Harley, Docs consider AS a treatment as well. The biopsies and MRIs and PSAs medicalize the condition. But they seem less invasive than surgery or radiation so there is a tendency think of AS as a non-treatment. It is a treatment. Howard
Changing the name won't change surveillance. The idea is to prevent emotional distress and financial toxicity by calling it a noncancer. I was in the grey zone like you--waiting for an additional test. 13 years ago when I was diagnosed things were different. It was all biopsies all the time.
Harley, is your follow-up with an MRI or a biopsy? These days, they are recommending an MRI.
Where do you see the urologist? City? Academic medical center?
My heartburn (with this whole thing) is that based on PSA (6.33)→SelectMDX (74%/47%)→TRUS (1 core/3+3)→Decipher(0.25) I am on AS, which is what I chose w/my Uro. Nothing happens again until Labor Day, but what I am wondering is "What might have been missed, if anything, from the TRUS?"
I don’t think so. In fact, there is some caution out there in the urology community for not prescribing AS. Frankly, I consider AS a treatment, and it is far less expensive for the insurance industry than the alternatives. Detection of G6 is no guarantee that something else isn’t lurking in there and until research shows unequivocally that G6 absolutely will not grow, will not metastasize, etc., etc., etc., AS must remain in place for those with only a G6 diagnosis.
Harley, Docs consider AS a treatment as well. The biopsies and MRIs and PSAs medicalize the condition. But they seem less invasive than surgery or radiation so there is a tendency think of AS as a non-treatment. It is a treatment. Howard
Changing the name won't change surveillance. The idea is to prevent emotional distress and financial toxicity by calling it a noncancer. I was in the grey zone like you--waiting for an additional test. 13 years ago when I was diagnosed things were different. It was all biopsies all the time.
Harley, is your follow-up with an MRI or a biopsy? These days, they are recommending an MRI.
Where do you see the urologist? City? Academic medical center?
My heartburn (with this whole thing) is that based on PSA (6.33)→SelectMDX (74%/47%)→TRUS (1 core/3+3)→Decipher(0.25) I am on AS, which is what I chose w/my Uro. Nothing happens again until Labor Day, but what I am wondering is "What might have been missed, if anything, from the TRUS?"
My concern about relabeling Gleason 6 is that my health insurance will stop covering AS. Any validity to that fear?
I don’t think so. In fact, there is some caution out there in the urology community for not prescribing AS. Frankly, I consider AS a treatment, and it is far less expensive for the insurance industry than the alternatives. Detection of G6 is no guarantee that something else isn’t lurking in there and until research shows unequivocally that G6 absolutely will not grow, will not metastasize, etc., etc., etc., AS must remain in place for those with only a G6 diagnosis.
Thanks, David.
That's a great point.
I have been in discussions with docs where this question has come up.
They said the way to approach this is to come up with new reimbursement codes. That's not something that will happen overnight.
Also, there are changes in the works regarding pathology reports that could ease the skids.
Howard