WSJ – Cancer Treatment’s New Direction

WSJ – Cancer Treatment’s New Direction

“Genetic testing helps oncologists target tumors and tailor treatments”

Wall Street Journal LogoEvan Johnson was a vital young man several years ago and breathless workouts and upper body bruising caused him to seek treatment at the Mayo clinic in 2014 per an article this week in the Wall Street Journal. The then North Dakota State senior received genetic testing that diagnosed him with a particularly aggressive form of acute myeloid leukemia.

The next few years brought a roller coaster of treatments and up and downs. The medical team treating Mr. Johnson showcases the new treatments that can be found via genetic testing to see which treatments would work best/are most effective with his genes. Tumors mutate such that they can resist some until recent common treatments.  His medical team tried a failed stem cell transplant, at least  six drug regimens, four relapses  and some near death side-effects.

Journalist Ron Winslow highlights:

“Nine months in, his leukemia had evolved to develop a surprising new mutation. The change meant the cancer escaped one treatment, but the new anomaly provided doctors with a fresh target, one susceptible to drugs approved for other cancers. Doctors adjusted Mr. Johnson’s treatment accordingly, knocked out the disease and paved the way for a second, more successful stem cell transplant. He has now been free of leukemia for a year”

This treatment revolution occurred in real time due to the continuous genetic testing giving the oncologists more information and thus more treatment options. Ten years ago oncologists were grasping at straws without this genetic testing. The tumors get sequenced at major cancer centers like the Mayo clinic. This sequence allows doctors to tailor drug regimens to treat it more effectively and track mutations so they can change treatments much faster. It is analogous to traveling with GPS now as opposed to traveling in the dark years ago.

The largest issue with this type of treatment so far is that it is evolving so fast that certain drug cocktails that are recommended  by doctors are not insurer approved thus leading to a significant increase in out-of-pocket cancer treatment costs. While this genetic testing is not best suited for all patients, many would benefit.

The team that treated Mr. Johnson discovered that his cancer was caused by a mutation in a gene, called FLT3, best treated by a stem cell transplant. Over half his bone marrow cells were myeloblasts and in order to reduce them to less than 5% standard chemo was applied. That failed and led to a near death experience via a fungal infection. Miraculously the infection departed and chemo was considered but rejected in favor of a new 2 drug combination including a drug approved to treat liver cancer, Nexavar, and a stem cell transplant from his brother. That failed and caused another relapse leading to the trial of experimental drugs and further weight loss to 120 pounds forms a healthy 175 when all of this started.

Continued genetic testing revealed further mutation of Mr. Johnson’s cancer via the Philadelphia chromosome for which the drug Gleevec and a few other new drugs treated well. This repeated genetic testing armed oncologists with the right diagnosis and thus the more correct treatment options for Mr. Johnson. These drugs wiped out his cancer and his immune system causing a lung inflammation side-effect. So again, the drug regimen was changed.

The net cost of Mr. Johnson’s treatment was approximately $4 million. It would have ben higher but for an insurer who worked with doctors to pay for drug treatments not generally approved for cancers like his. The genetic testing probably persuaded the Insurer to go forward with the treatments and Mr. Johnson’s co-pays were manageable.

Like Mr. Johnson’s insurer, medical practices require a medical billing partner who understands the needs of medical practices including having a state of the art EHR and Practice management system like Physicians Billing Service does. We put out EHR and PM software in the cloud thus reducing the hardware and software investment of our clients. Our staff are experts on the ICD-10 and we bill it right the first time and within 24 business hours. Further we do not get paid until you get paid.  And if you like, we can train you to have your staff use our system if you so desire.

For more information you can contact Michele Stahl our owner or her experienced staff at 703-978-0756 or use our Medical Billing Company online contact form by clicking here. We service medical practices in many states including Connecticut, Delaware, Florida, Maryland, Massachusetts, New Jersey, Virginia and West Virginia.

See our many cities serviced: We can also service new cities just ask us!

To read ‘Cancer Treatment’s New Direction’ on the Wall Street Journal web site, click here.

By Michelle Stahl, Owner, Physicians Billing Service

You can Find Michelle Stahl, Owner of Physicians Billing Service on Google+.


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