Prophylactic oophorectomy vs Zoladex...A cost/insurance issue

dtorrent

Long story short, 42, ILC < 1cm, lots of LCIS everywhere, BMX 4/8/2015. No reconstruction, healing fantastic, nodes clean, no radiation, Oncotype 11! Just got that number yesterday, thrilled!

So my MO thinks my best therapy is Zoladex + AI. I know Zoladex is frightfully expensive. My insurance does cover it as a specialty drug, I would have to pay all costs of it until I meet my max out of pocket, which is $6600. I have obviously met that this year, so everything till the end of the year is no cost to me.

However, next January I would start afresh, and I can't afford big money for Zoladex every month. Especially given the hope that I won't need any more treatment, and therefore won't come close to meeting max out of pocket.

Am I crazy to think the best option is to try the Zoladex for a few months ("free"), see how I do with side affects, and then talk my doctor into an oophorectomy before the end of the year so it's covered under this year's insurance?

Its nuts that I am thinking about having another surgery to save me money next year...but this $6600 this year has drained my bank account.

NineTwelve

My oncologist referred me to a surgeon for oophorectomy. I looked into it, but the statistics looked about equal for Zoladex versus oophorectomy. My MO admitted there is no statistical advantage of one over the other, but some patients prefer to get an oophorectomy because of the costs. (I'm lucky that my insurance fully covers my Zoladex shots.) While I was getting my answers, I received several responses from members here who got the oophorectomy and felt fine about it. In fact, there were no posts from anyone who regretted the surgery. I don't think you're crazy at all, btw. No one wants to be wiped out financially, on top of having a difficult illness.

inks

You are a smart woman to consider the possible cost of treatment and taking cost cutting measures.I did a similar thing - when I found out I needed radiation I changed my insurance plan to one that had half the co-pay per rads visit. I ended up saving money even though the plan was more expensive.

dtorrent

Thanks for the replies! I think this actually might be a better topic for the Hormone section, I think i will post up there as well.

mhenz

Dtorrent, I am asking myself the same question. Except I DID roads and have Prescott for tamoxifen. At t 42 I'm terrified of cancer off the insured or uterus especially since it is hard to detect. Therefore become more advanced. Love to know your decision.

Oncearunneralwaysarunner

Hi there,

I think starting with Zoladex to see how your body reacts to being thrown into menopause before deciding to go the surgical route is a good idea. Zoladex is less permanent than having your ovaries removed. I'm not ready to have my ovaries removed since we are considering having a second child but I did try the Zoladex in the mean time. I'm glad I did since my body is very responsive to hormonal fluctuations and I had severe menopausal symptoms. I'm 33 (diagnosed at 31) and the side effects of being thrown into menopause, even if it was artificially, impacted my quality of life too much. I know that for me, removing my ovaries in the near future is not an acceptable solution.

Had I had reacted fine to the Zoladex, I certainly would have considered having my my ovaries removed so I would not have to take an additionaldrug. I have to also mention that I have very good extended health insurance and I'm in Canada, so either way my out of pocked costs would have been very low. I still would have considered surgery if the symptoms were bearable after trying for a baby. I don't think it's nuts to consider the financial impact like you are. You are simply considerting all of the factors you need to in order to make the best decision for you.