2nd Opinions for MRIs
Thank you to Eric Milsen for putting together this list of 2nd opinions for MRIs.
1. Botimage AI for MRIs
https://botimageai.com/prostatid/ ($250, can also be used for biopsy targeting guidance)
2. NIH 2nd Opinion MRI (no fees)
Choyke, Peter (NIH/NCI) Radiologist (pchoyke@mail.nih.gov)
3. Second opinion of MRI from Johns Hopkins
Images and Reports for Providers | Johns Hopkins Radiology (hopkinsmedicine.org)
Email: eradiologycenter@jhmi.edu
Phone: 443-287-7378
Fax: 443-769-1210
4. Accolade Radiology NY, PA
https://accoladeradiology.com/mritap.html
5. Radiology Check (Switzerland)
https://radiologycheck.com/en
Telehealth gets extended through 2027!
Telehealth gets extended through 2027!
As some of you may know, the liberal telehealth rules to conduct medical appointments remotely that were enabled during Covid, sunsetted late last year. AnCan was upset and vocal that many of our patient advocacy organizations active on The Hill did not campaign more widely to extend it. Organizations like ZERO (prostate cancer) have significant and expensive government relations groups precisely to address such issues on behalf of us patients. AnCan had to bring it to ZERO’s attention to move the ball at a time when ZERO’s high paid CEO was self-admittedly sleeping on the switch.
Telehealth was temporarily extended for those living in rural areas. Then one of our newly minted prostate cancer Moderators, David Sharpe, brought it to AnCan’s attention that legislation was passed on Feb 3, 2026 that has extended comprehensive telehealth through the end of 2027. We asked David to blog its welcome return to wider availability and tell his story around telehealth – thank you Mr. Sharpe!
Medicare Telehealth Coverage Is Extended
The federal government has restored Medicare coverage for telehealth until the end of 2027. That means you can now possibly consult with your doctors online rather than having to meet with them in-person.
Why did I say possibly? Because state medical licensing laws still apply. Often, they can undermine your doctor’s ability to join you on the call. Here’s why: (Don’t construe the following comments as legal or medical advice. This is general information only.)
Telehealth consultations are easiest to arrange when a patient and doctor are in the same state. For instance, if you live in Springfield, Illinois, and want to have a virtual chat with an oncologist in Chicago, no legal impediments are likely to stand in your way.
Things can get tougher if the doctor practices in another state. Physicians are typically required to be licensed in the state where the patient is physically located during the consult. Therein lies a common problem: the doctor is licensed in one state, and you’re in another.
But loopholes exist. According to the Center for Connected Health Policy (CCHP), “A few states have licenses or telehealth-specific exceptions that allow an out-of-state provider to render services via telemedicine in a state where they are not located, or allow a clinician to provide services via telehealth in a state if certain conditions are met (such as agreeing that they will not open an office in that state). Still other states have laws that don’t specifically address telehealth and/or telemedicine licensing, but make allowances for practicing in contiguous states. . . .” For specifics about your state’s rules, explore CCHP’s handy state-by-state guide: https://www.cchpca.org/topic/cross-state-licensing-professional-requirements/.
Despite those exceptions, many physicians and medical centers require patients to be in the same state as the doctor during telehealth appointments. I wish I’d known that last year, before trying to set up virtual consultations from my home in Portland, Oregon, with Fred Hutch (Washington), UCSF, City of Hope (both California), and MD Anderson (Texas0—all of whom turned me down. Oregon Health & Science University (OHSU, Oregon)) would have refused, too, if I had been in any other state.
But some physicians and hospitals were more relaxed about it. Despite remaining in Portland, I wrangled a telehealth visit with a UCLA specialist. Two AnCan buddies of mine in Oregon and Arizona did so as well. I had even better luck with out-of-state doctors in community practices. Two agreed to confer with me online, and one declined.
If you live near—but not in—the state where your doctor practices, perhaps the easiest option is to make a run for the border. One AnCan member has adopted that strategy as a convenient means of communicating with his faraway medical team in an adjacent state while also satisfying the legal requirements. To have that meeting, he travels a few miles from home to a casino just across the state line; the casino lets him conduct telehealth consultations there. That approach shaves hours off what would otherwise be a protracted road trip to talk with his doctors face-to-face. # # #
David Sharp davidsharp1@me.com
Hi-Risk/Recurrent/Advanced PrCa Video Chat, 1/13/26
Hi-Risk/Recurrent/Advanced PrCa Video Chat, 1/13/26
AnCan is closing out its Annual Fundraising Campaign. If you haven’t donated yet, consider the priceless value we bring . Please donate – especially if you watch our recordings and are not on our Mailchimp list. https://ancan.org/donate/
Hear Founder, rick davis talk about how AnCan came to be in this 20-min podcast dropped this week on Empowered Patient Radio http://empoweredpatientradio.com/virtual-support-groups-remove-barriers-encourage-sharing-honest-experiences-to-fight-misinformation-with-rick-davis-ancan
AnCan thanks the following sponsors for making this recording possible: Novartis, Johnson and Johnson, Telix, Blue Earth Diagnostics and Foundation Medicine.
Views expressed in this Recording are solely the opinion of AnCan Foundation, our Moderators and Participants.
AnCan does not accept sponsored promotion. Any drugs, protocols or devices discussed are based solely on anecdotal peer experience or clinical evidence.
AnCan cannot and does not provide medical advice. We encourage you to discuss anything you hear in our sessions with your own medical team.
AnCan reminds all Participants that Adverse Events experienced from prescribed drugs or protocols should be reported to the pharmaceutical manufacturer or the FDA Adverse Event Reporting System (FAERS). To do so call 1-800-332-1066 or download interactive FDA Form 3500 https://www.fda.gov/media/76299/download
All AnCan’s groups are free and drop-in … join us in person sometime! You can find out more about our 12 monthly prostate cancer meetings at https://ancan.org/prostate-cancer/ Sign up to receive a weekly Reminder/Newsletter for this Group or others at https://ancan.org/contact-us/
Join our other free and drop in groups:
Men (Only) Speaking Freely…1st & 3rd Thursdays @ 8.00 pm Eastern https://ancan.org/men-speaking-freely/
Veterans Healthcare Navigation… 1st & 3rd Tuesdays @ 8.00 pm Eastern Schmier Room https://ancan.org/veterans/
Veterans Speaking freely… 4th Tuesday @ @ 8.00 pm Eastern Schmier Room
Editor’s Pick: Denovo metastatic BRCA2 Newbie stumps us all!
Topics Discussed
High volume denovo Mx Gent with BRCA germline can’t fiing a treatment that controls his T or his PSA; starting IMRT along with constipation; 2nd docetaxel easier with less fatigue than the first; liver returning to normal after 6x docetaxel; so back to full daro dose; T returns within 3 months of stopping 12 mo of orgovyx; BCBS turns down Prolia for -2.7 osteoprosis – did doc ask for wrong denosumab; ‘ciiling cap’ discussion; opting for new Plan Ds (drugs); Inherited Mutations discussed;
Chat
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Alfredo in Houston, TX sent: 4:24 PM
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Larry (Alaska) sent: 4:50 PM
should we test for LH and FSH levels?
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Alfredo in Houston, TX sent: 4:51 PM
Dr. Jack, would an LH level be helpful in this case?
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Jeff Marchi – San Francisco sent: 4:52 PM
small cell= neuroendocrine (not exactly: rd)
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AnCan–John A sent: 4:55 PM
advanceduropathology.com 5162807930 Dr Epstein prostate pathology expert
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Alfredo in Houston, TX sent: 5:00 PM
the relatively long half-life of injectable testosterone undecanoate means its effects can last for weeks, but probably not months
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Jeff Marchi – San Francisco sent: 5:08 PM
has anyone had VMAT radiation?
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Gary Martin sent: 5:09 PM
I had that prostate inflammation first and second round docetaxel. my oncologist did not know cause. Suggested UTI, which have the same symptom I had in round 1 and 2. I figured it was chemo working on prostate.
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Julian – Houston sent: 5:13 PM
Jeff, I have had VMAT radiation.
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Jeff Marchi – San Francisco sent: 5:13 PM
how well did it work? any side effects?
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Jack sent: 5:14 PM
Enzalutamide blocks androgen binding which disrupts the negative feedback loop that normally supresses testosterone this leads to compensatory increases in LH and subsequent increases in testosterone
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Julian – Houston sent: 5:14 PM
It worked quite well – I have been in remission for over 5 years. I am now having some radiation effects but not severe
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AnCan – rick sent: 5:18 PM
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Bruce Schrimpf sent: 5:20 PM
I have not met or heard of him.
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Gary Martin sent: 5:32 PM
I had insurance denial of Prolia (bone strengthening)- anyone encounter denial of Prolia?
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Julian – Houston sent: 5:34 PM
Aetna no longer approves Prolia.
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Larry (Alaska) sent: 5:36 PM
Bone loss is largely drivenby estradiol deficiency (just as it is in post-menopausal women). Testosterone deprivation also lowers a man’snatural estradiol. A low-dose estradiol suppement can avoid the need for bune-building agents. Agents which are expensive and bring their own set of adverese side effects.
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Larry (Alaska) sent: 5:43 PM
Calcium + Magnesium:
AI Says: Why Separation Helps Competition for Absorption: High levels of calcium can block magnesium absorption in the intestines, and vice-versa. Optimizing Intake: Spacing them out (2-4 hours apart is a common suggestion) minimizes this competition, allowing your body to absorb each mineral more effectively. When It’s Okay to Take Them Together Multivitamins: If they are in smaller, balanced amounts within a multivitamin, the interaction is usually not an issue. With Food: Taking them with food can also help with absorption and reduce digestive upset.
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RJ Smith (Seattle) sent: 5:47 PM
Cold Cap system is https://paxmanscalpcooling.com/
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Julian – Houston sent: 5:52 PM
Volumetric-modulated Arc Therapy (VMAT)
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Alfredo in Houston, TX sent: 5:55 PM
Well, here is a longish article, but it does seem to describe the difference between IMRT and VMAT, https://en.wikipedia.org/wiki/Radiation_therapy
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Julian – Houston sent: 5:57 PM
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Alfredo in Houston, TX sent: 5:58 PM
I have to leave now, sending everyone good wishes for the new year. Good night! and thank you!
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Alan Swope sent: 5:59 PM
Thanks all. I have to leave. Good information.
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Don Rogers sent: 5:59 PM
look at Scriptco.com for generic drugs. Huge saving even with the $140 yearly fee.
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Bruce Schrimpf sent: 6:01 PM
Thanks for the good discussion!
Monthly Art Friends Art Class
Welcome to AnCan’s regularly scheduled guided art class! These free sessions are open to everyone and thoughtfully designed with our chronic illness and cancer community in mind.
Each class features a pre-planned, step-by-step art lesson led by one of AnCan’s instructors. No prior art experience is required. Participants are encouraged to work at their own pace, and modifications are always offered to support energy levels, physical limitations, cognitive fatigue, and access to art supplies.
In addition to learning creative techniques, these sessions are intended to support mindfulness and emotional well-being. Art can be a grounding practice—offering a moment to slow down, focus on the present, and reconnect with yourself through gentle creative expression.
Our goal is to create a welcoming, low-pressure space where creativity can feel restorative, calming, and accessible. We do our best to make every session as accommodating and inclusive as possible, so you can focus on creating in a way that feels right for you.
Sessions take place every 3rd Thursday at 8pm Eastern time
Register for each individual monthly class