Woman Pleads for ‘Chance’ at Life : Medicine: She seeks bone-marrow transplant to fight potentially fatal brain tumor. Her insurance company has denied the request, but an appeal is pending.
ORANGE — Jeanne Larner is pleading with her medical insurance company to pay for a bone-marrow transplant she believes will greatly increase her odds of conquering a fast-growing brain tumor.
“All I need is a chance, and I can get better,†said Larner, 24, who is under treatment at Children’s Hospital of Orange County, a medical center with expertise in bone-marrow transplants.
Larner’s physician, Dr. Mitchell Cairo, who heads CHOC’s bone-marrow transplant and cancer research program, contends that by using a transplant of the young woman’s own bone marrow, he can increase her chance of survival from 30% to between 60% and 70%.
Chemotherapy designed to annihilate cancer also destroys the bone marrow of cancer victims.
By extracting bone marrow from Larner and freezing it, Cairo said, it will be available later to be restored to her body after chemotherapy to help rebuild her blood and immune system.
Bone-marrow transplants, he said, allow a much more aggressive, and potentially more effective, regimen of radiation and chemotherapy. However, Traveler’s Insurance Co. on Dec. 23 denied Larner’s request for a bone-marrow transplant, contending that more conventional chemotherapy would be sufficient.
Larner, who lost her job earlier this year in the wake of discovering her cancer, says she has no other way to pay the estimated $200,000 for the transplant and is appealing the company’s decision.
Dennis Milewski, a spokesman at Traveler’s corporate headquarters in Hartford, Conn., said Larner’s claim has been sent to transplant experts outside the company for review as part of the normal appeals process.
“A national network of practicing transplant experts handles these kind of claims, and we asked them to expedite it,†said Milewski, adding that he wasn’t certain when a decision would be reached.
Time is of the essence, noted Joan Larner, the cancer victim’s mother. “The earlier her treatment, the better her chances,†she said.
She said her daughter, a business graduate of UC San Diego, was working in the accounting services section of a bank in Denver in early November when she began having headaches.
Concerned that she might be getting the flu, she saw a doctor who sent her for a CAT scan that showed she had a tumor in her brain. On Nov. 20 she had surgery to remove as much of the tumor as possible without impeding her ability to speak and understand.
After being laid off, Joan Larner said, her daughter moved back to her family’s home in Lake Forest and sought treatment at CHOC.
Cairo said bone-marrow transplants have been used for more than 15 years in treating malignancies and for the last five to seven years in treating brain tumors. More than 125 such procedures have been paid by private insurance in the United States, he added.
But insurance company opposition is not unprecedented.
“About 5% or 10% of the time the insurance company initially denies approval and we have to go back and make our case again,†he said. “Most of them re-evaluate the decision and allow the best therapy for the patient.â€
Cairo said he sympathizes with the Larners for reaching out to the public with their plight. “It is a very fast-growing tumor, and that is why the family is seeking help,†he said.
CHOC accepts patients up to 18 years of age, but in Larner’s case an exception was made because of Cairo’s expertise in bone-marrow transplants.
Meanwhile, Cairo said, he is going ahead with chemotherapy in an attempt to slow the tumor’s growth, although he would have preferred first to harvest a portion of the patient’s bone marrow.
Traveler’s contends that in making its decision, it will consider only the medical effectiveness of the proposed bone-marrow transplant. “Cost does not enter into it at all. It is strictly a medical decision,†Milewski said.
Jeanne Larner finds that hard to believe.
“I think they are playing gods with my life and not giving me a fair shot,†she said. “I think they are looking at it in dollars and cents and there has got to be more than that.â€
