Weighing the cancer risk reduction & quality-of-life cost of ADT?

@dietzpagan Regular Medicare, not advantage.

@dietzpagan BTW If you want to know whether “Advantage” is worth it for you, I suggest calculating the cost compared to whatever benefits you would probably use. For most people, “Advantage” costs more than its savings. It is an insurance plan that is a profit generator for insurance companies.

@jimgaudette
My Advantage plan cost me $119 a month. I get $300 every other year for glasses. They pay for my gym membership at a 24 Hour Fitness.

Yes, when I have an MRI or a CT scan it does cost $210 but going to see the doctor is $10, but my PCP is free.

Prescription max is $2100 and almost everything’s included in that, I haven’t found any prescription they won’t cover.

Flu, RSV and Covid shots are free.

I paid about $200 to get my knee replaced.

I guess some advantage plans are better than others.

@jeffmarc I get all that with regular Kaiser Medicare and never pay for any doctor or have a medication max. Medications are either free, $5 or $7 per month if generic. I pay about $200 for a PET scan and nothing for radiation. I did pay about $200 for a dual IPP/AUS surgery with 24 hours in the hospital. Everyone on Medicare is eligible for Silver Sneakers free gym memberships, although I get free membership for my whole family because I teach yoga at 24 Hour Fitness. I guess all plans are different.

@jimgaudette
I have Kaiser as well, But I’m on the advantage plan.

I know my sister in Oregon pays almost nothing for Kaiser And has cheaper prices.

Interesting how they charge different prices in different places.

@jeffmarc Yeah , come to New York but remember to bring plenty of ‘lube’. Advantage plans here are a waste - you pay for everything out of pocket if you need more than a checkup.
Phil

@jimgaudette
Forgot to mention the one benefit of my Kaiser plan.

For the last eight years, I’ve been a patient of the only Genito urinary oncologist In the Kaiser system in the country. She has never failed to answer a question I have asked, and never had to say “I’ll have to look into it.” My questions can get quite esoteric at times, She really keeps up.

She was trained at UCSF, which has a really good Prostate cancer group of doctors.

ADT will eventually bring your cancer under control. Mine was present in all twelve cores Stage 3 but confined to the lymph nodes, no bone.

However the associated drop in testosterone will lead to muscle loss, overall weakness, loss of libido, and ED.

How important is your sex life vs longevity? At 81 it was not much of an issue for me; fear was greater. However, now at 86 and the cancer in remission I really miss it and my wife cries herself to sleep hoping I won't notice.

@soli During my recent 02/04 visit to the Emory Proton Beam Center, the R/O gave to me the same 70% and 5% numbers. Along with many of the stories of quality of life degradation of ADT, I also see that a side effect is blood clots. I have a history of pulmonary embolism, which is another reason at this time my decision is to forgo ADT treatment.

@ebooneac

I had DVT and PE in 2010 while on a work trip to San Antonio. Flying back to Kansas City I was like damn, breathing was getting difficult...but, we're on final approach so just gut it out and go to the ER when you get on the ground.

We landed at KCI, got off the plane, I questioned if I really needed to go to the ER, told my wife maybe it was "nothing...", she says I'll meet you at the ER, you are not coming home!

So, being a guy, I waited for my bags, took the shuttle bus to the parking lot, drove to the ER...

She had obviously pruned the pump or just the fact that I said o was experiencing shortness of breath and being 53, they whisked me right back and preceded to do what they do best.

The ER doctor after running various tests said Kevin, you have DVTs in your legs and PEs in your longs, they are shutting down...

Yikes...

They administered powerful clot busting drugs, maxed out the oxygen and admitted me.

My wife later told me when she asked the doctor outside my room what was the prognosis, his response was "if he makes it through the night...!"

I did...

I have been on blood thinners since - 16 years...First warfarin and later Eliquis.

Interestingly, my cardiologist lowered my Eliquis from 5mg 2x daily to 2.5mg 2x daily after cardio ablation for my Afib was "successful."

Less than a year on that lower dose I experienced multiple TIAs over a three day period requiring a stat in the hospital. Exhaustive imaging and jabs and labs found no "cause" but they believe the lowering of my Eliquis may have left me "under protected" so back on 5mg 2x daily.

Was my Afib a result of the 18 months of ADT? We'll never know...

Interesting, my PCM at the time of my DVT and PE had just completed a CEMU on the relationship of those with cancer and started to order labs and imaging to determine if I had cancer. First up, the colonoscopy.

I'll make this long story short, the colonoscopy was the path to determine I had PCa. I had no symptons and PSA was 2.1 which would not have triggered concern.

Kevin, what's your point? Just this, there are ways to manage risk with the side effects and co-morbidities.

That's a discussion with your medical team.

My cardiologist humorously told me that if I die of a heart attack then they have done their job, I have not died of PCa.

For me, I would want to lower the risk of stroke by blood thinners, I would hate to have one...well, a "serious" one that left me with quality of life issues.

Kevin