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Frank Adsit and Vicki live in Jacksonville, Florida, USA. He was 59 when he was diagnosed in September, 2009. His initial PSA was 2.4 ng/ml, his Gleason Score was 6 and he was staged T1c. He is undecided as to his choice of treatment. Here is his story.

During my last annual visit to my GP my bloodwork revealed that my PSA had gone from 1.7 to 2.9. My GP recommended seeing a urologist and having a 2nd PSA. That test revealed my PSA was 2.6, but the Urologist thought that was still a fairly dramatic change and suggested I have a biopsy to check further.

I had a 12 core biopsy taken. 10 of the cores were clear, 1 showed a 3% malignancy level, and one showed a 50% malignancy level.

The urologist categorized me as a T1c and evaluated my Gleason Score as a 3+3=6.

I've done a lot of work reviewing information on YANA, thanks so much for all of you sharing your information, and have also joined the BOB group. We have a Proton Center right here in Jacksonville and I'm investigating the potential for that treatment.

Right now, I'm trying to decide between Seed/IMRT (Intensity Modulated Radiation Therapy) or Proton. I understand the advantages of the Proton treatment as being much more targetable with less collateral damage, but even the 15 year Loma Linda study points to a 90% success rate in early detections. My radiation Oncologist has cited a 93-95% success rate, and is pretty down on Proton Therapy.

I've heard from a number of people about both treatments, and their voices do share +/- to both plans.

Insurance issues may dictate the Seed route.

 

UPDATED

November 2009

 

 

Sorry that I haven't been in touch of late.

It has taken me this long to learn from Humana that my request for PBT was denied due to it not being part of my group policy. I've spent the better part of 2 months with Humana and my Provider going round and round regarding denials, "no consensus" claims, and the like and have been ferried between a number of different groups within Humana: Clinical Intake, Health Help, Claims, Customer Service.

So now I've learned that I have to go through a Grievance Committee and I wonder if any of you have suggestions as to how that letter should be crafted.

Thanks, Frank

 

UPDATED

January 2010

 

 

For whatever reason, my insurance battle with Humana ended positively when I received a call out of the blue letting me know they had approved my request for Proton Therapy.

I had been in discussion with them since September and was told "not a chance" over and over as I worked closely with one of the insurance aides at the Jacksonville Proton Center and with Jean Chase of BOB. On a Monday in Dec I was told my case was closed and it wouldn't be reopened. That same Friday, as I was putting the finishing touches on my Grievance, I got a call from them indicating they decided to approve my request. Thank goodness I kept a running record of all my phone calls, and managed to get conference calls within the departments of Humana to clarify and point out conflicting information. I found that the different departments did not have access to the same information, and decided that rather then have me put on hold while they discussed items, why not ask for conference calls so I too could be involved in the discussion. It was an arduous and roller coaster ride and I'm thankful I had so many people praying for my success.

Last week I got all of the prep work done: CT scans, bone scans, Pelvic MRI's (both regular and nuclear contrast) as well as the CT and MRI simulations at UFPTI. How could I almost forget that I also had the marker implants lodged around my prostate. All of these tests were done with a great deal of professionalism and were no problem. I marvel at the rhythms that are created in the MRI machines and found myself drifting to the Islands, Techno music, and other wonderful soundtracks while inside the machine (might as well make good use of any distractions)

My first PBT treatment is scheduled for Feb 2 and it will be interesting to see how that progresses.

 

UPDATED

March 2011

 

 

I feel I've been doing wonderfully as far as my post treatment issues are concerned. I've had no complications of any kind, plumbing is working fine, and I was even able to have a colonoscopy a couple of months ago without incident. My oncologist was kind enough to draft a letter to the physician who performed the colonoscopy indicating that he might see an inflamed area in a particular spot that was the result of Proton Treatment and that area should not be biopsied. I made a point of taping that letter to the back of my surgical gown even though a copy of it was presented previously to the physician.

I can't say that everything with Humana has gone as well, even though it should work out. I was approved by them at 100% coverage, after months of dealing with them. Six months after I completed my procedure, I received a letter from them indicating they had reviewed my case and were not covering the treatment. Lots of phone calls later, I was able to get the supervisor who shared the "100% coverage message" to me to go back into the logs and make that clear to the other parts of the Humana hierarchy. I thought that was all resolved until I got a letter from the University of Florida Proton Therapy Institute last month, indicating that Humana had not completed all their payments to the provider. Back to the phones, back to the logs, and back to a supervisor in a different branch of Humana, who said she would resubmit my claims for review, even though many of the charges they were denying were claims for services they had covered throughout the treatment process. Go figure.

According to UFPTI, Humana has now reaproved the claims and will be making the payments to my provider. Time will tell and I am more than ready to file a grievance with the State Medical Claims board should that be necessary.

As you can see from the chart below, all of my indicators seem to be going in the right drection. [Unfortunately the way in which Frank's figures came through make them fairly unintelligible. It seems that the main measure - his PSA - has fallen from a level of 4.7 ng/ml prior to treatment to 4.1 ng/ml at March 4, 2011.] I have a consult with my doctor in early April to learn more about what each of these columns mean and how that relates to my case.

 

UPDATED

May 2011

 

 

Frank clarifies the position regarding his PSA:

My initial PSA at diagnosis was 2.9 and it went up to 3.7 during treatment. My six month PSA was down to 1.1 and a year after treatment (March 2011), it has dropped to 0.8 .

Frank's e-mail address is: adsitf@comcast.net