Question re: Ablation of Liver Mets

[Gallivanter]

Hello!

I've had liver mets - in addition to bone - for a little over a year. When I was scheduled for a biopsy of the liver (a year ago), I asked my doc if they could ablate the tumor at that time and she "found/chose" a surgeon who would do this. So it seemed to be non-routine.

I received a bill for about $7k of the procedure since insurance denied it as "experimental".

It took a while for the bill to find me (actually the collection agency...we had moved, never received a bill) and I paid it (to the hospital...didn't want to give $$ to the collection agency, who pays pennies on the dollar for medical debt...).

Anyway, I'm confused because I see folks on this site who get ablation seemingly all the time. And repeatedly, as if every little thing that crops up gets fried/frozen/otherwise dealt with. That's the world that I want to live in!!

I'm wondering who is tapping in to all this ablation (!) and how? For a bit, I thought it was Europeans, who have a superior health care system...but I think I see folks in the US getting this, too?

Is it about my insurance (employer-provided, Aetna, good coverage...)? The fact that I live in the US? My medical facility?

I'd appreciate any clues or insight you could provide....

Thanks!

[Chamisa]

I’ve wondered the same as you. I’m in Texas and received my MBC diagnosis August 2022. (Mets in lungs, liver, and bones.) I’ve read about people having ablation done on select liver mets to reduce the overall burden on the liver, and I’ve asked repeatedly about having the procedure done on me. My Dallas UTSW onc said no, that we’d just do systemic therapy instead. I repeated my request at MD Anderson in Houston and it was also dismissed… when I pressed my MDA onc, she said it would cause damage to surrounding tissue and that would be just another thing my liver would have to overcome. BUT, I’ve certainly read in these forums and others I participate in, that some locations (maybe mostly Europe) do routinely offer that. 🤷🏻‍♀️

[jersey-jazz]

At Memorial Sloan Kettering Cancer Center, they do ablations of cancerous lesions in the liver. I've had ablations four different times removing a total of ten lesions, with no insurance repercussions. I too prefer it to systemic treatments but have ended up doing both.

Unfortunately, the last ablation went horribly wrong when the instrument slipped and put a hole between the liver and the colon. I am still dealing with the consequences eight months later.

[Gallivanter in reply to jersey-jazz]

Thanks for the great info. I go to Sloan sometimes to see a consulting, so maybe I can score some ablation there, when new mets crop up.

And I'm so sorry about the issue you're having! What a shame to have to contend with that, on top of everything else.

[1711JPD]

I have had ablation procedure done twice. I am on Medicare with Supplemental Plan F from AARP/United Health Care. I live in NC.

My onc wasnt 109% keen on me having the procedure, but did refer me to an interventional radiologist. After looking at a new abdominal CT, and most recent PET he told me I was a candidate for the procedure.

He now receies accesz to all of my testing results and has become part of my team. Can you ask your onc for a referal and see what happens? Can your cancer center call Aetna on your behalf?

Best wishes and happy holidays!

Joyce

[Gallivanter in reply to 1711JPD]

Thanks for the intel! It's especially helpful since I'll be moving to Medicare within the next year or two and have been curious about procedure approvals might change...sounds like it's possibly for the better (in some regards)...

[1711JPD]

I dont think Plan F is offered any longer. But a phone to Units Health Care Custom Service (800.523.5800) should give you info on what has replaced Plan F. It is the nost expensive plan, but I had already had breast cancer when I joined, and was always concerned about it coming back.

Best wishes!

[13plus]

I think the ablation is not possible for everyone, depending on the size and locations of the lesions. And as you can see from one of the previous comments here, sometimes things go wrong with directing the laser beam