The Last Resort

(2 of 2)

But it's also not certain that it isn't, and that's where things get muddy. It took experimenters years to collect the volunteers they needed to give their findings any statistical oomph--in part because women didn't want to risk being in the half of the sample group that received conventional therapy instead of the transplant. Over that time, transplant methods improved, and it is thus possible that higher mortality rates from women earlier in the research are dragging down more positive results from women later on. For now, the only answer appears to be more and better studies.

How insurers will react to all this is unclear. US Healthcare (now merged with Aetna) and some Blue Cross/Blue Shield plans helped bankroll three of the recent studies, an act of good corporate citizenship that seemed to signal a willingness to keep paying for transplant treatments in breast-cancer cases. A doctor working with Kaiser-Permanente, the nation's largest HMO, offers more direct reassurance. "It will be up to the doctor and the patient," predicts oncologist Louis Fehrenbacher.

For HMOs that have been disinclined to offer coverage, however, last week's news offers little incentive to do things differently. Legislative pressure--plus the ongoing threat of more jackpot lawsuits--may yet force the hands of those holdouts. But whether that will be enough for women like Tawnya Geisbush, still awaiting an O.K. from her insurer, is unclear. "I have a fairly small window of time to work with," she says. By the time the company is persuaded, one way or the other, her window may have already closed.