My father and mentor
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Bill,
You have been more help than you know! I am so grateful to have met you on here.
Thank you so much, and I wish the best for you and your wife!
Nicole
http://www.patientpower.info/listenhealthtopicdetails.asp?showid=HR062707&Topic=Health%20Insurance
Listen to this radio program!
_____Here is CIGNA’s position stating they will cover Therasphere.
______Kathleen’s coverage is with a Minnesota health plan called Medica. I don’t know if they did an exhaustive study of whether to cover Therasphere but they did cover it. She had two treatments.
Keep fighting and good luck.
Bill
Bill,
Thank you so much for your reply. It is so comforting to hear of the success your wife has had so far with this treatment.
You said that your insurance company covered the treatment with no problems, do you mind me asking what insurance you have?
My dad had the treatment, but had to pay close to $100,000 out of his pocket, in hopes that his second request for coverage would be approved since the doctor sent a letter.
We have just received the second denial and now have to go to appeal the Insurance Commission. I am trying to research cases where Blue Cross (which is what my dad has), or any other insurance companies have covered this treatment in order to help assist in the appeal. The appeal paperwork we received states that we are only eligible for appeal if my father would have died if not for this treatment. I’m sure the doctor’s will attest to that, but I want to cover all my basis just to be safe.
Thank you again for everything!
Nicole
I did not address your insurance question. Y-90 was covered by Kathleen’s health plan so we have not had to battle with insurance. Do not take “no” for an answer and enlist your doctor to make the case that this is necessary treatment and the best option for your father.
Good luck.
Bill
P.S. If you look up Therasphere, ytrium, 0r Y90 under “search” on this site, you will find other discussions about this treatment.
http://www.mds.nordion.com/therasphere/
My wife, Kathleen, had a couple Therasphere Y-90 treatments at Mayo Clinic. Prior to that she had two resections and a couple different rounds of chemo. The Therasphere was the least difficult and most effective treatment she has had.
Kathleen’s first Y-90 treatment was in October 2006 and the second one was February 2007. No other treatments were necessary during this period and she did start her next chemo until August. In other words, the Y-90 kept the cancer at bay for 10 months, with few side effects.
I strongly recommend Y-90. My initial understanding was that cc patients were not candidates and my wife was not considered until it was discovered she had a mixed cc-hcc tumor. I’m not sure that is the case everywhere though.
Good luck.
Bill
P.S. Kathleen’s story is included under the family blog section under Foley.
Hi Katia,
Here is a little bit of info that I was able to find on SIRT Y90:
Yttrium-90 (Y-90) radioembolization, also known as selective internal radiation therapy (SIRT), is a regional hepatic therapy used in the treatment of unresectable colorectal cancer (CRC) liver metastases. In SIRT, Y-90 impregnated microspheres are injected into the VASCULAR SUPPLY of hepatic tumor, leading to selective irradiation and necrosis of tumor TISSUE,” scientists in the United States report.
“While several studies demonstrate improved local control and survival with SIRT, the specific indications for this therapy have yet to be defined. Typically, SIRT is given in combination with chemotherapy as multimodal treatment for unresectable hepatic CRC. However, it has also found increasing use as a salvage therapy in chemo-refractory patients.Hi Nicole,
So sorry to hear about your dad. My dad was diagnosed in September and we are still getting to grips with the whole thing. It is so hard though.
I have never heard of SIRT-Y90. Could you give a little bit more detail as to whether it is chemo, radio, immunotherapy? Would like to look into it.
All the best to you, your family and your dad.Katia
My name is Nicole. I am 27 years old and live in California. My father was diagnosed with cholangiocarcinoma about 2 years ago. He has had 2 liver resection surgeries and has gone through chemo.
Recently, cancer has developed in his stomach. He has been ruled out for a transplant.
We were told of a treatment called SIRT-Y90, but don’t know very much about it. I was hoping to get some insight from others on the website who have been successful with this treatment. Any information that you can provide is so greatly appreciated. I would also love any info on how to fight his insurance company to pay for the treatment, as they have denied him payment since the treatment is so new.
This has been a tough battle, and having to deal with insurance is just something that neither him or my mom should have to deal with.
Thank you in advance.
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