Mammosite or not . . . that is the question

I had my pathology reports sent to Swedish Hospital the day following my oncologist visit so that I could find out whether I might be a candidate for the Mammosite procedure (see preceding blog entry for more info).

I received a call at work on my cell phone from "Bob-The-Scheduler" at the Swedish Hospital Radiology Department. He said that the doctor had looked over my report and thought that I could be a candidate. He set up an appointment for me to come to Seattle next Thursday morning to meet with her (the doctor).

In the meantime, he told me to round up my mammogram, ultrasound, and MRI films and to bring them with me to the appointment.

I was also told to call "Dan-The-Insurance-Guy" at Swedish to talk about insurance coverage. After several phone calls back and forth, the bottom line was this: my primary insurer will almost certainly NOT cover the procedure, as I am going out of network for it.

My husband's insurance (under which I am also covered) would not commit to paying for it, either. They said they might pay some or all of it AFTER the treatment is done and AFTER they see what my primary insurer's coverage or lack thereof is.

Therefore, if I were to proceed with the treatment, Swedish would require me to sign a waiver stating that I will pay out of pocket for the procedure if my insurance refuses it. Not gonna happen. I don't have a cost on it yet, but I'm told it's definitely in the 5-figure range.

So, after all of my excitement about the prospect of getting the Mammosite treatment, my enthusiasm was deflated. But, I have been praying and putting it into God's hands and know that if He wants it to happen, everything will work out.

Since my husband's employer is self-insured, they may be able to sway the insurance company. That's my best hope. I called my husband and asked him to get his employer to go to bat for me.

He talked to the insurance dude at his company. This guy's wife also had breast cancer 5 years ago, so he's somewhat sympathetic with our situation. His wife underwent experimental therapy and at first, the same insurance company said they wouldn't pay. However, they ended up paying.

So, the guy told my husband to keep the appointment at Swedish and ask the doctor to write up a pre-authorization request (and to "make it good."). He says that if the insurance company still refuses to commit to paying, he'll talk to them about it.

So it's still up in the air. I hope my trip to Swedish won't be wasted, but it's all out of my control. I said that I would pursue this avenue until I hit a roadblock and I will.

I still have an appointment the day before Swedish with the radiology doctor (for conventional radiation) at my local cancer care center. I'm betting he will try to talk me out of the Mammosite procedure (just a feeling I have).

But I consider the Swedish visit along the lines of a "second opinion," and I'd like to think that I still have some choice in the matter of my treatment (maybe it's an illusion?).

In the meantime, I contacted two women via email about their alternative radiation treatments. One had the Mammosite procedure 4 years ago (I found her through the Mammosite web site) and her advice to me was, "GO FOR IT!"

The other woman is a friend of my sister-in-law. She had a different version of the catheter radiation where several catheters are inserted with radioactive seeds. She chose to do it because she lives 45 miles away from a hospital and would have had to drive that far (back and forth) every day for 6 weeks for conventional radiation.

She had some rather unpleasant side effects from her treatment, including "severe scarring" at the site of the radiation and chronic diarrhea for almost a year afterwards (she thinks the diarrhea was an allergic reaction to the anti-swelling medication she was given). I have to keep in mind that the scarring she got was unusual and so was the allergic reaction. Also, the Mammosite procedure uses only one catheter, not several, like she had.(Can you tell I'm trying to talk myself into this?)