Bruce’s Story: A PET Scan Found My Recurrent Prostate Cancer
In 2018, I was diagnosed with prostate cancer. My doctors were able to surgically remove my prostate, and it looked, at the time, like the cancer was contained within the removed gland and we had prevented the cancer’s spread to other sites within my body. Nonetheless, doctors continued to monitor my prostate-specific antigen (or PSA) level because a detectible PSA level following a prostatectomy can be an indication that cancer has returned.
In August 2020, a follow-up PSA test confirmed that this was the case, but thankfully, a friend had told me about a new study and imaging technique that was being researched in California – a positron emission tomography (PET) scan. This scan used a new radiopharmaceutical capable of informing imaging at very low PSA levels. After some additional investigation, as well as speaking with a person involved in the clinical research, this PET scan sounded like a good fit for my circumstances.
By April 2021, another test showed that my PSA level had risen further, so I traveled to receive my scan. It showed that there was oncological activity on the right side of a presacral lymph node, an uncommon site. Armed with that knowledge, my urologist and radiation oncologist were able to develop a modified treatment plan that included six weeks of daily radiation precisely targeting my cancer.
My urologist told me that without my PET scan, it would have taken months—if ever—to find the cancer. I truly believe that having this scan allowed me to treat my cancer earlier and saved on the greater costs of trying to later treat more advanced disease that had spread throughout my body.
Unfortunately, access to advanced PET scans is limited because of the way they are paid for by Medicare. Providers receive a single “bundled” payment for the procedure, but this payment is markedly less than the cost of the drug needed for the scan. To provide this procedure, hospitals lose money because they must cover the difference between the drug and the payment they receive from Medicare. Because of this, many hospitals have decided offering these types of advanced imaging isn’t worth the cost despite the benefit for patients and potential to better understand their disease.
A bipartisan bill in Congress, The Facilitating Innovative Nuclear Diagnostics Act of 2021, has been introduced to address this problem by directing Medicare to pay separately for certain diagnostic radiopharmaceuticals. Doing so allows hospitals to provide these procedures without taking the financial hit.
I was fortunate in being able to afford the cost of my scan and travel, but Congress can change the current payment policy to make advanced nuclear diagnostic scans more widely available. I’ve already contacted my Congressional representatives and asked them to support the FIND Act. Please help me by doing the same.
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