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Utterly. &ire Servicing Oakland, Wayne and Macomb Counties: Auburn Hlb‘ Livonia Foninglon Sterling Morn Hil s Fei ghis (810) 926-2920 Ext. 202 giving them much higher doses of chemotherapy to destroy the cancer cells be- cause the blood stem cells reconstitute a patient's blood system." Before the intensive chemotherapy begins and after the patient's stem cells are collected, a catheter is surgically implanted in the patient's chest so that her stem cells can be later transplanted directly into a vein. "We have nine apheresis and stem cell collection sta- tions in the Transplant Unit," says Dr. Klein. "Pa- tients spend three to five hours a day on a machine that spins and separates the blood. The number of days a patient spends on the machine is determined by the amount of stem cell sup- ply needed." The stem cells are then tak- en to a cryopreservation area for frozen storage. Following the 4-5 day high dose chemothera- py, the patient is discharged and stays at the nearby Inter- national Center apartment com- plex for a couple of weeks, usually with a family member. During this period, she returns daily to the outpatient clinic for evaluation and re- infusion of her own stem cells. Within 14-21 days, the patient's bone marrow supply is replen- ished. Dr. Klein is in charge of seven clinical trials focusing on breast cancer. Elaine Weiss of West Bloomfield is a partici- pant. Mrs. Weiss was first diag- nosed with breast cancer in 1993. Following a mastectomy and chemotherapy, breast can- cer reappeared last year. Mrs. Weiss was referred to Dr. Klein, and during the past few months she completed the initial chemotherapy program — one day of treatment every three weeks for four cycles. A catheter was surgically put in place for transplant of her stem cells. At the time the pho- tos were taken for this article, Elaine Weiss was donating her own stem cells through the apheresis process. "Even though I understand intellectually what is taking place, it's a complete shock each time I hear the diagnosis — can- cer," says Mrs. Weiss. "It never seems to get easier. After a pe- riod of time I adjust, but there's always that fear of dying. It's almost like grief— shock, anger, depression, adjustment. "I do know that without the support of my family and friends, and especially my hus- band, I'm not at all sure I would have made it this far. I need these people." ❑ An apheresis unit at the Karmanos Cancer Institute. Taking On Insurance Plans According to attorney Lisa Gleicher of Gleicher and Reynolds PC in Detroit, Blue Cross has recently agreed to pay for high dose chemother- apy and stem cell transplan- tation for Level IV breast cancer patients. "Imagine the emotional cri- sis of these families," says Ms. Gleicher. "They've just learned that they were diag- nosed as basically terminally ill and then they learn that their insurance company won't pay for the treatment that their doctors recommend. The stories of sacrifice that families have made so that their wives, daughters and mothers could get treatment are heart breaking." Lisa Gleicher has repre- sented several women who have sued their insurance companies to cover the cost of treatment. She takes on this work pro bono. "Before September of 1996, less than a year ago, insur- ance companies denied pay- ment to women who required this kind of treatment for their survival. Their reason was that the treatment was experimental. "Well, 90 percent of Level IV breast cancer patients are in clinical trials because it's been recognized that the ag- gressive treatment works. What woman in her right mind would want to be in the control group and not receive the aggressive treatment when her own doctors have told her that's the only treat- ment that will give her a chance?"