The name of this blog
Today is my first day of chemotherapy in conjunction with radiation therapy.
I called this blog “Same Time Tomorrow” because the therapy involves taking a chemo pill at home and then reporting to my radiation machine at MD Anderson Cancer Center in Orlando at exactly the same time each day. I get a break from radiation on weekends, but I’ll take the 140 mg temozolomide capsule called Temodar every day for 42 days. That means the finish line for me will be on Wednesday September 30.
I will describe more details of radiation after I’ve gone through it for the first time. But I’ve already learned something about the Temodar pill by talking to my doctors and checking the website of the medicine’s manufacturer (Schering). It says: “TEMODAR® acts directly on the DNA in the cells in your body. DNA controls the growth of normal cells as well as brain tumor cells. Because these tumor cells grow much faster than normal cells, they are affected to a much greater extent by the effects of TEMODAR® Capsules.” That means temozolomide will be the infantry in my battle to kill the remnants of my brain cancer. The radiation will be the air force. If it works right, it’s supposed to be like medical shock and awe. Let’s just hope Dick Cheney and Donald Rumsfeld are nowhere near the controls.
The side effects I can expect from this regime will be accumulating fatigue from both elements of it, some scorching on my head from the radiation as well as the possibility of some nausea from the pills. I’m not too worried about nausea, though. Only a relatively small percentage of patients are said actually to get sick from the pills, and I’ve got a pretty good cast-iron stomach. Since Ronald Reagan left office, I’ve only thrown up once. That was during a trip to California in August 2001, about a week or so after George W. Bush lost the top-secret memo entitled “Bin Laden Determined To Strike Inside The U.S.” in a stack of Field & Stream magazines at his Texas ranch. So unless naked photos of U.S. Sen. Charles Grassley (R-Iowa) surface on the Internet sometime during the upcoming health-care reform debate, I should be safe. But even if that happens, I’ve got backup anti-nausea pills.
Okay, enough politics. Let’s talk about health-care reform (ha, ha). Check out the price tag on these Temodar pills. I casually plugged them into the website of my insurance company when I was filling the prescription a couple weeks ago, and learned that the actual cash price of the 42 pills is $12,000. Still, compared to some of the intravenous chemo drugs used to treat other forms of cancer, Temodar is pretty cheap. Thank God I’m covered, except for a small copayment. And at about $286 a pop, as my buddy John Huff said, I’d better not be dropping one of those pills down the toilet.
I understand some of the forces at work here: Schering obviously did years and years of R&D to develop Temodar, spending gazillions of dollars to create an effective medicine in fighting deadly glioblastoma multiforme brain tumors such as mine. And in the few years since it has become the standard of treatment, the drug is showing very promising results. I don’ t know how long their patent on the drug will last, but I’m sure they only have a fairly short window of exclusivity to make all that money back plus make a profit for their shareholders. After that, you’ll probably be able to buy 42 temozolomide capsules from the new ShamWow guy for $9.99 by dialing some toll-free number during late-night M*A*S*H re-runs. And they’ll even throw in a free towel. The ShamWow people recovered their R&D costs years ago, so they’ll be cool with that.
I’m extremely fortunate that I have maintained my insurance coverage, and I realize that the past few weeks and the next couple months alone will have made all those years of paying premiums worthwhile. I’ve had good jobs with good benefits plans over those years. If I’d blown off just one COBRA payment after I left my old newspaper job and started up my own company (which is eligible for participation in so-called “one-person group” health plans), I’d be screwed. It would be hard as hell to get individual insurance coverage as a basic freelancer. Also, I would have had no “creditable continuous coverage.” So even joining a good group health plan with a new employer would not have made me eligible for coverage of this “pre-existing condition” for many, many months.
As it happens, my COBRA coverage runs out October 12. My lucky timing is compounded by the fact that August is the one-month window each year that “one-person groups” like mine are allowed to enroll in plans that bring together larger pools of insurees. I was working toward that goal with a company financial advisor months and months ago, long before any of this cancer crap came up. And I expect to be accepted into the new plan, with new coverage to commence Oct. 1. So I’m very grateful.
I can’t imagine how someone facing a fight like this could do it without insurance. It seems to me that when medical knowledge and treatment are available, having a good job or not shouldn’t make the difference between life and death. That said, until health-care costs overall are brought under control, I’m not sure how cases like mine logically fit into any actuarial model. So those folks in Washington better quit namby-pambying around and get this whole thing figured out, whatever it takes.
And put your clothes back on, Chuck Grassley. You don’t look good naked.