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Comment by ruralfam | Hacker News Reader

I have a friend nearing mid-60s. Retired military so now covered by Medicare, then Tri-Care. Having prostate issues. PSA went from 12 to 19. Desperate to get a PET scan to determine his is benign BPH, or cancer. Cannot get his scan approved since both insurances will not approve a PET as an early diagnostic tool (scan is about $7500). Cannot imagine what will happen if everyone getting a cancer DNA signal of this type tries to get clarification via additional tests. USA health care really does not work that way. HTH, RF

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A PSA of 12 is pretty far past the threshold for an MRI (don’t know about a PET scan) and an MRI would be pretty determinative about whether or not a biopsy is warranted. A biopsy would be pretty good at identifying cancer.

Sounds like either there are complicating factors or an absence of standard protocol adherence.

US health insurance is a mess, but that doesn’t sound like the entire story. I suspect urologists see a fair amount of friction for routine procedures related to prostrate health.

He had the MRI. Not conclusive. The PSA jump (alredy very high) is biggest concern. PET would -- according to him -- be most conclusive. Yet he cannot get it approved, so lives in a cruel medical purgatory.

Prostate biopsy is an out-patient procedure and is a standard protocol for determining the presence of cancer.

Like I said, there is more to this story.

He had a biopsy a while ago. It was negative (and very painful he said). He has been working closely with his urologist who has recommended the PET. Given the PSA jump he is really worried, and cannot get what I presume is his urologist's next recommendation. He has taken all the right steps, just to be denied re: PET. (To be honest I do not know if PET is that effective, but he says it would be definitive.) He was told, though, that should he get cancer the PET would be approved to enhance the diagnosis. My heart goes out to him. RF.

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