PSA was 10.3. The only tx available in Mazatlan was RP, and would cost $5-7000 out of pocket. After researching the options, I contacted Dr. Michael Lazar at California HIFU, in Santa Rosa, about HIFU. He looked at my biopsy and pathology reports and felt HIFU would be an option. Because of insurance complications I couldn't do anything until July 1, 2018. I switched to a vegan diet with fish to deter cancer growth and waited. Dr. Lazar requested a mp MRI and I had it done on July 13. It showed the cancer still only on the left side but bulging toward the nerve bundle. Dr. Lazar wasn't sure if he would need to ablate the bundle or not. I had the HIFU done at the San Francisco Surgery Center on 7/26. I am happy to say the outcomes have exceeded my expectations; catheter for 7 days, then mostly continent from there, minor ED problems. Dr. Lazar said the HIFU, "encroached" on the bundle but most of it was untouched; and the right bundle was untouched. I have nothing but positives to say about Dr. Lazar, and about HIFU. With Medicare, it will end up costing me about $10,000 out of pocket, but certainly worth it to me and my wife.

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Smallfall profile image
Smallfall
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20 Replies
AlanMeyer profile image
AlanMeyerModerator

I'm glad the procedure went well. Let us know what you find on your first post-HIFU PSA test.

Alan

Smallfall profile image
Smallfall in reply toAlanMeyer

Will do. I asked Dr. Lazar what to expect for PSA with 1/2 prostate; he said it should bottom out within normal limits within the next 3-6 months, and then not go up, the last part is more important than the bottom numbers.

AlanMeyer profile image
AlanMeyerModerator in reply toSmallfall

From what I have read, HIFU is one of the very few treatments that can be repeated if the first treatment is not successful in stopping the cancer. Hopefully, you won't need that, but if you do it's a possibility.

Smallfall profile image
Smallfall in reply toAlanMeyer

Thank you Alan.

Dr Lazar performed my HIFU surgery in Oct 2016. Medicare / insurance did not cover it at all at that time so it was $25K out of pocket for me. Glad that insurance is now covering it. I've had good results so far.

Smallfall profile image
Smallfall in reply to

Sorry about the extra expense, but glad for your results.

in reply toSmallfall

I was able to recoup a decent portion of that through the medical expense deduction. Luckily, I had enough income and taxes withheld that year to get a nice refund.

rf3rf3 profile image
rf3rf3 in reply to

what was your 3 month/6 month PSA? after my HIFU my PSA dropped from 8 to 1.2 at 2 months but is up to 2.1 at 3 months. Doc says to wait a bit but i’m not sure i want to wait another 3 months to see....

in reply torf3rf3

After allowing for the six month eligard effect to wear off I was undetectable for 9 months. Then PSA was 0.1 May '18, 0.2 June '18, 0.3 Sept '18. Local urologist not very concerned but I am wondering if it is time to consult with Mayo here in Phoenix.

Smallfall profile image
Smallfall in reply torf3rf3

I just got my 3 month PSA; with half of my prostate "ablated", my PSA went from 9+ to 2.76.

in reply toSmallfall

Although the tumor was confined to only one half of the prostate (5 of 12 cores) I had the 'whole gland' ablation. Not sure what to think of the PSA creeping up. Not many urologists have experience with HIFU so I'm not sure how I am doing PSA-wise. Not undetectable any more and that's a concern.

Smallfall profile image
Smallfall in reply to

You're right, there isn't a lot of common knowledge about HIFU. I've found that when I am really concerned, it is helpful to consult with another "expert"; going to the Mayo Clinic may help you decide on a path. Good luck.

Londear1992 profile image
Londear1992

Hello, Smallfall. Just wondering if your Medicare supplement paid for any of your costs? If so, which insurance company are you with. Thanks so much

Smallfall profile image
Smallfall in reply toLondear1992

Hello, I have straight Medicare. They paid 80% of the facility cost, which was billed at $6000.

Londear1992 profile image
Londear1992 in reply toSmallfall

Thanks so much. We are planning to have HIFU outside the US and for that we know Medicare will not cover the costs, but we wondered if any of the insurance companies folks have for their Medicare supplement might cover anything. I could call them directly but not sure how helpful they would be. So glad to hear your PSA was stable at 6 months - a good sign for sure!

Smallfall profile image
Smallfall in reply toLondear1992

Thank you. I heard there was at least one insurance company that covered some of the cost, but don't remember who. Before I had mine done in Cali I checked with the HIFU clinic in Puerto Vallarta, who have been doing HIFU for a long time; they wanted $16000 usd.

Londear1992 profile image
Londear1992 in reply toSmallfall

Thanks! We plan to go to Germany where the doctor has been providing HIFU treatments for 22 years and has a good track record. The cost for TURP, if he recommends it beforehand, is about $5,600 and the HIFU is around $6,000 (depending on the exchange rate.) He does both on the same day if needed. It is cheaper than $25,000 (which seems to be the going rate in Canada and USA) but if our private insurance would cover any of it, it would be good to know. I will try to call and ask them, but I think they usually say to submit the claim and see.

So glad this has worked for you. It is inspirational for sure to hear how things worked out for others.

Smallfall profile image
Smallfall in reply toLondear1992

You might check with the clinic in Germany to see if they have had any success billing your company. If not, you can still get a great trip to Germany for what you're saving in HIFU cost. Best of luck to you!!

Londear1992 profile image
Londear1992 in reply toSmallfall

Thanks so much. Yes, it will be Easter in the Alps for us (hope we can enjoy it a bit!) And thank goodness for the air miles - they will help for sure. All the best for your continued success!

Smallfall profile image
Smallfall

PS: My 6 month PSA was basically the same as the 3 month, 2.63. Dr. Lazar said that was a good thing.

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