This week, I went in for my breast cancer checkup. My doctor, Sheila Garvey, agreed with me that there is a cure for breast cancer. Shocking news? Not really. The proven "cure" is EARLY detection and treatment. How do I know this? I am the "poster girl" for early detection.
First, a little background. My sister died of breast cancer in 1994 after 8 years of aggressive treatment both traditional and experimental. Why did she die? Her cancer was not diagnosed EARLY. She probably had carried that cancer around in her body for over 3 years. My mother had a double mastectomy and aggressive treatment due to breast cancer in 1987. She will be 91 years old in a few months. Why is she alive? EARLY detection and aggressive treatment.
I have such a high percentage of the developing breast cancer due to this family history that I have had 4 negative biopsies over the last 10 years. I am diligent about my annual mammography and conduct self-breast examinations at least weekly. In August 2009, I discovered a lump during one of these self-breast examinations. My breast surgeon, Dr. Sheila Garvey, saw me within 48 hours, ordered all the appropriate tests, and determined that the lump was indeed breast cancer. This lump was not observable on my previous annual mammography.
Because of such EARLY detection, I was able to have a lumpectomy. (In fact, several studies have shown that 80% of women with EARLY detection are well suited for breast conservation via lumpectomy. If your surgeon recommends mastectomy, be sure to ask WHY.) My lymph nodes were clear so I was fortunate to skip chemotherapy but was a candidate for radiation via BRACHYTHERAPY. And now this is the part where you really need to pay attention. Many doctors and most women believe that whole-breast, external beam radiation is the only treatment for breast cancer. WRONG. Previous research, that I have if you would like it, and research released just this last month by the American Medical Association has shown that breast brachytherapy or partial breast irradiation has the same "cure" rate as external beam. Brachytherapy has been used for years and is NOT experimental.
With external beam radiation, daily treatments of external beams are given to the entire breast
Monday through Friday for 6 to 8 WEEKS. This treatment affects the entire chest including breasts, ribs, lung, heart, and skin. Breast brachytherapy delivers radiation deep into the breast, in and around the lumpectomy area where microscopic cancer cells are most likely to remain. It is very convenient since treatment is complete in just 5 DAYS. Radiation is given only to the part of the breast adjacent to the original cancer. There is little or no negative effect to the ribs, lung, heart, and skin.
The selection criteria for brachytherapy includes at least 3 of the following 5 indicators:
Age 45 years old or greater;
Invasive ductal carcinoma or ductal carcinoma in situ;
Total tumor size less than or equal to 3 cm in size;
Negative microscopic surgical margins of excision;
Axillary lymph nodes/sentinel lymph node negative.
Brachytherapy is usually covered by the majority of insurance companies. Of the 10 major insurance companies in Utah and Medicare, all covered brachytherapy except SelectHealth. Of course, as luck would have it, SelectHealth is my insurance company. They denied approval of my treatment. With the support of my doctors and my insurance agent Karen Leonardi, I appealed their decision. I provided support letters from my medical team and a file of extensive research into brachytherapy. I presented the following to the panel:
The American Society of Breast Surgeons published a consensus statement in 2005 recommending brachytherapy for breast cancer in lieu of whole breast radiation;
The American Society for Radiation oncology, the leading radiation oncology organization in the world, published a similar consensus statement in 2009;
The Tumor Board has provided the consensus statements and relevant research to doctors, oncologists, and radiation oncologists at their in-service meetings at McKay Dee Hospital in the summer of 2009;
The cost of whole breast radiation and brachytherapy are basically the same;
The amount of time for brachytherapy is 5 days as apposed to 6 to 8 weeks for whole breast radiation.
SelectHealth approves brachytherapy for treatment of prostate cancer for men but not breast cancer for women. (Don't even get me started on this one!)
Bottom line: My appeal was reviewed by an Independent Review Organization who overturned SelectHealth's denial based on the research I provided. I was able to receive the brachytherapy and now one year later, I am cancer-free.
I was shocked to learn that most women do not appeal when denied insurance coverage for this therapy. Moral of this story:
1.EARLY detection can not only save your breast, it can save your life.
2.If you are diagnosed with breast cancer, ensure that you have complete information to determine if a lumpectomy or a mastectomy is the right approach. Don't just blindly follow your doctor's recommendation.
3.When you are referred for radiation, cover all the options including whether brachytherapy is appropriate for you. If your doctor doesn't support or know anything about brachytherapy, find one that does. (Gamma West is a good choice; Dr. Hansen and his staff preformed brachytherapy for me).
4.If your insurance company denies any treatment that is the best option for you, APPEAL
Last month, I was able to hold my new grandson within his first hour of life. I plan to be there for all the important events in his growth into manhood. Early detection will help me with this goal. I want all women to be able to reach these important goals. Please contact me if you would like a copy of the research and contacts that can help you get the best breast cancer treatment possible for you.
Bair, a breast cancer survivor, lives in Nordic Valley.