When it comes to cancer care, don’t take no for an answer | Viewpoint

As a lifelong advocate for cancer patients, I wish more people knew about the tremendous developments in oncology that are rewriting cancer care.

One of the most transformative frontiers in cancer care is biomarker testing, laboratory or blood tests that reveal the genetic or molecular signals driving a patient’s disease. These insights help doctors personalize treatment, avoid unnecessary therapies, prioritize patient preferences and detect recurrence earlier than ever before.

Within this category, MRD (molecular residual disease) testing stands out as a breakthrough.

Through a simple blood draw, an MRD test can detect cancer recurrence, often months before symptoms appear. The testing can also be used to monitor a patient’s response to treatment.

For patients, that kind of clarity can be life-changing. It can spare them physically grueling treatments they may not need, free up time and resources for those who need more care, and provide peace of mind when uncertainty can be its own kind of pain.

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Early-detection MRD tests can also help doctors “stay in front” of cancer recurrence and intervene sooner, when treatment may be more effective. If more patients were familiar with the science of MRD, they could ask their oncologist to schedule a test as early as reasonably possible.

And knowing that such a test is available can also improve a patient’s mental and emotional well-being. Early detection—and, even better, early determination of non-recurrence—can literally be life-changing. Patients consistently cite fear of recurrence as their greatest source of cancer-related distress, with 57% of Cancer Experience Registry respondents reporting moderate to severe concern about their cancer returning.

However, a test being available and a test being accessible are two different things.

Currently, Medicare covers this testing for a broad range of cancers, and commercial insurance providers are legally required to cover MRD and other biomarker testing in over 20 states. Yet, even where laws require coverage, many patients still face denials. Some oncologists may hesitate to order MRD tests, assuming insurance will reject them. Others have claims denied outright despite state mandates. The result: patients miss out on potentially life-saving information, not because the science isn’t ready, but because the system isn’t.

If you, your loved ones, or your patients are in this situation, what can you do?

First, stay informed. Research which MRD options might be available to you, and ask relevant questions of both your oncology team and your insurer if necessary. If your doctor determines that an MRD test would be viable in your situation, you owe it to yourself to request that the test be ordered.

Second, stay resolute. If your doctor or your insurance company says no to MRD, keep asking, or find a provider who says yes. Remember, if biomarker testing is covered in your state, your insurance company must follow the law.

While we at CSC, along with many other cancer advocates, are calling upon insurers to comply with the state laws, we also know that current cancer patients cannot wait. If your insurer rejects your doctor’s test order, you have the right to appeal, and you should. There are even online templates for insurance appeal letters, so you don’t have to start from scratch. Contact Cancer Support Community’s Helpline at Is Cancer in Your Life? | Cancer Support Community and speak to a community or financial navigator.

Finally, stay hopeful. While biomarker tests aren’t yet required to be covered by commercial insurance in all 50 states, the science is on your side, and so is the momentum of cancer patient advocacy groups in over 25 states. The value of MRD testing in the fight against cancer is undeniable. And when hope becomes fact, it’s only a matter of time before reality - and insurance coverage - catches up.

As any survivor will tell you, managing cancer doesn’t stop until the final bell rings.

When it comes to receiving the best cancer care possible, don’t stop advocating on behalf of yourself or your loved ones who have been diagnosed. Don’t stop educating yourself about the newest and most effective treatment options. Be empowered by understanding your treatment options and making choices that feel right for you.

When you’re informed, you become your strongest advocate and you can reach out for support to help strengthen your ability to cope.

Don’t leave the fight early.

Don’t give up hope.

And above all else: when it comes to your cancer care - and your life - don’t take “no” for an answer.

Sally Werner serves as Chief Executive Officer of Cancer Support Community (CSC), a global nonprofit dedicated to uplifting and strengthening people impacted by cancer by providing support, fostering compassionate communities, and breaking down barriers to care.