The Limited Access to Proton Therapy for patients with some private insurances.

Patient Denied Access to Proton Therapy

Just last week, there was another news story out of Mississippi where a patient is being denied a medically recommended course of Proton Therapy.

I think it is an interesting read and emphasizes just how much work we need to do to increase patient access to treatments that potentially offer significant benefit.

I try and be careful and therefore used “potentially” above. In my opinion, without me have more direct knowledge of the case and the exact location of the tumor and critical structures, it’s hard to say with any certainty the amount of benefit from the integration of proton therapy into the patient’s care plan.

A Physician’s Analysis

I do bet that it is a case where the patient would benefit. Rarely are patients referred for proton therapy from a state that does not have proton therapy for this type of treatment. Maybe part of that is due to the patient’s knowledge and his individual effort to seek out potentially better treatment. But it is a brain case where proton therapy really does perform well. CNS tumors are in ASTRO model policies Group 1 category (highest level of data and support) for coverage due to studies showing better outcomes and less toxicity with Proton Therapy.

But in either scenario, I think it speaks to the importance of being your own advocate and learning and inquiring about options for your cancer. That really is the reason that I’m building resources so that more patients and care providers can be well informed relating to the benefits and potential opportunities for improvement in cancer care when proton therapy is utilized.

Here is the link to the article that touches upon the case and trouble that patients can have gaining access.

Article in the Clarion Ledger

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