Good Radiology near Northeastern California?

[Smallfall]

In 2018, with a Gleason score of 3+4, and cancer on the left side of the prostate only, I opted for HIFU of the left side. All went well until about 9 months out, then my PSA began climbing, and has continued to climb. I had a biopsy done in Reno, Nv last week. Out of 12 cores, 8 were 3+4, 1 was 4+3, and 1 was 4+4, spread throughout the left and right sides. I have a CT scan of the abdomen and pelvis scheduled in a little over a week. This scan last year was clear. After research and consulting this site, it looks like salvage radiation is the best option for me; the Urologist in Reno also favors radiation with, "1 or 2 years of ADT". I haven't been able to find much info on Reno radiation expertise. In northern Cali, it looks like UCSF would be a good option, and I could travel to UCLA or another So Cal location if it were the best option. I'm hoping to start treatment sooner rather than later. I would appreciate any suggestions you can offer. I have Medicare only, but I'm able to pay additional out-of-pocket supplement.

[Tall_Allen]

If you can be treated in San Diego, Don Fuller has been doing salvage SBRT (5 treatments) after radiation failure, but he can probably do salvage SBRT after HIFU failure too. Worth a call.

prostatecancer.news/2016/08...

The other option is whole gland salvage high dose rate brachytherapy. Joe Hsu at UCSF can do this.

I think it is a good idea to get a PET/CT to rule out distant metastases. I don't know if Medicare will approve an Axumin PET/CT after HIFU. If not, and you can afford it, UCSF is allowing patients to pay for a PSMA PET scan.

[Smallfall in reply to Tall_Allen]

Thanks T Allen, this gives me some good info to follow-up on.

[Smallfall in reply to Tall_Allen]

I just talked with Don Fuller's office; he does do salvage RT after HIFU failure.

[Tall_Allen in reply to Smallfall]

Great!

[Hidden]

You’re thinking clearly by wanting to start sooner than later . I like the plan . Imrt and double adt including Lupron helped me into remission for over four years now . Sounds like you have options. That is good . You Will do what Is best for you . You can limit your fall by staying Positive and living healthier than ever before . I grew up in nor cal . I can imagine that there are many fine Doctors and facilities ., UCSF we’ve always liked . You’ll figure this all out soon . Then there’s no looking back . It about curing yourself and getting back doing things that you love again . Please stay in touch . A lot of helpers here . Take care

[Smallfall in reply to Hidden]

Thanks for the encouragement, p.

[timotur]

SF: it would be worth your time to talk to Dr Chang at UCLA for HDR-BRACHY. He did mine last year for stage t3b G7(3+4) with excellent results (see profile).

[Smallfall in reply to timotur]

Thanks, I'll look into this.