Depending on your insurance company and policy type, you may find that some or all parts of the procedure will be covered. Medicare unfortunately does not reimburse the tests. In order to have an assay done, tumor cells must be accessible through biopsy. Tissue, blood, bone marrow, and ascites and pleural effusinos are possibilities, providing tumor cells are present, and only live cells can be used. At least one gram of fresh biopsy tissue is needed to perfom the tests, and a special kit must be gotten in advance from the lab.
Arrangements have to be made with the surgeon for preparation and sending of the specimen.
Biopsies and inital or follow up surgery is an excellent time to obtain a specimen for testing, even when chemotherapy is not planned, as the tumor tissue may not be accessible later on when the information may possibly be needed. Data suggest that patients patterns of sensitivity and resistance do not change in the absence of intervening chemotherapy. The non clonogenic total cell kill assays or cell death , also known as CD assays, are the ones that have been studied, advocated for and applied by Larry Weisenthal M.D. since 1979. These include the DISC assay, the MTT assay, the Flouroscein diacetate assay and the ATP assay. Weisenthal has been a pioneer in the developement of these assays since 1979.