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Old 10-22-2010, 04:06 PM   #1
Joan M
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Cutting cancer Medicare costs

Here's how they do it. And the next to last paragraph mentions Herceptin.

www.nejm.org/doi/full/10.1056/NEJMhpr0807774

Dr. Bach, the author of the article, was mentioned in a recent NYT article about modeling Medicare cost-cutting.

Joan
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Diagnosed stage 2b in July 2003 (2.3 cm, HER2+, ER-/PR-, 7+ nodes). Treated with mastectomy (with immediate DIEP flap reconstruction), AC + T/Herceptin (off label). Cancer advanced to lung in Jan. 2007 (1 cm nodule). Started Herceptin every 3 weeks. Lung wedge resection April 2007. Cancer recurred in lung April 2008. RFA of lung in August 2008. 2nd annual brain MRI in Oct. 2008 discovered 2.6 cm cystic tumor in left frontal lobe. Craniotomy Oct. 2008 (ER-/PR-/HER2-) followed by targeted radiation (IMRT). Coughing up blood Feb. 2009. Thoractomy July 2009 to cut out fungal ball of common soil fungus (aspergillus) that grew in the RFA cavity (most likely inhaled while gardening). No cancer, only fungus. Removal of tiny melanoma from upper left arm, plus sentinel lymph node biopsy in Feb. 2016. Guardant Health liquid biopsy in Feb. 2016 showed mutations in 4 subtypes of TP53. Repeat of Guardant Health biopsy in Jana. 2021 showed 3 TP53 mutations, BRCA1 mutation and CHEK2 mutation. Invitae genetic testing showed negative for all of these. Living with MBC since 2007. Stopped Herceptin Hylecta (injection) treatment in March 2020. Recent 2023 annual CT of chest, abdomen and pelvis and annual brain MRI showed NED. Praying for NED forever!!
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Old 10-22-2010, 05:21 PM   #2
Nancy L
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Re: Cutting cancer Medicare costs

Unless Obamacare is repealed which is highly unlikely, there are other Medicare cuts coming. The link you included was describing what Medicare was doing regarding Herceptin back in 2009. Who knows what is planned next but if they need to cut a lot of dollars, they are going to target the high priced procedures and drugs. I am Stage IV and on Herceptin/Tykerb. I have to go on Medicare next summer so I guess I will find out then.

Thanks for the post.
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Old 10-23-2010, 07:06 AM   #3
AlaskaAngel
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Re: Cutting cancer Medicare costs

I think the pressure here needs to be on studies that are designed to help to identify which patients actually benefit and which do not, so that the ones who do not are not wasting precious time and money getting it without any benefit. Half do not benefit. Pressure also needs to continue on studies that help to identify why it stops working when it does stop working for most patients who initially benefitted from it, so that if there are ways to get continued benefit from it, patients have access to them.

A.A.
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Dx 2002 age 51
bc for granny, aunt, cousin, sister, mother.
ER+/PR+/HER2+++, grade 3
IDC 1.9 cm, some DCIS, Stage 1, Grade 3
Lumpectomy, CAFx6 (no blood boosters), IMRT rads, 1 3/4 yr tamoxifen
Rads necrosis
BRCA 1 & 2 negative
Trials: Early detection OVCA; 2004 low-dose testosterone for bc survivors
Diet: Primarily vegetarian organic; metformin (no diabetes), vitamin D3
Exercise: 7 days a week, 1 hr/day
No trastuzumab, no taxane, no AI
NED
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