At least that's the question by my insurance company, which has denied the claim by my doctor to allow me to be treated with radiation. This treatment was supposed to begin tomorrow, 7/5. But let me start from the beginning...
In my last post I noted how my cancer had, unfortunately, returned and I was electing radiation treatment over chemo. Since that post (6/20) I have had several more doctors appointments meeting with the two doctors who offer the treatment. First up was the Cancer Center at Sibley Hospital where I was getting a consultation for radiation treatment. Then we visited with Washington Oncology Hematology for the chemo consult, where is where I received my chemo last year.
I also called & spoke to the surgeon who did my cancer surgery last year (left radical orchiectomy).
All three doctors said the same things: First, it sucks that it came back and it really shouldn't have. Second, since it did come back, this is exactly where you would expect it to return (abdomen). Third, very treatable and I again have two options; three weeks of chemo (BEP) or three weeks of radiation.
Chemo never sounds like fun, and unlike last year when I had a single, somewhat weak drug (carboplatin) for just one (huge) dose, this time I would have to have 3 weeks of BEP. BEP is a much more powerful series of drugs, these are the ones that saved Lance Armstrong. Interestingly my oncologist, Dr. Fishman, told me he contacted "the famous Dr. Lawrence Einhorn" about my case. When Julie & I sat with a blank look on our faces ("the famous Dr. who?"), Fishman explained that Einhorn was the doctor who led the team that saved Lance Armstrong. Apparently Einhorn is the one who pioneered the BEP chemo cycle. So Fishman contacted Einhorn about my case, and Einhorn thought (like any good oncologist) that BEP/Chemo was a great way to treat my cancer, but admitted that radiation was just as likely to achieve the desired result.
While chemo sounds miserable, had any of the doctors said it was the preferred method of treatment, I'd have said "let's do it." But all things being equal, I'm going to choose the (slightly) easier option. Going with BEP chemo would almost certainly meant taking 3-4 weeks off from work. This is an almost daily treatment regimen which requires IVs in between treatment to hydrate, booster shots for your immune system, etc. And of course doing this chemo course would remove BEP as a treatment option down the road if my cancer ever does return (just like I'll never again get carboplatin, the drug I had last year).
Radiation, on the other hand, is also daily treatment for 3 weeks. But this treatment takes less time (15 mins) and would allow me to continue working, although possibly on an abbreviated schedule. The level of radiation I'd be receiving is significantly less than say prostate cancer. So having radiation now at a lower lever means I could conceivably still get radiation at higher levels later in life should cancer return.
Prior to receiving radiation treatment you have to have a mapping appointment, which I had on 6/27. My mom was in town and went to the appointment with me so she could see the hospital, meet some of the staff, and see people coming & doing for treatment. At that appointment they do a 360 degree CT Scan of your body and put three marks on you (one on the belly and one on each side/love handle). Right now I have temporary marks in those areas but tomorrow (7/5) with my first treatment, I was to have the permanent tattoos put into place (mole size). Those tattoos become the marks the drs use to triangulate the location for the series of radiation blasts my body will absorb.
Or should be absorbing. Now with this letter from my insurance company (talk about ruining my day yesterday... had a bit of a pity-party when I read that letter) denying the treatment, I don't know what to think. I hope this is just a coding misunderstanding, although the letter is awfully damn specific. I have an email in to our benefits admin at the office who fights with the insurance company for employees all the time, and I'll call Sibley in the morning (Sibley, coincidentally, is both the name of the hospital AND my radiologist, although there is no relation there otherwise) to see if they can get this fixed. The temporary marks on my body which have already lasted a week will not last forever. So I don't know if I'm getting tattooed and irradiated tomorrow or not.
If for some reason insurance really will not cover this (inconceivable, radiation is the preferred method of post-testicular cancer treatment when caught early) but they will cover chemo, then that's what I'll do. Losing my hair, taking 3-4 weeks off from work, and being otherwise totally miserable aside, I'll do what I have to do.