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How My Insurance Company Is Deciding My Breast Cancer Treatment

Last week I had my first cycle of chemo for Stage IV breast cancer.  The results of the PET Scan were not as bad as expected.  I do have Stage IV breast cancer, but that’s because it has moved to the lymph nodes underneath both arms.  No cancer cells were found in my organs nor bones.

That doesn’t mean it won’t spread because my insurance company is denying my oncologist the drug that stops division of the cancer cells.

Also this week, as friends and families educate themselves to help me get through this, I’ve found that I have to keep reminding them that there are different types of breast cancer cells. As my friends and family talk to cancer survivors and read things online about breast cancer, survival rates, etc. it’s important for them to remember that breast cancer has different cells.  The type of cells are important for diagnosis and treatment.

The parasites that are trying to give life to themselves by eating my body from the inside out are HER2-positive cancer cells.  They are aggressive.  Four days after the biopsy, the tumor had grown 2 inches.   By the time the PET Scan was taken and the results in, the MUGA Scan was taken, and the first chemo scheduled, that parasitical, invasive tumor was even larger.

If you’ve been reading this blog for years, then you probably know that I’m one who trusts in vitamins, herbs and other supplements.  I do not reject traditional medicine.  I also follow Dr. Peter J. D’Adamo’s Blood Type Diet as close as possible.    It all seemed to pay off for me because in order to start chemo, I needed a MUGA Scan score of at least 50.  My MUGA Scan score was 72.  My blood pressure and blood work were all fine.

I had been taking supplements all along, but after my diagnosis, I looked for specific supplements.  I want my body to heal in between treatment cycles.  But first, I needed to know more about my enemy.  I tried reading reputable websites, and found Healthline.com.

“When you have a breast biopsy, the tissue is tested for hormone receptors (HR). It’s also tested for something called human epidermal growth factor receptor 2 (HER2). Each can be involved in the development of breast cancer.”

“HER2 is a gene that creates HER2 proteins, or receptors. These receptors help control growth and repair of breast cells. An overexpression of HER2 protein causes out-of-control reproduction of breast cells.

HER2-positive breast cancers tend to be more aggressive than HER2-negative breast cancers. Along with tumor grade and cancer stage, HR and HER2 status helps determine your treatment options.”

My insurance company tossed a wrench into the battlefield.

Without naming my medical providers, staff, or other identifying features, I will name my insurance company.  It is Humana.  This week, my first chemo cycle was delayed for about an hour as my oncologist informed me that he had been on the phone with a doctor with Humana who first denied one of the drugs to be used in my chemo.

The drug, Taxotere and cyclophosphamide (TC) destroys quickly dividing cells. It can be given either to shrink the size of the tumor before surgery to remove it, or after surgery to kill any cancer cells that may be still present in the body.  The goal of TC is to cure.   But there are only two sites where I was able to find that it’s the drug’s goal.  One site is guess what?  That of trial attorneys.  More on that later. Read the rest of this entry

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