Re: Another CyberKnife rejection

[Guest guest]

Carol:

Sometimes things do not happen " by accident. "

I recommend that you query UHC about proton beam radiation therapy at

UF Shands in ville, if you are in FL. If you like CK, you are

going to love PBRT. However, this may be another dissapointment if

the insurance goes through the same junk of initial rejection.

I can only say that I know of only two agencies/companies that refuse

to cover PBRT, they are the Veterans Administration (which doesn't

make sense, because the Army sends some patients to Loma for

PBRT), and Kaiser Insurance, that Laurel and Greg are currently doing

battle with.

Anyhow, it may be worth a shot, since PBRT is no doubt more expensive

than CK, and it might be an incentive to get UHC " off the dime! "

Good luck!

Fuller

>

> This morning my husband called United Healthcare Benefits

> Coordination. They have rejected his request for CK treatment.

Naples

> CK Center knew nothing about the rejection. While the coordinator

of

> the CK treatment program told my husband to wait through an appeal

> process, he is not a doctor. I think only my husband's doctor can

tell

> him whether he thinks that is a good idea or not. With a Gleason

7, he

> initially said, waiting a few months was ok BUT it now is a few

months

> already.

>

> We are disappointed but not surprised--UHC is not on the CK

bandwagon

> for ANY procedure, prostate or other!

>

> Carol

>

[Guest guest]

Carol:

Here is a VERY interesting link:

http://www.harp.org/bard.htm

that details a lawsuit filed about 1999-2000 against UHC to recover

the cost of PBRT by a patient. Unfortunately, I have not been able

to find out how this was resolved, but the points raised in the

documentation are certainly points that you MAY be able to use

against your case with UHC for CK.

Laurel, if you have not seen this, it may be of use to you and Greg

also.

Again, good luck.

>

> This morning my husband called United Healthcare Benefits

> Coordination. They have rejected his request for CK treatment.

Naples

> CK Center knew nothing about the rejection. While the coordinator

of

> the CK treatment program told my husband to wait through an appeal

> process, he is not a doctor. I think only my husband's doctor can

tell

> him whether he thinks that is a good idea or not. With a Gleason

7, he

> initially said, waiting a few months was ok BUT it now is a few

months

> already.

>

> We are disappointed but not surprised--UHC is not on the CK

bandwagon

> for ANY procedure, prostate or other!

>

> Carol

>

[Guest guest]

Apparently, CyberKnife is approved by the FDA and Medicare for

certain tumors, and accordintg to the Univ. of Tenn site, prostate is

included.

" The CyberKnife System is FDA-cleared to treat malignant and benign

tumors and lesions throughout the body—such as with lung cancer and

brain tumors—to include those that are difficult to reach and

conditions such as vascular malformations (i.e., arteriovenous

malformations) and functional disorders functional disorders (i.e.,

trigeminal neuralgia). ... "

" The following is a list of various conditions treated by CyberKnife.

Malignant Tumors

Benign Tumors

Vascular Malformations

Functional Disorders

Extracranial Tumors and Lesions

Base of Skull

Brain Tumors

Neck

Cervical Spine

Thoracic Spine

Lumbar Spine

Lungs

Pancreas

Liver

Other lesions, tumors and conditions anywhere on the body when

radiation treatment is indicated, including prostate. "

See:

http://www.utmedicalcenter.org/cms/Brain+and+Spine+Institute/Medical+S

ervices/CyberKnife+Stereotactic+Radiosurgery/CyberKnife+Treat/118.html

Or Google Cyberknife medicare

However, as I have stated previously, this is STILL photon radiation,

and in spite of all the claims, the long term effects of the low dose

EXIT radiation on the tissue and organs that are in the " path " of

this radiation is at present unknown.

Fuller

>

> Medicare does not cover experimental therapies. Is CyberKnife

experimental

> for prostate cancer with Medicare? I do not know.

>

>

>

> Kathy

>

[Guest guest]

Gee, I used UHC for my Prostate with RCOG (here in Atlanta )three

years ago and they paid virtually everything.

Just,

Bob

>

> This morning my husband called United Healthcare Benefits

> Coordination. They have rejected his request for CK treatment. Naples

> CK Center knew nothing about the rejection. While the coordinator of

> the CK treatment program told my husband to wait through an appeal

> process, he is not a doctor. I think only my husband's doctor can tell

> him whether he thinks that is a good idea or not. With a Gleason 7, he

> initially said, waiting a few months was ok BUT it now is a few months

> already.

>

> We are disappointed but not surprised--UHC is not on the CK bandwagon

> for ANY procedure, prostate or other!

>

> Carol

>

[Guest guest]

:

Care to share your thoughts and experiences about RCOG? I am very

interested, as I almost went there.

Also how are you doing, have you reached PSA nadir yet?

Thanks

Fuller

>

> Gee, I used UHC for my Prostate with RCOG (here in Atlanta )three

> years ago and they paid virtually everything.

> Just,

> Bob

>

> -

[Guest guest]

Hi:

RCOG = Radi0therapy Clinic of Georgia in Atlanta

See: http://www.prostrcision.com/

Fuller

>

> Please tell me what " RCOG " is????

>

>

[Guest guest]

Carol:

Dr. Critz at RCOG does what he calls " Prostercision " -- It is NOT

CK. It is a combo of seeds and radiation. You can investigate his

site (see the Q & A I posted in a previous post also), but you should

also check out comments about the results, which is why I asked

the question.

Also if you do go there, I would INSIST on the IMRT for the radiation

part, as is is less destructive of normal tissue than straight photon

radiation.

Fuller

>

> Was it the same procedure? CyberKnife is a very specific-to-the

organ affected high intensity radiation. They formerly used it only

on brain tumors, but FDA approved it four or five years ago for use on

any organ of the body. United Healthcare does not seem to believe

that it is no longer experimental, so they turned down the request.

>

> If you know something we should know, please post me! We are

still looking at options.

>

> Carol

>

>

> ---------------------------------

> Boardwalk for $500? In 2007? Ha!

> Play Monopoly Here and Now (it's updated for today's economy) at

Yahoo! Games.

>

[Guest guest]

What procedure are you referring to, Carol?

thanks

Fuller