• Any metastatic cancer patient

    Asked by KB2013 on Tuesday, April 24, 2018

    Any metastatic cancer patient

    Are stage IV's supposed to avoid invasive, elective, non-cancer related surgeries due a higher risk for infection? Are elective surgeries to improve on an existing problem to be avoided by this patient group? Do they have the same legal rights as non-cancer patients when things go wrong and the physician refuses to repair or refer to another specialist? Anyone have or know of a patient who experienced this situation?

    16 Answers from the Community

    16 answers
    • JaneA's Avatar
      JaneA

      Anyone receiving chemo is not supposed to have any dental work done due to risk of infection because chemo may lower your white cells and decrease your body's ability to fight off infection.

      Depending on the chemo that you are receiving (such as Avastin which can cause bleeding issues due to surgery), many patients are told be off chemo 4-6 weeks before and after surgery. In other words, if everything went exactly right, you would need a 2-3 month break in your chemotherapy. That might compromise your cancer treatment.

      Your insurance company may deny elective surgery because you are in active Stage IV treatment, due to risks outweighing the potential positive outcome.

      My guess is that only emergency surgery is appropriate for Stage IV patient - such as bowel blockage about to rupture or acute appendicitis. I am a Stage IV rectal cancer survivor - given my low white counts and low platelet counts during treatment, I doubt that I would have been a candidate for any elective surgery. I had my major, potentially curative surgery eight weeks after chemoradiation and resumed mop-up chemo (due to positive lymph nodes found during surgery) six weeks after my surgery. I hope that this helps you understand the risks.

      4 months ago
    • carm's Avatar
      carm

      @KB2013,
      Any treatment whether surgery, radiotherapy or chemical therapy is palliative when you are staged as a 4. There is no intent to cure only prolong life with comfort. Therefore, when you request coverage from your healthcare provider for elective surgery they will consider if that is a palliative intent... in other words, will that procedure extend your life or increase your comfort. I am an oncology/End of Life nurse and I work for a major healthcare provider as a cancer care-specialist. In some ways @JaneA is correct. Where we differ is on the Avastin issue. Avastin is not a chemotherapy it is a biotherapy... an antiangiogenesis that blocks blood supply to a tumor thereby starving it. It should not increase the risk of bleeding however it will elevate blood pressures and she is correct in that you should wash off of Avastin or any other therapy prior to a surgical procedure. As I stated before, she is also correct with the insurance company probably denying that request. A stage IV diagnosis will always effect the options available to you because they must meet the definition of palliation. I hope this clarifies a bit.

      4 months ago
    • SandiA's Avatar
      SandiA

      Interesting question. I had never thought about that before

      4 months ago
    • KB2013's Avatar
      KB2013

      JaneA and Carm...I'm speaking of issues unrelated to cancer. I'm speaking specifically of procedures not paid for by insurance but, elective. I am speaking of patients who are not terminal but are NED a few years.

      4 months ago
    • carm's Avatar
      carm

      @KB2013,
      Your question started with "any metastatic cancer patient," so I think it is easy to understand our responses. If you are referring to a non cancer patient who is getting denied an elective surgery then you need to find out from your insurance plan why they do not cover it. There are many healthcare providers who will not cover elective procedures.

      4 months ago
    • geekling's Avatar
      geekling (Best Answer!)

      I do know that people with cancer or who have had cancer have exactly the same legal rights as folks who havent ever had cancer.

      Those rights, however, have nothing to do with whether some sort of surgery is a good idea or not.

      If there is a physician who has made some sort of error and hurt a patient, why would the patient trust the same clod to fix it? Or trust a referral from the messed up doctor?

      If a doctor has somehow caused harm to a patient, it is the patient's attorney who will work things out so the patient can be "made whole" again. Our society does not take eyes as justice these days. It iscash on the barrelhead only.

      Best wishes.

      4 months ago
    • KB2013's Avatar
      KB2013

      Carm, I said 'not paid for by insurance' by which I mean out of pocket, no insurance involved, no permission needed from an insurance company.
      I have metastatic nsclc, (cancer patient) seeking other stage 4's, not just nsclc patients but, any type of cancer who have paid cash for medical services no insurance covers because it's considered a 'choice' or 'elective' rather than necessary to sustain life.

      4 months ago
    • KB2013's Avatar
      KB2013

      Thanks geekling, that's what I needed to know.

      4 months ago
    • happydyad's Avatar
      happydyad

      I am not Stage IV and have also elected to by pass insurance as sometimes I don’t feel like waiting around for their self-serving review and approval. I rely on my own self-serving review and approval. I have also gotten care after a health insurance rejection then had them come back around and pay for it after they saw that (who knew?) I was right about getting a benefit from the test. Above all things, honor your inner wisdom. You know more than you think you do. Judy in KY

      4 months ago
    • BoiseB's Avatar
      BoiseB

      I have also found that age makes a difference. I have been Stage IV for eight years. Cancer free for five years (that was another cancer), I also turned 75 last year. The cancers that I have are esophageal cancer and uterine sarcoma. This year I was denied a mamogram by medicare.
      As for legal rights the sad truth is your legal rights are only as good as your lawyer. The good news is there are some advocacy lawyers out there. I have really not looked into Cancer Advocacy Groups because my brother is an advocacy lawyer for the handicapped and he would know right away where I should go if I needed it.

      4 months ago
    • KB2013's Avatar
      KB2013

      BoiseB, I heard they had a cut-off age for mammograms. Guess you reached the edge of the cliff we all were warned about a few years back. Glad you are still with us.

      4 months ago
    • BoiseB's Avatar
      BoiseB

      It makes me sort of angry because Medicare was something we paid premiums for all our working life and still pay premiums for part B. When we were paying for it we were also paying for private health insurance. My Medicare deduction has gone up since I turned 65 ($23 a month since in 16) and now my benefits are going down.
      By the way my son (also an advocacy lawyer) says you should get a copy of those consent forms you sign when you have any procedure but particularly if it is elective. You are really not giving up as many of your rights as you are lead to believe you are. And I have found out that they seem to have ways of slipping DNR's in those packets of forms they make you sign.

      4 months ago
    • KB2013's Avatar
      KB2013

      BoiseB, great point uou made re: consent forms. Conceald dnr orders? very scary.

      4 months ago
    • BoiseB's Avatar
      BoiseB

      Yes signing the consent form does not mean that you are consenting to malpractice. If there are risks involved you, you should get them in writing. And no matter what if damage is done you deserve repair if the Dr. doesn't know how to do the repair they should refer you to another Dr.

      4 months ago
    • Skyemberr's Avatar
      Skyemberr

      So if I needed some sort of vaginal repair now at stage 4 due to an insufficient transplant and poor plastic surgery, would the insurance approve that?

      What about repair to the damage done to my torso from all of the cancer surgeries? It looks like someone took a bite out of me. I honestly don't care about that so much, but it seems like I was a bit mutilated and I don't know if I am allowed to get surgical fixes for those things anymore.

      This is a good question. Sorry for hijacking this a bit with my own questions but I have been wondering about this for awhile.

      4 months ago
    • geekling's Avatar
      geekling

      @BoiseB I cant tell you how annoyed office workers get because I insist on actually reading a form before I sign it. As often as not, I add codicils, excluding this by crossing it out and initialing or adding that by handwriting my change with sentence ending initials prior to signing. They hardly ever notice or object. If they do object and insist doctor wont see me unless I sign a form intact, I do not bother to see doctor. One gal told me I needed to sign a form intact but could change my mind later. Otherwise doctor would not see me. I replied "If doctor wont see me now why should I wait to change my mind?" and skipped out the door.

      The worst problems comes with hospitals and their electronic signing. Great for them but I like hard copies and to read what I am to sign prior to actually signing.

      I keep thinking of cases where wrong procedures were performed and of the woman with a natural immunity to breast cancer who lost the rights to her own tissues, blood, and DNA. There is no actual research going on via her samples because the company which owns her bits are charging so much money for samples. Go figure. As long as I am able, I will do what I think is best for me instead of submitting to someone else's idea of what is best for themselves in using me or my parts.

      Keep the Faith

      4 months ago

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