PSA and Medicare

[Hondo555]

I am going to MD Anderson in January for a second opinion. Gleason 3+4 =7. Path report shows perineurial invasion. My urologist said he used to do an MRI when he saw this but stopped because it was too expensive. Seemed crazy to me?? Since cancer can spread along this nerve fiber to the bones, I would like not only a MRI but also a PET scan. However, Medicare is my only insurance. I have read that they do not cover a PET scan for prostate. Anyone have experience with this?

[Tall_Allen]

There are no PET scans that are FDA approved before primary therapy, only for recurrence or advanced PC. Some surgeons like an mpMRI to help prep them for surgery, others consider it a waste of time and money -- they would do the same surgery anyway. If you are also looking at various kinds of radiation therapy, they will order a CT scan after fiducials have been placed for image guidance. Either way, you should let the doctor order whatever he needs.