Columbus woman battles cancer and insurance company
When a rare form of cancer struck a young Nebraska woman, she learned the treatment could save her life but do damage to healthy tissue along the way. That risk would be eliminated by a unique therapy at the Mayo Clinic in Minnesota. But there's a catch. Her insurance calls the procedure experimental and won't pay for it.
Playing in the background is her favorite song called "Hell Of A Night," which describes many days in treatment for 21-year-old Ashlyn Kula. "Sometimes the mask pinches my lip or presses on my gums, so sometimes it hurts."
Recovering from mononucleosis in January, Ashlyn developed a lump on her neck. "It just kept growing so it was really scary and I didn't know what it was."
It's Nasopharynx Carcinoma that strikes just five people in a million each year. "I want to give her the best treatment that I can give her and I feel like I can give her a better treatment," said the Mayo Clinic's Dr. Michelle Neben Wittich. "That's very frustrating for me."
The radiation Ashlyn now gets attacks cancerous cells, but damages healthy tissue along the way that may have long-term effects. Among the side effects are not being able to swallow, not being able to eat normally and memory loss is a real possibility.
There is a treatment she could get with less side effects and that's why her battle is not just with cancer, but also with insurance.
United Healthcare, which provides Ashlyn's coverage through her father's employer, won't pay for proton beam therapy, saying there's not enough evidence it will work for Ashlyn. The treatment would zap a tumor without hurting healthy cells.
"It saves thinking processing and memory for the brain," said Dr. Wittich. In an appeal, Dr. Wittich, sent proton beam success stories and data to medical experts working for the insurance company. "In looking at her case, the proton plan is better and I'm convinced it would spare her these unnecessary side effects down the road."
Still, the United Healthcare medical director, also an oncologist, upheld the denial of payment for proton beam therapy.
"To me it doesn't seem right that someone sitting behind a desk at an insurance company can override what an radiation oncologist says," said Ashlyn's mother, Krystal Butacan.
At the Mayo Clinic, Ashlyn continues the more damaging radiation therapy, three dozen times over three months before she's through. "It's getting old. I'm just ready to get home."
United Healthcare Public Relations Director Maria Gordon Shydlo sent Six On Your Side this statement:
“In some instances when requested services are not covered, individuals have the right to have their cases reviewed by an independent third-party medical professional. In this case, an independent medical professional reviewed her case and upheld our decision based on current medical guidelines. We remain committed to working with Ashlyn and her family to help address her health care needs.”