Prostate cancer rating

Question

7528 Malignant neoplasms of the genitourinary system

100

Note - Following the cessation of surgical, X-ray, antineoplastic chemotherapy or other therapeutic procedure, the rating of 100 percent shall continue with a mandatory VA examination at the expiration of six months. Any change in evaluation based upon that or any subsequent examination shall be subject to the provisions of § 3.105(e) of this chapter. If there has been no local reoccurrence or metastasis, rate on residuals as voiding dysfunction or renal dysfunction, whichever is predominant.

Does this mean after the chemotherapy I do annually and annual scope for 6.5 more years to see if the cancer is abated or starting again that after 6 more months from that last treatment the 100% rating will be re-evaluated?  I ask because I have an RFE scheduled about 8 months after my initial P&C disability rating which feels like a potential reduction.  I find this to in contradiction to the stated 38 CFR above.

Thank you for your help.

Jim's Reply

I'm not sure I follow you? Future exams after prostate cancer treatment are ordinary and usual events. The reference you cite addresses the rating the veteran patient will receive after prostate cancer therapy. In very broad terms, VA rates all service connected cancers at 100% while the cancer is active. Once treatment is accomplished and the cancer is gone, the vet is rated on the residual effects of the treatment - usually leakage of urine and erectile dysfunction after surgical or radiation therapy. The prostate cancer is usually checked by following the PSA closely. The PSA usually falls after treatment indicating the cancer is gone. If the PSA rises the vet may seek a 100% rating if it is determined the cancer has recurred.

I'm not familiar with an annual chemotherapy regimen for prostate cancer nor am I familiar with an "annual scope" that would diagnose a recurrence. Chemo is fairly unusual as a treatment for PC and the chance of recurrence is monitored by PSA. Have I missed something?