PSMA scan

[runtrails]

Insurance denied my test, again, even after showing, as requested, rising PSA post surgery (.64 at 90 days after RALP then .9 after another 4 weeks). Then when RO called them, 3 days in a row, they say they are having computer issues. Ugh. Wondering if I should be patient in the appeal or start the prescribed Casodex and subsequent Lupron. Apparently even on approval it can take 6 to 8 weeks to get it done

[runtrails]

Thanks. I did tell my RO I can easily go anywhere in USA..so hopefully that will help.

[Tall_Allen]

ADT may increase your PSMA for about a month, so you can start while you appeal. 6-8 weeks is a lot - where are you located?

[runtrails in reply to Tall_Allen]

Olympia washington

[Tall_Allen in reply to runtrails]

Closest Pylarify is available at:

1. Madigan Army Medical Center

9040A Jackson Ave,

Tacoma, WA 98431

2. TACOMA RADIOLOGICAL ASSOCIATES

2502 South Union Ave,

Tacoma, WA 98405

3. Sound Cancer Care, pllc

2940 S. Meridian,

Suite 100

Puyallup, WA 98373

[runtrails in reply to Tall_Allen]

Thank you..Il fly to phoenix, Denver, Boston, wherever..if that improved getting approval or time. But Tacoma is good. Its close. Fingers crossed Onco gets somewhere with it this coming week.

[Tall_Allen in reply to runtrails]

I’ve never heard of delays getting the scan if your insurance approves it. Who told you that there’s a delay?

[runtrails in reply to Tall_Allen]

RO..based on recent patients I think. We are having a lot of hospital and related staffing shortages in PNW. My wife works in one of the hospitals amd seems to be in all areas. My urolgist moved away to out of network and to get a new apt at another doctor in same clinic was 3 months

[Shooter1]

SCCA Seattle has it all. Also their house is only $82 per night..... I go their when local area doesn't have what I need... North Idaho- 30mi from Canada.

[Hidden]

I remember my urologist mentioning that insurance required 3 rising PSA readings before they would approve my Axumin scan, which they did.

[maley2711]

also rreasonably close to Seattle and Portland clinics.

[leebeth]

My husband had his first PSMA scan last December. It was ordered on 12/13, approved 12/16, and he had the scan on 12/17. I had it scheduled already for the 17th and I was a very squeaky wheel with insurance company. I knew that with the holidays coming, we need to make some decisions.

Subsequent scans have been scheduled in advance. He gets them every 12 weeks now that he is on Pluvicto.

[SeosamhM in reply to leebeth]

Hi, leebeth. Can you answer some quick questions? I am entering the Pluvicto process and was wondering how far along your husband's treatment is now (I have been told 6 treatments at 6 weeks = 36 weeks). Did he start soon after the first PSMA? How far along in the treatment is he now, and what side effects (and their intensity) should I prepare for? I've had Taxotere - the Pluvicto side effect "menu" is familiar, and only the isolation after infusion seems unique. Thanks! - Joe M.

[leebeth in reply to SeosamhM]

I am happy to answer any questions you may have.

His first PSMA scan was December 2021. We tried to get him in the expanded use trials but Novartis had halted it, due to supply issues. Therefore he had 8 cycles of Jevtana/carboplatin, while we were waiting for availability. This took him to mid-June. PSMA scans in July showed new PSMA avid lesions so they began the process of getting him started on Pluvicto. His first treatment was mid August and second was last week. He has had no side effects whatsoever, and feels great! His last treatment is in March with scans in April.

It felt really good to have those dates locked in the calendar, for planning and just for the psychological thought that they planned he would still be here, if that makes sense.

[SeosamhM in reply to leebeth]

Thanks, LB! This makes sense - while my PSMA is scheduled for mid-October, I've been told Pluvicto supplies are tight and may take awhile. Was the J/C chemo run explicitly offered as a bridge therapy? It seems like a good use of time if Pluvicto is not available for several months.

Re: "...just for the psychological thought...", um, thought :), I understand completely! It's tough to get my mind around whether any specific treatment (other than, blech, ADT) is somehow "last ditch" instead of just another gateway to life! I may reach out to you via chat if I have further questions - is that okay? Thanks again! - jm

[leebeth in reply to SeosamhM]

of course you can reach out! Yes, the chemo was bridge/trying to keep him in ok shape for Pluvicto. He tolerated chemo very well. Better than I do!

[MateoBeach]

You do indeed need that PSMA PET scan to determine if prostate bed and full pelvic SRT is futile or possibly curative. Be aggressive (squeaky +) . OK to start ADT during planning phase, but confirm with your RO.

[maggiedrum]

I had my PSMA scan done at SCCA in Seattle. No problem with insurance approval at all. But I am a couple of years post radical prostatectomy and my PSA is much much higher. Just a wild thought - you insurance company may not consider you PSA high enough to warrant a PSMA scan. I don't think location would have anything to do with an insurance approval. It definitely has a lot to do with the specific insurance company and your plan with them. I have an oncologist made the recommendation for the scan. It may also depend on the specific doctor or specialty who recommended the scan but have no basis for wondering if that might be an issue. The doctor would definitely be your advocate for the scan appeal. Without his/her support you will not have good odds. And, you have to follow to the letter then appeal process. They are very picky about that.

[Gl448]

I share your frustration. It took 5 weeks to get Axumin PET scan for me here in the suburbs of Los Angeles. Insurance approval was like a week, then stupid bureaucracy at the center. I was originally supposed to get a scan at (the imaging center needs corporate approval for pet scans, which takes 7 to 10 business days.). Then add another 2 - 3 weeks because the imaging centers insurance allowed just don’t have that much capacity.

I was like you at one point, willing to go anywhere, and even pay out of pocket just to get the darn thing done sooner. Good luck!