Making a Medical Plan
- The Veterans Health Administration (VA) offers extensive services for prostate cancer, but not all locations have specialists such as urologists for certain tests and treatments.
- If your local VA facilities don’t offer the treatment you need you may be able to get a referral to doctors in the community.
- The VA provides a process for community referrals, allowing you to receive care from non-VA providers. The VA will handle eligibility confirmation, referral authorization, and appointment coordination.
- It’s so important to actively participate in your treatment. Be proactive about understanding all your options, regardless of whether you nave your treatment at a VA or a community facility.
Managing your care
Even if your local VA does not offer all of the care you need, your care team will refer you to doctors in the community who have an association with the VA. In the meantime, your VA doctors will continue to support you.
Read MoreTaking control of your treatment
“As a patient, it’s easy to take a passive approach and just have your doctors tell you what to do,” Dr. Rettig says. “But whether you’re a patient at the VA or at an academic medical center, it’s really important for you — as the patient, as the veteran — to learn about your cancer and to come up with the important questions to understand why treatment options have been selected and what the treatment options are.”
RELATED: The VA’s Approach to Prostate Cancer: Treatment and Support Services
That’s not to say staying up on everything that’s going on won’t take some work on your part.
You’ll have to do some research, come up with questions to ask your doctors, and do your best to understand every aspect of your care. You’ll want to have a handle on everything from scheduling to side effects to finances.
If organizing your care is not your strong suit, is there a family member or trusted friend who can take the lead? Has a professional been assigned to your care team who can help explain what you need to know? Now is the time to ask for help.
Determining where to get treatment
The type of treatments available differ by each VA location. Once you and your care team decide on the best course of action, find out the nearest place that offers what you need. You can use this directory of VA facilities to help your search.
“There are some facilities like the one I’m at in Los Angeles where we have all the subspecialty care, all the specialists that would need to execute treatment for your prostate cancer, very similar to the subspecialty care that you can get at my academic affiliate UCLA,” explains Dr. Rettig. “So it’s quite easy to receive all the necessary care at my VA.”
However, if you live in, say, a rural area, the nearest VA may be far away. Even then, it may not offer every medical specialty available.
You may have to travel to get the best care, or, as Dr. Rettig suggests, you can ask for a referral to a community specialist who works outside of the VA system but offers care to veterans. Weigh your overall options to help decide what makes sense for you.
Getting a community referral
A community referral is a way for Veterans to get care from a non-VA provider. The community referral process works like this:
- You will need to do some research to find an in-network community provider who offers the type of care you need. Ask your VA health care team for help.
- Once you identify a community resource, you must fill out a request for a referral from your VA health care team. The VA will review the request and contact you to confirm your eligibility. The VA will then prepare the referral and send it to both you and the community provider. This can take up to 14 days.
- Next, you’ll schedule an appointment with the community provider, either by yourself or with the help of your care team. You must let the VA know you have an appointment within 14 days.
- You will get an authorization letter from the VA, which approves your request which includes the details of the provider, the care, and the duration of the approval. Bring this letter to your appointment, along with any medical records or images that the provider requests.
- Keep track of your ongoing appointments and referrals. Ask for a new referral if you need more care. The VA will not cover any services that are not included in the authorization letter.
Dr. Rettig notes that “there are fewer options if you are referred to the community” as compared to “having private insurance and you’re picking out your urologist from a long list of possibilities.” He recommends doing your own legwork to understand your options, using your VA care team to assist.
As a Patient, what should I know about the VA?
The VA strives to offer equal access to health services for all men diagnosed with prostate cancer. No matter who you are or where you live, the VA wants you to get the best treatment with the most successful outcome possible.
The VA has a rich history of research and clinical trials that have helped vastly improve prostate cancer care. Because you are a veteran, you will have access to great medical care for your prostate cancer through the VA.
Learning more about prostate cancer treatment
Most men will have choices about how to treat their prostate cancer. Your care team will recommend specific treatments based on how aggressive your prostate cancer is, what your treatment goals are, and your overall health.
For example, you may be presented with surgery and radiation as two equally effective treatments that cause different side effects. Your team will explain the pros and cons of each to help you decide which makes sense for you.
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One choice your team may discuss with you is sometimes called “watch and wait”. Your doctor may also refer to it as “active surveillance”. This means your doctor will continue to observe the cancer but not treat it.
While letting cancer sit there while taking no action can be a scary idea, this is sometimes the best way to manage prostate cancer. Your care team will help you understand if it’s the right way to go in your case.
Prostate cancer often grows slowly without causing problems. On the other hand, most treatments have side effects that can be hard to manage. You and your care may decide that keeping an eye on your cancer and doing nothing while the cancer does not pose an immediate problem is actually the smart choice for you.
“It’s important to recognize that prostate cancer, even when it’s advanced, it’s spread or metastasized, should be considered as a chronic illness that you can live with for many, many years,” Rettig says.
If however your cancer returns, treatment options may change. Your care team will advise you every step of the way.
Additional reporting by SurvivorNet Staff
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