Considering Tulsa Pro or Proton radiation (full gland)

@jaygk Your research suggests a 10% increase in metastasis free survival with the addition of 6 months of ADT.
Yet, you don’t see that as a big enough reason to take it…
How about a financial investment that garners a 10% return for 10 years…How does that sound?🤗
Phil

@brianjarvis
I wish that was enough.

In 2023 my medical provider decided to charge for Lupron shots. I was charged $800 for a six month shot. The three month shot would be $400.

Yeah, if I ever exceeded my part B minimum of about $8000 I wouldn’t have to pay anymore, but I have never reached any thing even close to half that.

Part D on the other hand exceeds the $2100 limit with the first order of Nubeqa In January. And from then on all my drugs are free.

I switched from Lupron to Orgovyx Because of that. Then I found it gave me a fewer hot flashes.

@jeffmarc I’m familiar with Medicare Parts A, B, and D. I also have a supplement (Medigap) plan. I’m unfamiliar with any “minimums.”

When I had my two Eligard injections (April & July 2021), Medicare Part B covered 80% of the cost; the supplement plan covered the rest. (I had no out-of-pocket costs.)

The supplement plan provider cannot “decide to charge for…..shots.” Whatever Medicare determines is covered, the supplement plan provider must cover their 20%.

Do you have Medicare Part B + Supplement plan? Or do you have a Medicare Advantage plan (that contains Parts A, B, & D)?

@brianjarvis
I’m on Medicaid advantage there are no supplementals.

For the first six years, I had no payment for the Lupron shot then they decided to start charging the 20%.

That’s why I switched to Orgovyx. Good move.

@jeffmarc I see. Advantage plans have their own underwriters and can pretty much make up their own rules (within certain limits). Supplemental plans have to pay if Medicare pays.

@brianjarvis
It’s $15 for me to see a doctor for any issue. Check up is free of course.

$275 for an MRI or CT scan,

Blood tests are free. X-rays are free.

Any type of surgery is no more than about $200

I pay $119 a month And that covers a gym membership and $300 toward glasses every 2 years.

ER visit is $175

I think supplemental insurance is a lot more.

@jeffmarc True - Supplementals are a lot more. But, I prefer no surprises, rarely need for a referral, and no networks. That access comes at a price$$$ (With multiple gym and Y memberships that accept SilverSneakers.)

I had a 3+4 I sent it to Dr Epstein he graded it to a 3 +3 but my urologist at Nebraska Med Center continue to call it 3+4 doing Watchfull waiting for about 4 years going back for another biopsy in July the last one was 2 years ago

Thanks.

Hoping Epstein regrades my <5% of the 5 to an4.

@rice Remember that a Gleason score is a pathologist’s educated, experienced opinion of what he (she) sees under a microscope. Much of the interpretation of tissue slides (as well as scans) is often as much an art as it is a science, and depends on the skill and experience of the person interpreting them. What one sees as a 3+4, another might see as a 3+3, and another as a 4+3.

In my case, when I got a 2nd opinion on my 3+4:
> if the 2nd opinion came back a 3+3, I was still going to be treated to a 3+4;
> if the 2nd opinion came back a 3+4, I was going to be treated to a 3+4 (of course);
> if the 2nd opinion came back a 4+3, I was going to be treated to the 4+3.

As it turned out, the 2nd opinion came back a 4+3. Not knowing which one was “right,” I chose to be treated to the 4+3.