Cancer treatment in Buenos Aires (30 y.o male)

americas

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Hi all, a cousin of my girlfriend's was recently diagnosed with cancer. He is 30 years old, has a young child with his wife, and is a tucumano living in tucuman (I'm the expat living here). He does not have a lot of money and I'm trying to educate myself on what his options might be and to see if I could assist in any way (financially, assistance with finding US-based care, or help navigating the system). It's a cancer with a relatively high chance of survival, but it is also quite advanced and the prognosis is not great. Maybe the odds are 50-70%.

1. Does anybody have experience with cancer treatment or sufficient experience with the healthcare system in general to give basic guidance (eg. definitely don't use public hospitals or definitely go to Buenos Aires for treatment).

2. Simply because there is no harm in trying, I'm calling various US-based organizations to see if charity care is available for international patients. Long shot, I know, but let me know if you have any tips. Here's one helpful resource I've found, they provide legal assistance and could help with things like travel visas for medical care: cancerlegalresources.org

3. In my short time here, my experience has been that good professionals are very competent but often lack the best tools. However, finding competent professionals is challenging and institutions aren't particularly helpful unless you are really advocating for yourself. Is that reasonable? I have no idea how the outcomes of patients here would compare with patients in the USA.

Get your checkups, people! https://www.cancer.org/cancer/testicular-cancer/detection-diagnosis-staging/detection.html
 

Quilombo

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Hey, I'm sorry to hear that, it's unfortunate to have to go through a cancer diagnosis at such a relatively young age.

Honestly, this is going to be the best advice he is going to get: Amparo, Amparo, Amparo, Amparo, Amparo
and the National Oncological Drug Bank

Why do I say this? Argentina, in theory (but not in practice) has universal healthcare for all people within the territory
of the Republic. Provided a doctor orders a treatment following a diagnosis, it is up to the Federal and Provincial health
authorities to provide this for people who do not have an Obra Social or Pre-Paga. If your gf's cousin has one, he MUST
go through the Superintendencia de Servicios de Salud and make any denuncias there should they not provide care for
him or eliminate his coverage because of the cancer diagnosis.

All that being said, the issue is that contrary to the Ks "Primero la gente" propaganda you see in the streets and on TV,
the healthcare system is chronically underfunded, both in the K aligned provinces and JxC run CABA, especially when
it comes to cancer and associated treatment for it. This is where the amparo comes in.

What is an Amparo? It's basically an emergency procedure in which a judge can force a provincial/federal health authority
to act, si o si, when they are violating a person's fundamental rights, one of which is health as explicitly stated on the link I
shared.

As I have said to other members on other topics, I am not a lawyer, so take my advice with a grain of salt, but my understanding
is that the process is as such:

- Obtain your diagnosis
- Obtain your treatment plan (doctor should be explicit on the order; "Sr. X needs Y by date [DD/MM/YYYY] for Z"
- Attempt to execute on this treatment
- Be denied by the health authority (i.e. insufficient spots, medications, etc.)
- Obtain proof (as much as possible) that you have attempted to execute on the medically necessary treatment and the denial,
document everything, dates, names, times, places, etc.
- Contact a lawyer via the provincial/city's legal aid/clinic, the Argentine Bar's legal aid, public universities, etc.
- They initiate the Amparo claim in front of the relevant judicial authority

Now, in the case that the local health authority, whether the city, Tucumán, or CABA, etc. doesn't have the medication (which
from my understanding is the most common occurrence because of how expensive it is) this is where the National Oncological
Drug Bank comes in. For this, you require:

- Lack an Obra Social/Pre-Paga and present proof of this via the negative ANSES certification
- Be treated at a public hospital
- Present the documentation required for both admission and continuity of treatment before the corresponding jurisdiction

For Admission you need:

- Copy of the DNI of the patient and/or the person picking up the medication.
- Oncological medication request form (the admission form).
- Prescription signed by a specialist and hospital director, less than 30 days old
- Copy of the pathology report or the other relevant one which confirms the diagnosis (medulogram, immunohistochemistry,
immunophenotype, etc.).
- Copy of assessment for advanced disease (if applicable)
- Summary of the patient's clinical history.
- Survey with socioeconomic data
- Negative ANSES certification

For Continuity of Treatment you need:

- Prescription according to Argentine pharmacopoeia
- Oncological medication request form (renewal form) pre-printed to be completed by the treating physician every 3 treatment cycles.
- In the case of advanced disease, a copy of the disease assessment study reports must be attached at the beginning of the requested
treatment and a copy of the medical studies that assess the response to treatment every 3 treatment cycles.

The most difficult of the above requirements is often the letter from the hospital director because it basically requires them to admit to the government that they are incapable of obtaining the medication required for the most serious conditions for one of their patients.

All that being said, I hope he doesn't have to go through this process, but having read other peoples stories online, this is how you fight
for your right to medical treatment in Argentina, and how you obtain the medication in the likely event the hospital/clinic doesn't have it
in both Tucumán and CABA.

As for hospitals, the best cancer hospitals are in CABA, and you do not need to live here/have a DNI issued in CABA to obtain
treatment at one
. While I am sympathetic to the city's complaints that we receive the most serious cases, poorest cared for citizens, from
Provincia and the interior, etc. this is the blessing and curse of being Buenos Aires; we are the wealthiest city/province in the country and
that requires us to take on the challenges other provinces won't/can't because it's the right thing to do an even when stretched thin, we find
a way thanks to our dynamism and solidarity (and this is also one of the reasons I hope the city wins the fight over equalization payments).

I hope this helps, and I hope your gf's cousin gets the treatment he needs promptly.
 

nikad

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I might be able to give you some guidance within the local system. Send me a pm
 

americas

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Thank you both for the response! @Quilombo a family member is very familiar with the Amparo process so they are most likely going to go down that route. I'm currently investigating whether private insurance is a preferable option for getting better / faster care and also reviewing hospitals in CABA.

Probably a dead end, but for anybody curious, the responses I got from hospitals in the US were that they do have international patient services:

1. They don't do charity care for international patients

2. Some people buy insurance specifically to get coverage before going to those hospitals

3. Estimated cost for a round of chemo + radiation therapy was USD$200,000. They often offer remote second opinions + exam reviews for~US$5,000

4. I don't have a feel for how accessible emergency medical visas are for getting treatment -- the other visa process seemed pretty heavily focused on not being a burden on the state, so on one hand I can't imagine them flying sick people into the country, but on the other hand if those sick people can pay $200,000, I can believe it

5. Clinical trials are generally a good way to get access to the top researchers in the field if YOU ever need treatment in the USA. It didn't seem like clinical trials accepted foreign citizens, though: https://www.nih.gov/health-information/nih-clinical-research-trials-you/finding-clinical-trial
 
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