Question: My father has malignant melanoma, and it was cut out and tested, and he also had a skin graft. It has been more than a year and the spot is back, but he never returned to the doctor. He is still paying off the first medical bill, and no one will insure him because of the melanoma. He is only 46. What can we do?
Dr. Beer's Answer:
There are a few different problems here. One is the melanoma itself and the other is the lack of healthcare coverage. For the melanoma, he needs to be evaluated as soon as possible to see if it is back and if so, where it is.
This can be done, depending on where you live, at a dermatologist’s office with a biopsy and with a CT/ PET scan. If the disease has spread, he may want to see someone that specializes in melanoma.
There are some new treatments and some new clinical trials (look at www.clinicaltrials.gov) that can be helpful if the melanoma is in multiple places. Depending on where you live, he can be seen at a center that specializes in this.
With respect to the coverage issue, this is one situation that is not really discussed in the healthcare debate but should get more attention. If he is able to work and is employed, he may be able to get group coverage, or he can work for a government agency that will cover him.
If he is not working, he can apply for public assistance, but this can be arduous. Either way, he can discuss the situation with the doctors and hospitals that are caring for him and sometimes they are able to discount their fees. Many will but some can't afford to do so.
If he enters a clinical trial, the cost of the trial is paid for by the sponsor. If he is not able to do any of these and you live in one of the few areas in the United States that still has a county hospital system, he should seek care at one of these.
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