Outside of PSMA scans what tests are important to new patients?

GLT - this is odd isn't it ? I have never heard this before . In my PC groups here on the island , ADT always drove it down . Did anyone have a explanation as why ADT didnt drive the PSA to zero or near it ? James on Vancouver Island

Aberaterone drove PSA to zero for about a year. Then PSA started rising and went to Xtandi which did not drive it to zero. Then PSMA showed widespread advanced disease. Now on docetaxel

Prostate cancer, Gleason 7 (4-3), seminal vesicle invasion. extracapsular extension. T3bNO. Doc says I need PSMA PET scan. Insurance denied the scan. Appeal has been filed. I’ll be 79 this month and life expectancy is less than 10 years so they feel I’ll die of something else before the Prostate cancer kill me. What do you think.

There is a separate (and very active) prostate cancer group here at Mayo connect. You are welcome to join us, and you'll get a lot more feedback there.
https://connect.mayoclinic.org/group/prostate-cancer/

Welcome, @kenporter. I moved your message to the Prostate Cancer support group to this particular discussion:

- Outside of PSMA scans what tests are important to new patients? https://connect.mayoclinic.org/discussion/outside-of-psma-scans-what-tests-are-important-to-new-patients/

I think you'll appreciate the comments shared. You can also use the group search to find additional discussions related to you. For example:
- Discussions related to PMSA scan https://connect.mayoclinic.org/group/prostate-cancer/?search=PSMA&index=discussions
Discussions related to Gleason 7 https://connect.mayoclinic.org/group/prostate-cancer/?search=Gleason%207&index=discussions

Your age and cancer stage are definitely criteria to consider along with quality of life when making treatment decisions. Did your cancer team help with submitting the appeal to insurance?

medicare will pay for the Pet scan ( do you have an advantage plan ?) Continue with your doctors appeal and get whatever appeal paperwork that you might need should your medical team appeal is unsuccessful. Also, consider a letter to your congressman so that they might intervene. Take no crap from your insurance company and it is good if you get the reputation of a demanding but polite policyholder. The pet scan will better determine where the cancer is and how extensive and then the appropriate treatment. With appropriate treatment I suspect that PC will not kill you Good luck

PS Ken you maybe too old for somethings but not too old for a pet scan

kenporter,
I think the decision will be reversed on appeal. Pylarify is the newest contrast agent and the most expensive. Insurance companies like to deny everything.
You may well die of something else because cancer treatments have improved greatly and you 'd better plan on more than ten. In another year you'll be outliving women 3 to 1.
I also think that it is great that you have 0 nodes. They will need to treat the seminal vesicle and since you've invited me to think, I think you should look at radiation with a Viewray Meridian.
https://www.nyp.org/locations/david-h-koch-center/mri-guided-radiation-therapy

Thank you so much @gently for your reply and excellent input. I will definitely take a look at that Viewray Meridian radiation. I beat bladder cancer after a 4 year battle and I’ll beat this damn prostate cancer as well. Hope you are doing great and have a wonderful weekend. Ken

Colleen, thank you so much for the information and direction. My Urologist has submitted an appeal to the insurance and I hope to have a decision by August 15th. I will definitely seek out a second opinion when I’m have the PSMA results. Thanks again for your help.
Ken