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44yr PSA180 Gleason9 non-metastatic. Surgery or Treatment?
Prostate Cancer | Last Active: Apr 7 9:21am | Replies (172)Comment receiving replies
Hi @westernflyer, my problem is that the PSA is 180, and about 80% of the biopsy cylinders are affected with Gleason 9, so the cancer is very aggressive. I am a veteran but I live in Germany as an ordinary citizen and I have German health insurance. Unfortunately there are no VA centers overseas.
I heard that i can get some treatment for VA Service Connected related issues at the Landstuhl Hospital, but so far I have not had the need to.
Thank you fro sharing your struggle. If push comes to shove, I may consider flaying back to the States to get seen at the VA center. But so far the German system has provided plenty of options and in a relatively fast pace, even though I had to make lots of phone calls
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Heidelberg University Hospital also has proton radiation therapy available, but I would not expect that therapy to be recommended for your specific condition.
I believe that you are on the right track with the medical team that you will pull together and can come from your tumor board members or you may eventually decide to later find another a medical oncologist (Urogenitale Onkologie) that can help guide you through the next step treatment alternatives for your specific condition. A good one in Germany will be connected with the best ones in the US, as they see each other at conferences.
And you can always ask questions in this forum to get the most updated information on treatment alternatives.
You will find that the prostate cancer centers of excellence in Germany are all interdisciplinary and are now comparable to like centers in the US. Many of the doctors know each other in each country.
For example, the PSMA Pet Scan was invented in a collaboration between Heidelberg University Hospital and John’s Hopkins. The refinement of a DaVinci prostatectomy to reduce incontinence risks was developed at Martini Hospital (Hamburg) in collaboration with to hospitals in the US. Etc.