Showing posts with label herceptin and taxol. Show all posts
Showing posts with label herceptin and taxol. Show all posts

Friday, July 24, 2009

medical aid rejects appeal to pay for herceptin

Discovery has rejected the appeal. First they declined to pay for herceptin because i did not surgery. Ok, know that is unusual for breast cancer but there was no primary tumour, only two cancerous lymph nodes, and it was on doctors' advice that I did not have surgery. Had radiation instead.
So my oncologist appealed against the medical aid's decision. Then today I heard they rejected his appeal. Oh, I do need herceptin they say, because i have a high-risk cancer, well, it's aggressive, but they cannot authorise it as a single treatment. I need taxol as well.
Now taxol as far as I know, is another form of chemo. I met a lady in the radiotherapy waiting room who had had it and now had no feeling in the tips of her fingers and on her feet. I had AC chemo and after four treatments, my cancer went away. To the extent that the doctor who did the scan said if I were a first time patient, he would never have known I had had cancer.
So why does Discovery say I need more chemo? I have since had another scan - when my neck swelled up during radiation - which was also clear so why give chemo to someone who has no cancer in them?
My oncologist apparently laughed at their suggestion.
"I am a reporter," I said to the oncology centre. "Give me an appointment with the doctor so that I can get the facts and figures, more than i can get from the Internet, and I will get to the CEO (well, I can try, can't I?) and I will fight for it."
But the onocologist said: don't fight, do nothing, he will sort it out by Monday.
"Between Friday afternoon and Monday?" I said. But we will see.
The Yoga Man says that Dr D, our mutual opthamologist, said that people get illnesses which challenge them - not the illnesses per se, but the way they affect them. And that my cancer has taken away my control and that is what affecting me the most: the ability to control my life.
Oh by the way, this is what taxol is. Gonna read about it now.
PS: Nearly forgot a crucial part of this. Herceptin, well, the 17 treatments I will need, totals to just under a million rand. Even if/when Discovery authorises it, they will pay only 80% and I will need to pay just under R5000 a treatment. Each treatment is once every three weeks and sometimes two treatments fall into one calender month.