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08-31-2007, 12:58 PM
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#1
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Senior Member
Join Date: Feb 2006
Location: Acworth, GA
Posts: 2,104
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Medicare and Procrit
Medicare has changed their guidelines for receiving Procrit shots. Your hemoglobin now has to be below 10 in order to receive the shot. I was wondering if anyone on the board has been affected by this change.
__________________
Kate
Stage IIIC Diagnosed Oct 25, 2005 (age 58)
ER/PR-, HER2+++, grade 3, Ploidy/DNA index: Aneuploid/1.61, S-phase: 24.2%
Neoadjunct chemo: 4 A/C; 4 Taxatore
Bilateral mastectomy June 8, 2006
14 of 26 nodes positive
Herceptin June 22, 2006 - April 20, 2007
Radiation (X35) July 24-September 11, 2006
BRCA1/BRCA2 negative
Stage IV lung mets July 13, 2007 - TCH
Single brain met - August 6, 2007 -CyberKnife
Oct 2007 - clear brain MRI and lung mets shrinking.
March 2008 lung met progression, brain still clear - begin Tykerb/Xeloda/Ixempra
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08-31-2007, 01:28 PM
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#2
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Senior Member
Join Date: Apr 2007
Location: Mississippi
Posts: 600
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There appear to be medical reasons for this. I will look up the info and post it.
Leslie
__________________
In the world of destiny, there are no statistics.
Jan. 26- mammogram and ultrasound- suspicious lump
Mid-February- lumpectomy, infiltrating ductal carcinoma ~4.5 cm and a 1 cm DCIS, did not get clear margins, did not check lymph nodes
ER+/PR+, her2 +++, nuclear grade 3 of 3
February 20-PET scan showed something on liver. No biopsy.
March- Started carboplatin, herceptin, taxol on a four week cycle
May 3- Pet scan, with intent to do a biopsy, found nothing, liver or breast- no biopsy because there is nothing to biopsy
June 21- new onc, very concerned that there had been no biopsy,
June 18th-CAT scan, bone scan-negative
August 7th - Brain MRI-negative
August 9th- mastectomy, all pathology negative
January 2008 still NED! New oncologist -herceptin for full year after chemo- until July, and tamoxifen---negative scans since May '07
July 2008-Finished Herceptin!
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08-31-2007, 03:41 PM
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#3
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Senior Member
Join Date: Feb 2006
Location: Acworth, GA
Posts: 2,104
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Thanks Leslie. My secondary insurance United Health Care has not changed their guidelines. I'm currently working with a patient advocate from United Health Care to get this problem straightened out. If Medicare will not pay for the shot my United Health Care will as my secondary. My hemoglobin drops very quickly -- always has since the beginning. My hemoglobin even dropped when I was only getting Herceptin. Seems like I suffer from anemia all the time and the chemo just makes it worse. I had no problem until I had to go on Medicare in March. I had been on disability retirement unrelated to cancer and after 2 years I had no choice but to go on Medicare. My employer pays for my secondary coverage.
__________________
Kate
Stage IIIC Diagnosed Oct 25, 2005 (age 58)
ER/PR-, HER2+++, grade 3, Ploidy/DNA index: Aneuploid/1.61, S-phase: 24.2%
Neoadjunct chemo: 4 A/C; 4 Taxatore
Bilateral mastectomy June 8, 2006
14 of 26 nodes positive
Herceptin June 22, 2006 - April 20, 2007
Radiation (X35) July 24-September 11, 2006
BRCA1/BRCA2 negative
Stage IV lung mets July 13, 2007 - TCH
Single brain met - August 6, 2007 -CyberKnife
Oct 2007 - clear brain MRI and lung mets shrinking.
March 2008 lung met progression, brain still clear - begin Tykerb/Xeloda/Ixempra
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09-04-2007, 02:46 PM
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#4
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Senior Member
Join Date: Apr 2007
Location: Mississippi
Posts: 600
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warnings about procrit, epogen and arinesp
I think this may be the reason for the changes. I kept meaning to post it but didn't get around to it. Silly me. I keep thinking it's financial.
http://www.procrit.com/HCP07.pdf
http://www.medpagetoday.com/ProductA...ptions/tb/5231
Leslie
__________________
In the world of destiny, there are no statistics.
Jan. 26- mammogram and ultrasound- suspicious lump
Mid-February- lumpectomy, infiltrating ductal carcinoma ~4.5 cm and a 1 cm DCIS, did not get clear margins, did not check lymph nodes
ER+/PR+, her2 +++, nuclear grade 3 of 3
February 20-PET scan showed something on liver. No biopsy.
March- Started carboplatin, herceptin, taxol on a four week cycle
May 3- Pet scan, with intent to do a biopsy, found nothing, liver or breast- no biopsy because there is nothing to biopsy
June 21- new onc, very concerned that there had been no biopsy,
June 18th-CAT scan, bone scan-negative
August 7th - Brain MRI-negative
August 9th- mastectomy, all pathology negative
January 2008 still NED! New oncologist -herceptin for full year after chemo- until July, and tamoxifen---negative scans since May '07
July 2008-Finished Herceptin!
Last edited by fauxgypsy; 09-04-2007 at 02:51 PM..
Reason: forgot to add links
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