Derek Willingham

By proton-admin | February 23, 2018

“It doesn’t take a rocket scientist to see that brain tumor patients and doctors should be launching a fight on cancer, not insurance appeals.”

I have always been in awe of the cosmos; how breathtakingly beautiful and vast our universe appears to be. My interest in astrophysics and engineering led me to my dream job as an aerospace engineer with NASA upon graduating from college. I began working at the Marshall Space Flight center in Huntsville, Alabama designing rocket hardware, assemblies, and systems. After my marriage in 2016, I moved to Houston, Texas with my new wife to work at Johnson Space Center.

I had everything I ever wanted until a seizure last October immediately changed my life. After many tests and surgery, the doctors at MD Anderson Cancer Center confirmed that I had an Oligodendroglioma – a type of brain tumor. At 34 years old, I was uncertain how the diagnosis of this would affect my future with NASA, my relationships with friends, and all my time spent with family.

With the support of my family, I underwent an 11-hour ‘awake craniotomy’ to remove 40 percent of the tumor. My doctor suggested using proton therapy treatment to treat the remaining cancer. I am a strong candidate for proton therapy because it simply causes less damage to brain cells than traditional radiation treatment. Through my research about proton therapy, I knew it would be my best chance of preserving my current level of functioning so I could return to the job I love.

To my astonishment, my lifesaving treatment was denied by Blue Cross Blue Shield’s Federal Employee Program not once, but twice. Payment for my care was denied because of a lack of medical necessity and “insufficient evidence.” To receive proton therapy, I would have to pay approximately $100,000 out-of-pocket. I believed that the insurance company would pay less total in the long run when paying for proton therapy versus paying a lifetime of healthcare claims if my brain cells were damaged from traditional radiation.

While I recuperated from my surgery, my mother and sister contacted the media about my insurance denials, and my doctors at the MD Anderson Proton Therapy Center worked diligently on my appeal. Thanks to their tireless advocacy, Blue Cross Blue Shield reopened my case and approved my treatment.

I’m relieved and thankful that I will finally start to receive the care I need, but I also recognize that I am one of the uncommon ones. I have learned that there are other patients across the country who are going through the same sort of appeal and denial process, and many of them are forced to settle for potentially insufficient types of care. It doesn’t take a rocket scientist to see that brain tumor patients and doctors should be launching a fight on cancer, not insurance appeals.