RPLND - how long after chemo?

[ibyhousz]

I am looking for something to support that an RPLND is needed within X number of days of completing chemo. I feel like time is running out. I was told 4-6 weeks but can't get anything in writing from my Dr's. I need to try to push my insurance company to approve surgery at Sloan with Dr. Sheinfeld who can get me in within days. They are currently giving me the run around and want to to visit more local surgeons because my plan only allows in network Dr's unless I can prove the out of network Dr. can provide service that is materially different and that the out of network service is more clinically beneficial. They have already denied my appeal so now I am hoping to leverage the timing issues. Hoping to prove I need it done right away as apposed to waiting longer.
Any help would be greatly appreciated!

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Diagnosed 3/28/2009 Stage 3 high risk spread to both lungs, right retroperitonial ln, and supraclavicular ln. Beta hcg 389,000+
Right radical orchiectomy and left supraclavicular lymph node biopsy
Chemo - 4xVIP March 30 through June 5
Currently planning for RPLND and possibly lung surgery as well (fun, fun, fun

[cjjones]

I am sorry you are having to deal with insurance company. The urologist at IU says they do this surgery 6 wks out from the last dose of chemo. I hope soon you will find answers.

[dmann999]

I don't know who your carrier is,but ours is blue cross. The surgery needs to be done withing 4-6 six weeks because that the is optimal shrinkage of your tumor that has resulted from chemo. Also, if you have any teratoma in the tumor it can transform to yet a new type of cancer as happened with my son.

As far as out of network, our ins never questioned. However we went to IU. THis is is VERY VERY RARELY performed surgery and many urologists will not even attempt due to the MANY possible negatives if performed improperly. You always want a specialtist at the nerve sparing technique to prevent retro ejaculation. Even when a specialist performs this, it is no guarantee that it won't happen. Seems like your local

Scott can probably offer you more info but I think the standard guide lines say this. GOOD LUCK TO YOU... KEEP PUSHING. Dawn