Support Ellen's Cancer Treatment
Donation protected
As many of you may know, one night in late September, our mother lost her ability to comprehend and communicate simple words and phrases. She was immediately taken to the hospital and it was discovered that she was experiencing an aphasia seizure. This seizure was caused by a tumor in the temporal lobe of her brain, which affects her overall language and comprehension. After multiple tests, she was diagnosed with stage 3 glioma anaplastic astrocytoma-IDH1 mutation, brain cancer. Due to the severity of the diagnosis it was determined that a craniotomy be performed immediately to remove the tumor. The doctors were able to successfully remove 90% of the tumor, but unfortunately the remaining 10% was deemed inoperable due to the tumor’s location.
After the surgery, our family was informed that our mother’s doctors wanted to treat her tumor with proton radiation therapy, which has unique performance characteristics compared to the traditional photon beam radiation. Photon beam radiation starts at a high dose and degrades as it goes through the tumor and off into healthy brain tissue. The problem recognized by the medical community is that this leaves 40%-50% of the radiation dose in the brain, lowering her chances of a full recovery and quality of life. However, proton beam therapy operates on charged particles, which means that they are able to come to a full stop at a certain tissue depth. Several studies published in 2015 demonstrate that this in fact prevents damage to healthy tissue in the radiated region and offers greater overall survivability than photon radiation.
Cigna, her insurance provider, has denied all 3 appeals for coverage. They have stated that the treatment isn’t medically necessary, and that there is insufficient evidence to demonstrate that proton beam treatment offers any more benefit over traditional photon radiation. The Cigna policy on proton therapy is from 1999 and 2001, which is at odds with the current science. The third denial even stated that there is evidence to support the benefits of proton therapy to treat head and neck tumors but the reviewer felt that it wasn’t enough to approve the treatment. Published studies as recent as 2015 have demonstrated an overall benefit to proton radiation compared to photon radiation. We feel like Cigna has pushed the appeals/denial process so fast that by the time we get the denial from the first appeal, they’ve already responded to the doctor’s office on the second appeal.
Our mother’s treatment was supposed to start on November 16th but due to the denial from the insurance we have not been able to even schedule the treatment. Our family is down to our last option, which is paying for the proton radiation treatment out of pocket. The total cost of the treatment is $268,000. We would greatly appreciate any contribution that you would be willing to make towards our mother’s care. Our mom is an amazing and selfless person that has dedicated her life to helping others. She is a NICU nurse, a nursing professor, and most importantly, a wife and mother of four children. The amount of support she and my family has received thus far has been unbelievable and we are very thankful for that. We also wanted to thank everyone ahead of time for their donations to this cause, as we would not be doing this if we felt it wasn’t absolutely necessary.
After the surgery, our family was informed that our mother’s doctors wanted to treat her tumor with proton radiation therapy, which has unique performance characteristics compared to the traditional photon beam radiation. Photon beam radiation starts at a high dose and degrades as it goes through the tumor and off into healthy brain tissue. The problem recognized by the medical community is that this leaves 40%-50% of the radiation dose in the brain, lowering her chances of a full recovery and quality of life. However, proton beam therapy operates on charged particles, which means that they are able to come to a full stop at a certain tissue depth. Several studies published in 2015 demonstrate that this in fact prevents damage to healthy tissue in the radiated region and offers greater overall survivability than photon radiation.
Cigna, her insurance provider, has denied all 3 appeals for coverage. They have stated that the treatment isn’t medically necessary, and that there is insufficient evidence to demonstrate that proton beam treatment offers any more benefit over traditional photon radiation. The Cigna policy on proton therapy is from 1999 and 2001, which is at odds with the current science. The third denial even stated that there is evidence to support the benefits of proton therapy to treat head and neck tumors but the reviewer felt that it wasn’t enough to approve the treatment. Published studies as recent as 2015 have demonstrated an overall benefit to proton radiation compared to photon radiation. We feel like Cigna has pushed the appeals/denial process so fast that by the time we get the denial from the first appeal, they’ve already responded to the doctor’s office on the second appeal.
Our mother’s treatment was supposed to start on November 16th but due to the denial from the insurance we have not been able to even schedule the treatment. Our family is down to our last option, which is paying for the proton radiation treatment out of pocket. The total cost of the treatment is $268,000. We would greatly appreciate any contribution that you would be willing to make towards our mother’s care. Our mom is an amazing and selfless person that has dedicated her life to helping others. She is a NICU nurse, a nursing professor, and most importantly, a wife and mother of four children. The amount of support she and my family has received thus far has been unbelievable and we are very thankful for that. We also wanted to thank everyone ahead of time for their donations to this cause, as we would not be doing this if we felt it wasn’t absolutely necessary.
Organizer and beneficiary
Matt Sanborn
Organizer
Londonderry, NH
Ellen Sanborn
Beneficiary
