I’ve been with Kaiser for about 20 years. I’ve had prostate cancer for 15. I’ve had excellent care for prostate cancer.

I had surgery 15 years ago and 3 1/2 years later it came back and I had salvage radiation. 2 1/2 years later, it came back and I went on Lupron (ADT). I found out five years ago I have BRCA2 and that is why it keeps coming back. At that time, I was assigned an Oncologist named Dr. Andrea Harzstark. She is the only Genito Urinary oncologist in Kaiser’s whole system. That is the only oncologist you want since they specialize in prostate cancer. I’ve had a number of people I’ve worked with, On their difficult cases, switch over to using her as their oncologist. She was trained at UCSF and has had at least a couple of decades of experience. She can answer any questions i’ve put to her, and if you read things I’ve written in this forum you will find out I am very well informed. She is located in San Francisco and I’ve had people as far away as Sacramento switched to her as their primary. The thing is under some condition she will want you to come into San Francisco in order to get treatment. I have actually never met her in person, after 9 years. I’ve always been able to communicate with her by phone or video conference and I am not far from her, It has just never been necessary.

The problem with trying to get other insurance once you have prostate cancer is That supplemental insurance companies will not insure you, Or at least it will be very difficult to find one that will. They pay the difference between what Is paid for By your insurance plan and what you have to pay your provider out-of-pocket. Normally you have to get both supplemental medical and drug insurance. You may find it quite difficult, If you want to switch, you should See if it’s possible to get that type of insurance ahead of time. I’ve been told it’s either difficult or impossible.

If you do decide to switch, I would highly recommend you go to UCSF for treatment. They are really the premium center of excellence in this area. I think UCSF doctors are much better than Sanford’s to handle Advance prostate cancer, which your husband has. UCSF has an online advanced prostate cancer patient conference once a month, I’ve been going to it for about a year. You can get a lot of really great information there, And you don’t have to be a UCSF patient. I also attend a few other Advanced prostate cancer meetings every month, I could help you with finding out more information about them.

Salvage Radiation is definitely in your future. With positive margins it’s just a matter of how long it takes for his PSA to rise. Within seven weeks after surgery, my PSA was undetectable and stayed that way for 3 1/2 years. With what you’re saying has occurred it’s likely that his will not Be undetectable until salvage radiation is done.

Since it has already escaped the prostate and is likely in his bloodstream, over the years it is very likely to come back. The good thing is that the treatments they have today can enable him to live for many years. I have a genetic problem which causes my cancer to keep coming back yet I’m still here after 15 years.

One thing you may be faced with is ADT to prevent this cancer from spreading and growing. This has some real serious side effects, And I’ve had a number of them. That’s something to discuss later, but it will be something they’ll probably discuss with you When you get the next PSA test because they want to give ADT Before having salvage radiation. They gave it to me two months before my salvage radiation. As of now, I’ve been on ADT for nine years because of the BRCA2.

You can send me a private message here if you wanted to discuss this in more detail.

Jeff