Prostate cancer treatment delay.

Over the years of having prostate cancer and dealing with appointments, I have found that nothing moves very fast. It is what it is and you have to accept it. If you go to any physician and pay attention, you'll find that it's that way in the whole medical field. There's a shortage of doctors and more patients that need help so everything backs up. Your Gleason score doesn't indicate that you have a very aggressive cancer type. I would suggest having a talk with your urologist and oncologist and get a idea of your prospective treatment plan. Good luck!

I waited some 2-months from diagnosis to RARP and I was anxious that that was too long. However, I had PET scan (to find any spread) and DEXA (bone density) during that time.
If you're on track for the next step in 2-weeks it would seem foolish to upset that. But a good second opinion as soon as you can get it may help guide you better to stay on the slow track or kick things into high gear.
Prostate cancer isn't to be taken lightly. It can turn aggressive when one least expects it.
Good luck and put up your best fight - wherever that leads you.

I had almost the same diagnosis and BC/BS refused to pay for PET scan. I wanted it sooner so I shelled out $7600 for it.
Fortunate to have the funds but this was my LIFE and I’ve paid a lot more for ‘things’ which were totally trivial and unimportant. Hopefully the delay in your treatment has no effect on your outcome.

At age 58, I started with my original PSA test (14.7) in April 2023, to the official diagnosis in December 2023. In that time, I had the DRE, an MRI and a biopsy before I finally got the call. In January 2024 I had a Decipher test and a PMSA PET scan. My treatment plan kicked off on Feb. 14 (Valentine's Day) with a six month course of Eligard. I had fiducial markers and Space Oar implanted in April 2024. I completed five rads of SBRT (TrueBeam STX) in May 2024. My first follow up in August was a PSA of 0.17. I have my next followup in December along with a testosterone test in December. I'm recovering my strength and muscle mass, but my body still has issues with regulating its temp at times, but those are brief occurrences.

My main takeaways are: 1. You need to advocate for yourself at nearly every step. My urologist naturally recommended surgery within a few days of my diagnosis, but I opted for radiation; 2. Insurance companies will deny some things like my Decipher test at first, but my financial navigator at the cancer center was amazing and obtained coverage faster and more readily than I could have on my own; 3. The fight is never over until I say it is.

Fight on warrior, we're here for you.

Was your insurer hoping you'd proceed with a cheaper contrast agent than PSMA? 16 weeks is egregious. No delay with Original Medicare. If you are on an Advantage Plan, you might think about change plans according to what your oncologist thinks about future medications and treatments.
Though it could be a problem with your oncology office.
If you agree to ADT, you might wait another two months before treatment.
It may be the worst damage is the anxiety of this time of waiting. Because sadly prostate cancer is usually whole organ treatment. The possibility of metastasis and of biochemical recurrence with seminal vessicle invasion should have expedited your request.
If you are planning on radiation you should schedule appointments now with several radiation oncologists because of the various ways radiation is administered.
Best wishes
approval.

Yes it can spread and get worse after 6 months. A Gleason 7 (4+3) is somewhat aggressive but does grow slower than a higher score. The fact you had seminal vesicle invasion means that it has gotten out of the prostate so it could spread to lymph nodes or other areas.

Hopefully your pet scan will show it hasn’t spread.

Another issue is that the Gleason score is based on a small sample of prostate tissue. Many people find the score is higher if the prostate is removed and tested. That happened to me and many other people I know.

Your best bet is to just get moving as fast as possible on testing and treating. Right after the PSMA pet test you should try to get on ADT, which will stop the cancer from growing and spreading.

Ken Porter,
I think 6 months from diagnosis is pretty standard and probably won't adversely affect your outcome, although with the seminal vesicle invasion, you want to move quickly. I started on ADT four months post biopsy because my urologist and radiation oncologist seemed to be moving slowly to me. I waited 3 weeks just to discuss my biopsy results with my urologist because he was "really busy." Best of luck and try not to dwell on the issue. But get the team cracking as best you can!

When your situation is critical, healthcare systems can move quickly. I was 2½ days from spotting the metastasised spinal tumour on MRI to surgery. A week or two after that to starting ADT and Erleada, and a couple more weeks to my first radiation (I needed to heal a bit from the surgery first).

That rush meant that other patients were certainly getting bumped down the queue. I am truly sorry for that, and for the stress it must have caused them. But sometimes it can be a good sign when you're not top priority, even if it feels frustrating at the time. 😕

I was diagnosed with 3 + 4 in early April and because of personal reasons waited until September 24th to start treatments. No harm done but every person and situation is different. Since you have already waited you just have to stop worrying about it and remember that YOU are your best and only health advocate going forward.

I had RALP with Gleason 4+3 & seminal vesicle invasion, negative report on 13 lymph nodes removed, April of '23. Subsequent PSAs have all been less that 0.02 ("undetectable"). So radiation has so far not been considered for me. I assume your PSA has been elevated or there is some other reason (e.g., positive lymph nodes, strong suspicion that all the cancer on the margins was not removed) the doctors want to consider radiation for you? Even in those situations, it seems to me the PSA is the determining factor. If it's not elevated, why blindly shoot with radiation?