Dec 23rd 2020

Guiding Cancer Care: More Positive Patient Stories

Coping with a cancer diagnosis is not easy for any patient. It’s usually a time of gnawing uncertainty, with consideration of numerous treatment options as well as other emotionally taxing clinical and personal issues. While no one's cancer journey is exactly the same as another's, all patients benefit from caring and expert guidance provided by a team of people invested in improving their care.


Following are some real-life examples of benefits provided by eviCore guiding cancer care.


Marilyn’s Story


Marilyn’s* cancer had been in remission after receiving radiation therapy to treat a tumor that had spread to her brain. Following a routine radiology imaging procedure to monitor Marilyn’s health, her oncologist informed her that her cancer had returned in the same place where she received prior radiation treatment.


Marilyn’s oncologist submitted a request to eviCore to repeat radiation treatment to the same location, a risky procedure with potentially serious side effects. An eviCore board-certified radiation oncologist reviewed Marilyn’s case and suspected that the abnormality on the image was actually scar tissue that resulted from the initial treatment and was not necessarily a cancer recurrence. She initiated a peer-to-peer consultation with Marilyn’s oncologist and recommended that she undergo a more advanced type of radiology scan to better determine whether the tumor had returned. Marilyn’s oncologist agreed to the test and the results showed no evidence of tumor recurrence, which confirmed that the initial radiation treatment succeeded at controlling the cancer and Marilyn did not need additional radiation therapy.


A Second Look Gives a Sigh of Relief


As a result, eviCore helped Marilyn avoid unnecessary radiation treatment that would have put her at greater risk of negative cognitive side effects and additional financial burden. Marilyn also learned that the cancer had not returned, which provided her and her family a great deal of relief.


Some patients benefit greatly from the application of an alternative diagnostic test, which can indicate a substantially different treatment option after an authorization review.


David’s Story


David* is a 56-year-old man living with insulin-dependent diabetes and an early-stage, oral cavity, squamous-cell cancer. As part of David's treatment plan, his oncologist submitted a request to eviCore for authorization to treat him with 5 weeks of carboplatin and paclitaxil chemotherapy and anti-nausea medication in combination with radiation treatment. eviCore's board-certified oncologist reviewed the request and initiated a peer-to-peer consultation with David's oncologist because the NCCN®-recommended evidence-based treatment calls for radiation therapy alone without the need for systemic chemotherapy.


Collaboration Avoids Unnecessary Hardships


During the peer-to-peer, David’s doctor agreed that chemotherapy was not supported by the evidence and that radiation treatment alone was the best course of action. eviCore subsequently issued the authorization for radiation therapy and helped David avoid unnecessary chemotherapy and its associated side effects, which include numbness of the hands and feet, nausea, difficulty controlling his blood sugar level, and infection. David’s doctor and the eviCore oncologist collaborated successfully to achieve a better quality of life for David at lower total cost of care.


When patients receive the tests and treatment options backed by the latest scientific evidence, they can avoid inappropriate, expensive, and potentially unsafe procedures and treatments.


A primary mission of eviCore is to protect patient well-being by making sure their care aligns with the most current evidence-based medical guidelines for cancer care.


*To maintain the patient’s privacy, names and other potentially identifying details have been changed.