Recommended Tests

Posted By
ALA
8/27/2010 11:02pm
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ALA
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Replies: 5

Sept 2009 I was diagnosed with stage IIB melanoma, 11 mm deep but not ulcerated removed from mid back, margins clean.  SNB was not performed as the doctor assumed lymph node involvement given the depth.  Whole body PET scan and sonogram of suspect lymph nodes at neck and arm pit were clear.  Because my insurance ruled this a pre-existing condition I could not afford the recommended adjuvant interferon therapy and opted for watchful waiting.  Coming up on a year now with no articulable symptoms of recurrence or remote metastases which brings me to the subject.  Is there a recommended progression of follow up tests (from least to most expensive or with the greatest chance of detecting disease) I should be considering at this juncture?  Best wishes to all, Alan.

molly - (8/28/2010 - 2:43pm)

Alan, 

Curious as to why your insurance company considered this a pre-existing condition?

Are you seeing a melanoma specialist? Where are you located?  I'm sure you will get some helpful advice here. It is a great place with very knowledgeable folks on board. Things do get a little slow on the week-ends so please don't be discouraged if you don't get many responses quickly. 

My husband didn't do any treatments after his surgery but did have check ups every 3 months at first, then 6 months, and then yearly with a melanoma specialist.  They did a yearly CT scan on him. The scans are very individualized as to locations and hospitals and doctors....some do them routinely, others don't.

Best of luck to you and hopefully you will get some good information from the folks here.

molly

ALA - (8/30/2010 - 12:14pm)

To answer your question Molly, the original excision was performed by my primary care physician to remove a suspect mole after my insurance was in force.  I had conferred with my physician some months prior when he suggested that the mole should be removed but delayed doing so.  I have an inherited trait from my mother in that we seem to produce an excessive number of moles and a few previous excisions were all benign.  I took a chance that this one would be benign also and was wrong.  In any event, I believe the insurance administrator used the original recommendation as proof of the pre-existing nature even though the actual biopsy resulting in the diagnosis didn't occur until later.  Thanks for your reply and best of luck to you and your husband.  Alan

Fen - (8/28/2010 - 5:26pm)

I get blood tests and a chest xray every 6 months. I don't know where my primary was, but it metastasized to the lymph nodes in my neck so the lungs are a logical place to check.   I think there are some levels measured by blood tests that might indicate further tests are needed and blood tests aren't very expensive.  Some people get CT/PET scans frequently, but they are VERY expensive.

How is your oncologist?  Is he/she a melanoma specialist?  Have you tried arguing with your insurance company.  The pre-existing condition doesn't sound right and you might just need to appeal their decision.

Good luck!

washoegal - (8/28/2010 - 8:29pm)

Don't like to get into politics on this Board but one thing I read, is that in 2011 Obamacare will change the pre-existing rule.  Others might be more up on that, or you might want to do a search for more information.

At stage 2B, watch and wait , would be your recommended course.  I would suspect most Onc would recommend 6 month Pet and Cat scans to start.  I would certainly go for the Pet scan and Lung X'ray.  See a dermatologist  on a regular basis. 

An appeal on the pre-existing condition ruling might be worth while if you didn't get you insurance after your diagnosis.

Life is too short to be anything but happy. Falling down is a part of life, getting back up is living.

ALA - (8/30/2010 - 11:47am)

Thanks to all for your replies and valuable information.

I just talked to my insurance company and confirmed that the anniversary date for all pre-existing conditions expired August 25, 2010 so I should be covered for any further testing and/or treatments.  I went the appeals route when the issue first developed but to no avail.  That's in the past now and I need to concentrate on the future testing options mentioned in your replies.  I will be making an appointment with my oncologist soon. Thanks again to all.  Alan