Cancer care can be confusing to navigate

Confusion over screening recommendations and cancer treatments should not prevent women from pursuing their own best course of action, said two women diagnosed with cancer.

As “breast cancer pink” adorns numerous products during October, and events such as Mercy Medical Center's Especially for You Race against Breast Cancer take center stage, health care controversies throw a wrench into what's meant to be an enlightening and empowering time for women.

Megan Bye was diagnosed with cervical cancer in May 2009. Intensive chemotherapy and surgery didn't prevent the cancer from recurring in March of this year.

Her doctor prescribed Avastin, a cancer drug undergoing review by the U.S. Food and Drug Administration.

Diana Besler noticed an abnormality during a breast self-examination and insisted on a mammogram, even though she was told

her insurance might not cover it because it had not

been a year since her last one.

New recommendations for the screenings call for mammograms to begin at age 50.

Had she waited for that, the 49-year-old Iowa City woman said, “it would have been the death of me.”

As it stands, Besler, a nurse at University of Iowa Hospitals and Clinics in Iowa City, is undergoing chemotherapy after being diagnosed with breast cancer in July.

She plans to participate in Mercy's 20th annual race today.

Mercy spokeswoman Karen Vander Sanden noted that all money raised helps pay for breast care services, such as mammograms and biopsies, for local women who otherwise could not afford it.

Vander Sanden said interest in the race continues to grow, with more than 14,500 people registered.

Last year, 11,575 people raised $233,000.

Bye, 39, of Cedar Rapids, cited cancer fundraising efforts in questioning why the FDA would reverse course on Avastin.

“What's the point of doing walks for research and development if we don't use this,” she said. “Why take it off the table?”

The FDA is reviewing Avastin as a breast cancer treatment, after giving accelerated approval to the drug for breast cancer in 2008.

Early studies showed the drug halted the progression of breast cancer for more than five months, but newer studies show Avastin does not extend the lives of women with metastatic breast cancer.

Bye, who is self-employed and was prescribed Avastin off-label, realizes the FDA's decision should not impact her.

But it could for the women prescribed Avastin for breast cancer, because insurance companies could choose not to cover the cost if it does not have FDA approval.

Bye noted the drug is expensive - about $7,000 to $8,000 - for her treatments every three weeks.

“They're trying to weigh out if my life is worth that or not,” she said. “That's how I see it.”

Dr. Thomas Buekers, head of the division of gynecologic oncology at the Henry Ford Health System, said he sees both sides to the issue.

Buekers treated Bye before leaving UI Hospitals and Clinics for his post in Detroit this summer.

If data show a minimal benefit of a drug to patients, Buekers said a panel decision might be in the best interest of patients, so they can pursue better options.

“But there are so many individual situations that it's impossible to convene a panel to decide each case,” he said.

Avastin has been effective at keeping her cancer at bay, said Bye, who wants to see her 18-year-old daughter and twin 20-year-old sons have children of their own someday.

“I've fought for my life,” she said. “I don't want anyone to take that away from me.”