Zometa
Comments
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Here's my update.
Told my onc I wanted the Zometa infustions. (to prevent bone mets). She said, well that would be "off label" - let's get you a bone density scan.
Bone density scan showed areas of Ostopenia. I thought Great! Med Center checked with my insurance, and apparently they will not approve it! Even though I have osteopenia. Nurse practitioner said, something like, if you were on a AI, and the AI caused the Ostopenia, then they would pay.
Is that not the stupidest thing you've ever heard of? My husband and I have decided to call the insurance company and fight about it. I am on Tamoxifen for 1-3 years, then will switch to an AI...
(I have US Cigna!)
Spring.
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FYI, My husband pushed on the insurance company, and it turned out that (we think) the cancer center did not use the right "codes" when they initially tried to pre-approve it. I am approved, as my bone scan showed ostopenia.
I will get the Zometa infustion tomorrow!
Here are the codes that were approved, in case anybody has the same issues:
Reclast: 733.01 Osteopenia J3488
Zometa 733.90 Osteopenia Jcode: J3487
Spring
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Yeah Spring!
Glad you got to the bottom of the pre approval. Geeesh!
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My next appt with my onc is May 26th. I will definelty bring up the Zometa issue. He will probably shrug it off along with all of the other questions I've asked him. But I will push the issue on this one.
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Kim - I will be interested to see what yours says. I am going to bring it up at my next appt too. I think in Canada the 'rules' are different than in the States....we will see. I really feel I need to be doing more.
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All,
I had my Zometa infustion last Friday, and it took 30 minutes. For Osteopenia, you get it once every 6 months. For bone mets, you apparently get it once a month (same amount). But, I figure 2x a year is better than 0x a year!
I had absolutely no SE's from the infusion - it was a breeze. Just sayin'!
Spring.
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Kim40... & Kerry Mac
Please push your onc on the Zometa. I am in B.C. and my onc recommended it right away as soon as he got back from the ACSO last June. I think a lot of oncs are getting on the Zometa bandwagon, your oncs answer might surprise you!
Good luck!
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My insurance is United Healthcare and my nurse practitioner informed me that they will not cover Zometa because I only have ostopenia. If anybody has any luck convincing their insurance companies, I would like to know how to !!! I am currently taking Boniva but I definitely want to take Zometa to prevent bone mets.
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LRSeyes, call your insurance company YOURSELF. That's what we did. My onc's office said the same thing to us at first. If they don't comply, get a "case manager" to help you.
Here are the codes that were approved, in case it helps...
Reclast: 733.01 Osteopenia J3488
Zometa 733.90 Osteopenia Jcode: J3487
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I read all the promising medical reports on zometa four years ago.....finally got my oncologist to give it to me two years ago under the guise of having osteoporosis. He was never a fan due to the side effects and each time I came to get it he would try to talk me out of it. He never really got the idea that I was taking it to keep mets away. Last week he tried to get me off it again and I told him "what about all the great reports on it lately"....he said show them to me. I went home and printed gobs of medical reports and put a stack on his desk. That evening after reviewing and discussing with the board of other oncologists he called and said....come on in and get it....
I hope to stay on it for one more year which I hope is really all I need to keep the beast away. I have a really great oncologist but I think they are so busy seeing patients that they are not as current as us group of ladies. They wait for the one meeting a year to get a slice of what is happening.
We just need to continue to be our own advocates.
Jacqueline
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Jacqueline,
Do you get Zometa monthly? (I am scheduled to get it one time every 6 months).
Good grief about the oncologist, I mean really. ugh.
Spring...
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Just saw my Onc today and she won't give it to me. They won't prescribe it at the Hospital where I am being treated. She said she has had other patients ask for it, and the Breast Cancer Oncs have discussed it, but at this time they don't think it is ready to be used. She said that the study everyone refers to (with 35% reduction in Mets) didn't single out Zometa as the cause of the reduction in reoccurrence, the study looked at Stage 1 and 2 women only, with no nodal involvment, and no one got Chemo.
So, that is my situation at the moment. She is off to a conference in two weeks, and she will let me know if there are any developments.
So, I am a bit bummed, but I do trust her decisions, so I will have to go with it at the moment.
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Kerry
Sorry to hear. I'll let you know how I make out on the 26th.
Kim
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I spoke with my onc about Zometa and two of them agreed that the possible benefit did not outweigh the possible harm. They explained the possibility of jaw bone loss and so I didn't pursue it much further. I wonder how far sometimes to push things, I don't want regrets, but I feel great now and am hesitant to pursue something that may or may not be the answer. Sometimes I wish there were more clear cut answers...I still wonder about an ooph/hysterectomy and plan on a bilateral masectomy when I have reconstruction, but I have put that off for now. I keep getting answers like "it hasn't been shown statistically to change the outcome" or "the risks don't outweigh the benefit". Tough to argue.
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Spring...
I started with it every 6-8 weeks for the first year....moved to once a quarter after the first year.
I'll stay on once a quarter this final year and then get off of it. This is more than the studies however. Your plan is more in line with them.
Jacqueline
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Jacqueline, Thanks for the info. I need to anyway for my bones. I mean, they were going to need to put me on Fosomax or Boneva, I figured, may as well get the Zometa, given "infusions" are no longer a big deal.
Spring...
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Has anyone hear or having Zometa and hormone tx in lieu of Chemo???? Looking for any info on this! I would prefer Chemo and hormone b/c zometa seems too new for tx for BC alone. Any info would be appreciated!
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Hey girls. It is MONTHS since I have been anywhere except my own thread (Chemo May 08). I just swung by for a quick scan and I saw Zometa! My onc (the femara guru of the southern hemisphere) said that if it was his wife, he would buy it. Here in Australia we can opt for it but at our own cost, which is $450 X 3 (once every 6 months and that's it.) I have just finished getting my mouth in order so I can have it. I've had so much preventative dental work it's crazy..but it beats cancer-related work
I had to make sure that there would be no extractions required over the next couple of years..to avoid the jawbone death biz. Thankfully I can get the work done on the public health here because: I'm over 50, I have cancer and I am required to take a drug (femara) which causes osteoporosis. Great, isn't it? Grrrrrrr. XXX
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Rachel, Zometa and hormone therapy alone has been done in Europe, but is not approved of here as treatment for early breast cancer. The use of Zometa is either for advanced breast cancer spread to the bone, or as part of the clinical trial of bisphosphonates current under way. There is clearly some "off label" use of it being employed as well for those who wish to gain the added benefits of it along with their current treatment. It is not, however, aproved of for treatment of early stage (ie I-III) breast cancer.
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Thank you Timothy, I wonder where you have gotten your info so that I may go in prepared to my onco in a couple of weeks. any links or articles would be greatly appreciated. She is a great doc but I feel I need to be prepared., Thank you again!
Rachel
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Rachel - there is another thread on the Stage 3 board if you look down a bit - called Zometa anyone? Got lots of info there for you. My Onc was a bit resistant at first, but is setting it up for me now. It is off-label here in Canada, so I can't get infused in the hospital, but they are sending someone to the house. So you never know!
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Thanks KerryMac. Honestly I don't mind using it with chemo, but I am wary about it replacing chemo. Too new for me! I will check out the board!
Rachel
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Rachel, I posted this on the hormone therapy forum, then read your post so I thought I'd put it here, too. Good basic information about Zometa and the trials. G. These are reactions of different professionals to the published results of the ABCSG trial where pre-menopausal women were treated with Zoledronic Acid + either Tamox or an AI. It is interesting to read their ideas about how Zometa may prevent mets in tissues as well as bones. Also, their comments about vitamin D.http://content.nejm.org/cgi/content/full/360/22/2367 http://www.communityoncology.net/journal/articles/0601011.pdf
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Kerry - when are you receiving your first infusion of Zometa? My onc won't budge on the topic. How did you convince yours?
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Hey Kim - It is all being set up now, hopefully I will get my first dose next week. There is a programme called AccessZometa run by Norvatis, who is organising it all. They got all my info from my Onc, they have ordered the Zometa from my local drug store, we will pick it up ourselves, then they are sending a nurse to the house to infuse me. Very civilised!! Their number is 1-866-281-4765, you could call and see if they could help you out. You would need a prescription from your Onc though. We have to pay for it ourselves (each infusion costs about $600, I think) but my husbands benefits insurance will cover 90% of it.
My Onc at first said no, then I think she went off to the San Antonio Conference, and talked to lots of other Oncs who were giving it to their "high risk" patients. She more or less said she doesn't know if it will help, but the trials are promising, so why not. She says it won't do me any harm, at the very least it will prevent bone loss as I am on an AI, and it just may well have an anti-tumor effect too.
I would print off as much info as you can and take it to your Onc and ask directly "Why Not". We would have gone as far as to change Oncs over this, I am so glad she came around and it didn't come to that. Anyhow, try calling and see what they advise you, and good luck with it.
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You can see my dx at the bottom of my post. I will get Zometa today, for osteopenia. Pre chemo and BC I took Evista daily and Actonel once a week. My DEXA scans have stayed the same over the past 10 years - latest one was in May 2009. When I began chemo in June 2008, I stopped all medications as I did not want to complicate the chemo tx and onco agreed.
As an aside, if you take Evista or Actonel or the other similar pills, it is highly recommended to stop at least a month before an invasive procedure, such as surgery or root canal. And stay off it for a month after. Onco says the zometa, once a year, eliminates that problem should I need further surgery.
Just putting in my 2 cents worth. I am 63 years old - mom is 96, sis is 57. Mom and sis both have osteoporosis - I have osteopenia. Nancy
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Well, I went back to my onc and asked him again about Zometa. First he said "No Way". So, I asked him as to why - he told me nothing is proven. So, I told him that there are lots of Stage 3 gals that are getting this as a prevention of bone mets. Why do I have to wait to get them first? He said that he would think about it.
A couple of days later, he called me. Looks like I'm going to get it after all. THANK GOD!! I go back and see him in January, so we are going to get it set up for shortly after!
Thanks to everyone who told me to go for it!!
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Good for you, Kim!
First infusion made me fluey and feverish - bleck. Didnt happen for second infusion!
Hope this is our miracle.
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Kim, GOOD FOR YOU GIRL!!! I was going to tell you to switch onc's, but looks like he redeemed himself in the end...
For my first infusion - it was like a big *nothing*!! 15 minutes, in and outta there, nothing like a chemo treatment. No side effects!!!! Good luck! Report back...
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km40 - please do not be offended by my response, but if you are concerned and really want to start Zometa SOON - - I don't see why you onc is literally putting you off unitl Jan - next year. It certainly doesn't take that long to set up an infusion appointment. I'm certainly older than you and am now quite direct about getting my questions answered and not being put off by health care professionals. Don't be afraid to be assertive regarding your health.
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