Young cancer survivor fights for patient rights after insurance denies proton therapy

Posted at 6:22 PM, Jun 04, 2018
and last updated 2018-06-04 21:25:46-04

SAN DIEGO (KGTV) - When she was just 21-years-old Mariam Tariq's world was turned upside down after receiving a breast cancer diagnosis.

The UC Santa Barbara student's semester of homework and exams were soon accompanied by weekly chemotherapy visits in Los Angeles.

It wasn't the first cancer diagnosis to devastate her family, Tariq lost her brother to cancer when he was just 11-years-old.

After she was diagnosed, doctors learned Tariq has a genetic mutation, Li-Fraumeni Syndrome, which significantly increases her cancer risk.

"In patients who have this genetic mutation, we do everything to avoid radiation because radiation can cause second cancers," said Parag Sanghvi, Radiation Oncologist at UC San Diego.

Sanghvi became one of the doctors on Tariq's team after her doctor in Los Angeles recommended proton therapy. Doctors agreed it was the safest form of radiation based on her young age and her genetic mutation which predisposes her to secondary cancers.

Proton therapy is finely controlled and can more safely be delivered to tumors with less risk to healthy tissue. Meaning doctors could better protect Tariq's heart and lungs, hopefully preventing secondary cancer down the line.

Despite doctor's reasoning, UnitedHealthcare denied payment for Tariq's proton therapy.

A spokesperson sent 10News this statement:

We are committed to working with Ms. Tariq and her family to address her health care needs and to cover  services under the terms of her plan. We consulted with an outside radiation oncologist to re-review Ms. Tariq’s request for proton beam therapy.  Following the consultation, the radiation oncologist concurred that other types of radiation would be equally effective treatment for her condition. Ms. Tariq has the opportunity to appeal this decision and provide additional information.

Still convinced proton therapy was the safest form of radiation for Tariq's unique case, doctors asked California Protons to make an exception and move forward treating Tariq.

"You can't wait when your life is at risk," said Tariq. "Cancer doesn't stop growing because the insurance company says, 'Oh yeah, we don't want to pay for this'."

Tariq has teamed up with Alliance for Proton Therapy Access to help others in similar situations.

The patient advocacy group recently released a report looking at data from several U.S. proton centers and found that 63 percent of patients who were prescribed proton therapy were initially denied by commercial insurers.

They're gathering support for a campaign asking state insurance commissioners to fix broken insurance review and appeals processes.

The group says it wants to hold insurers accountable for providing cancer patients what they deserve.

Tariq is appealing her insurance provider's claim denial and says she will continue the fight long after her case is decided. 

Dr. Sanghvi is hopeful costs will go down in the future once ongoing studies further prove proton therapy prevents long-term radiation side effects.