Going for Tulsa Pro

Posted by paulcalif @paulcalif, Dec 29, 2024

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 🙂

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

bobbygene | @bobbygene | Dec 30, 2024

In reply to @paulcalif "Thanks for your response. From what I’ve read, getting Medicare to cover the procedure in 2024..." + (show)

We were watching my PSA hoping Medicare would cover TULSA in 2025. My PSA went from 6.3 to 7.43 in less than 5 months so I decided to get the TULSA procedure asap. I went to OU in OKCity and had it done in late November. Don't worry, it's a piece of cake. I went two days prior to prep with the laxatives and enema. I was under general anesthesia for about 4 hours. The only pain I had was my hips from the position they had me in. I wore the catheter for two weeks. Unpleasant but no big deal except for going out. I stayed home mostly. I didn't have bladder spasms or pain just some tenderness when sitting on a hard chair. I returned to OKC to have the catheter removed after two weeks and all went well. No incontinence or urgency. My Dr. came in the room smiling, the first time I witnessed that, and showed the MRI results to me and all was clear. He was happy and so am I. I have an appointment in March for PSA and follow up. The watch and wait was bothering me more than I realized and now the burden has lifted. I'm fortunate that I had the resources to pay for the procedure.

paulcalif | @paulcalif | Dec 30, 2024

Thanks for your response. From what I’ve read, getting Medicare to cover the procedure in 2024 isn’t guaranteed since the current codes are fairly generic. In 2025, codes specifically for procedures like TULSA are expected to go into effect, which might require hospitalization (though I’m not entirely sure about that part). Like you, I’ve decided to move forward regardless. It’s been almost a year since I was diagnosed with cancer, and my doctor felt it was okay to wait. How have things progressed for you since your last post? It’s been about six months, right?

jcf58 | @jcf58 | Dec 30, 2024

I did Tulsa at Mayo Rochester in July. Medicare and my BCBS supplement covered all but a $6 antibiotic pill😉. At 3 months my PSA is down from 8.6 to 0.68. My experience:
https://connect.mayoclinic.org/discussion/tulsa-pro-experience-mayo-clinic-mn-july-2024/
Good luck.