Has anyone had a PET-MRI Axumin scan?

[SpenceNYC]

14 months after surgery my PSA went from .01 to .036. My oncologist recommended this test, which was approved by the FDA in 2017. Axumin is a tracer that can detect prostate cancer. My insurance company, Oxford/United Health Care, is refusing to pay for it. Wondering if anyone else has experience with this.

[Tall_Allen]

Axumin is only approved for a biochemical recurrence (PSA confirmed over 0.2 for you) after treatment. It will not detect anything at your low PSA. That is why your insurance turns you down - they are right to.

There are only about a dozen places in the world where you can get a PET/MRI rather than a PET/CT.

[dale112]

I had the Pet-MRI Axumin scan done. I am thankful for this new type of prostate cancer detection. My urologist told me that the PSA test, which was going from .01 to .04, then to 0.4 indicates that the cancer has returned for a third time. He scheduled me for this type of MRI. It showed no cancer. Clean bill of health. I think without this Pet-MRI Axumin scan, I would be on some type of hormone therapy. As for my insurance, it paid for everything. Do hope that you can get your insurance to pay for it, and get the answers you need. Best of luck to you.

[dale112 in reply to dale112]

Sorry misspoke. Was a Pet-CT Axumin scan, not PET-MRI Axumin scan.

[SpenceNYC in reply to dale112]

Thank you for your reply. As Tall Allen said above, in my case the test was probably disallowed because my PSA is still low. Glad things worked out for you!

[ArtBR8 in reply to SpenceNYC]

There Should not be a PSA level threshold specified by insurance. As long as you have had prior therapy for PCA, and now the physician suspects recurrence due to some elevation in your PSA, then this falls wholly within the indication of Axumin. Go to axumin.com for more details.

[SpenceNYC in reply to ArtBR8]

Thank-you very much. I am submitting an appeal to the decision, so we'll see.