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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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Received my PSA result a few days ago, it is a 0.10 ng/mL. I had TULSA on 28 Feb, 2025 and this is the 3 month full gland ablation post treatment PSA. At the two month mark I began to lose my sex drive and have some mild ED, that I think is likely from low Testosterone. I see my local Uro tomorrow to discuss the PSA and low T. All in all, very pleased with TULSA, no regrets.
As a Vietnam veteran my prostate cancer claim is covered under the VA because of Agent Orange exposure. But TULSA isn't covered. The Dr. at my VA clinic never heard of TULSA. I did my own research and asked them to refer me to OU which they did. I had to pay for the procedure out of pocked but the VA covers the Dr. visits and other treatment. I go back June 3rd for a follow up MRI. VAs involvement depends on your disability status. If you haven't already applied, you should file a claim for your cancer.
BobbieGene
I am hoping to use the TULSA treatment, if I qualify. And I am also a veteran with full VA benefits. I am not looking for the VA to fund the treatment. I could not find any information within the VA Libraries or even doctors who were familiar with TULSA or a POC .... so with the lack of transparency and red tape at the VA to discuss the issue of TULSA treatment. I am going to decide the "when and where" and my insurances will cover the cost. However I don't know if VA needs to have input... Could you provide me any type of POC or even a reference of the VA's opinion?
BGJCL
Dutasteride and sweet wormwood.
Problem 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🤷🏻♂️
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 ReactionI 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.
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)
Please 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.
Whoa!! 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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