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Going for Tulsa Pro
I've posted here a few times over the last year and have read most of the posts from others. I was diagnosed in January 2024 through an ultrasound biopsy (it should have been MRI guided), followed by a PSA test CT scan, MRI, and Decipher test. My cancer is not aggressive, but there are three growths in my prostate. My doctors recommended a full ablation, and I’ve decided to go with the Tulsa Procedure at UCLA with Dr. Steven Raman.
I’ve waited until now because I believe Medicare will begin covering the procedure on the 1st. of 2025. Earlier this year, I switched from a Medicare HMO plan (Blue Shield) to Original Medicare with a supplemental plan, where Medicare covers 80% and the supplemental plan pays the remaining 20%. It’s been incredibly difficult to determine whether Medicare will actually cover the procedure, as I’ve received conflicting information. However, I think they will.
I considered going back to an HMO with United Health Plans, which includes UCLA physicians as in-network, but no one could guarantee that they’d cover the procedure either.
Anyway, I thought I’d document this journey. It begins on January 5th, when I’ll check into an Airbnb hotel near the procedure location. This is two days before the procedure. I’ll have to fast those 2 days and completely empty my stomach (I’ll spare you the details). In the best-case scenario, I’ll wake up with a catheter and a “burned out” prostate. I’ll need to wear the catheter for at least two weeks. Hopefully, they'll get it all 🙂
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So had my biopsy last week. Urologist office called today. Said results were negative and have another psa in 6 months. Wife is freaking out and I’m feeling like we are being blown off. I don’t want to be a pest or hypochondriac but I’m scared maybe he missed the masses with biopsy gun. MRI showed 2 masses that were PI-RADS 5. I’m gonna load my mri results on here. What do you guys think?
MRI report 4:15:25 (MRI-report-41525-1.pdf)
That MRI report is anything BUT negative!! It shows 2 diffuse lesions PIRADS 5 abutting the capsule - you need this looked at and addressed quickly by someone else.
Not to raise the alarm, but the interpretive read of the MRI at the bottom says it all.
Phil
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2 ReactionsI agree with Phil. Get another opinion on those lesions. I hope it was a fusion guided biopsy where they targeted those lesions with extra emphasis.
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2 ReactionsWhoa!! Your wife is correct to be freaking out, no kidding. I am not a doctor, but I see numerous warning signs in that report. Highlight/copy some of those findings and add in the word prostate, then Google and see what comes up. Not to frighten you, but you need to be immediately proactive on this. Have you determined if the University of Texas Southwestern in Dallas can take you and your insurance? If you cannot do TULSA, then look at HIFU from a local provider, it is about a 1/3 less expensive, I believe. Regardless, start taking action now, don't worry, but just have resolve and move forward.
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2 ReactionsPlease do ask for second opinion about MRI findings. Since you already had biopsy maybe you can insist on having PSMA scan. Was Decipher test done on your tissue ? If not- ask for it to be done. What is your PSA and what were previous PSA results if you are on active surveillance.
Have follow up on Tuesday. Dr only wanted to repeat psa in 6 months but we insisted on a sit down. In mean time we are working on second opinion. Psa has gradually gone up but has been sitting around 5.5 for last couple years. This spring it jumped to 7.8 and they put me on doxycycline for 6 weeks and repeated psa after it was complete. Psa came back down to around 5 but he wanted to do mri. After results of mri urologist wanted to do bx. Was not mri guided but was ultrasound guided. Just scared he missed the areas of interest. I had mri little over 1 yr ago and they seen nothing of interest. I attached mri from Feb of last year. Before mri I ask urologist about psma scan and he was like, let’s just see what bx shows first. If positive we will do one. In process of getting all medical records around for second opinion. I have read that some pi-rad5’s can be benign but very rare? Thanks everyone.
MRI 2:27:24 (MRI-22724.pdf)
I see that word in your 2024 MRI "prostatitis". It can cause almost everything you have from PSA to elevated pirads. I suspect the prostatitis is the main issue, because it messes with imaging and causes all kinds of error like throwing the pirads rating into a tizzy. Doesn't mean there isn't something there, but it is likely the issue causing imaging to be all over. Doc following right path, follow psa, another biopsy later. That being said for prostatitis sometimes antibiotics help, most times not, sometimes an OTC like liquid drops of sweet wormwood (not plain wormwood) or artemisia annua but just add liquid drops to drink for a month or two, over time it helps about as much as antibiotics which is just sometimes.
AI search "artemisia annua sweet wormwood antibiotic effect"
Artemisia annua, also known as sweet wormwood, has demonstrated significant antibacterial activity, particularly against a range of bacteria and parasites.
If it wasn’t MRI guided why even bother? He had you get an MRI and then did NOT use it to do the biopsy?? Am I missing something here?
Not to beat a dead horse but you should have a transperineal biopsy which can access all areas of the gland. Who knows if your Uro even hit these areas?
Also, your MRI went from PIRADS2 to PIRADS5….and that’s a six month wait and see? Please get away from this person no matter how much you like him.
Phil
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1 ReactionProblem is that mri was in 2024. Dr never gave that a second thought until 2025. 1 year later when my psa bumped. Then we started antibiotics and repeated mri 1 yr from 1st mri. 1st mri said possible prostatitis in 2024. MRI in 2025 after antibiotics read out the pi-rad5’s. Also looks like my prostrate has grown a lot in 1 year🤷🏻♂️
Dutasteride and sweet wormwood.