SIOUX FALLS, S.D. — Katie Blunck is fighting for her life in more ways than one.
In the last month, the 32-year-old Sioux Falls teacher had a tumor removed from her brain, a second procedure to relieve bleeding in her skull and a cancer diagnosis so rare it puts her among only a handful of others in the nation.
She's also battling her insurance company, which has now twice denied her request for coverage for a special targeted form of cancer treatment called "proton radiation beam treatment."
Blunck is set to start radiation on Monday. If her insurance company denies her request a third time, she'll have to use a different form of radiation called "photon radiation," which she worries will damage her brain cells that are not cancerous.
"I'm just hoping somebody can change it and say, 'yes,' so I can get the treatment that I need to save my life," Blunck said.
When Blunck started the school year teaching orchestra at both Memorial Middle School and Oscar Howe Elementary, she had no idea the challenges she would face.
It's her eighth year of teaching in Sioux Falls, where she got her first job after graduating from the University of South Dakota.
The Creighton, Neb., native was also just getting started in a new country band called Prairie Thunder Band alongside her identical twin sister Krissy Blunck.
'Aggressive, hard to kill and considered incurable'
Then, on Nov. 6, Katie Blunck came home from school, loaded her dishwasher, turned to hug her boyfriend and blacked out. When she came to, she was in the hospital recovering from a seizure.
That's when doctors found the tumor in her brain, which, at the time, didn't appear to be an immediate concern. She was advised of a few options: wait to treat, try medication to shrink the growth or operate immediately.
Blunck chose to operate immediately, and on Jan. 10, doctors removed a quarter-sized tumor. The mass was sent to the University of Minnesota for further testing, and eight days later, Blunck had a name for the disease attacking her brain cells: Anaplastic Pleomorphic Xanthro Astrocytoma Grade 3 (out of 5).
"It's very aggressive, hard to kill and considered incurable," Blunck said.
Her doctor described the cancer cells in her brain as peppered mashed potatoes. Each little piece of pepper is the rare, aggressive cancer fighting the rest of her brain.
The "peppered" nature of Blunck's cancer makes her a good candidate for the proton radiation because it's a more targeted form of treatment that is less likely to harm healthy brain cells, according to Mayo Clinic in Rochester, Minn., where she's receiving treatment.
In Mayo Clinic patient records provided to Argus Leader by Blunck, Dr. Andrea Arnett recommended proton therapy as a way to minimize exposing the rest of her brain to radiation.
The documents, signed by Arnett and dated Feb. 20, also note that the doctor initiated the request for insurance to cover the proton radiation treatment.
"It won't hurt my brain more than it needs to," Blunck said.
If insurance denies coverage for the proton radiation treatment, Blunck will move forward with photon radiation.
Denied and denied again
Blunck's insurance has twice said the proton radiation is "not medically necessary."
In the first of two rejection letters, Wellmark Blue Cross and Blue Shield — the insurance provider used by the Sioux Falls School District — noted literature comparing proton beam therapy with other forms of radiation is "limited."
"Further research is needed to prove the advantages of proton beam therapy over the other types of treatments," the letter read.
After the second rejection, Blunck began sending letters to any group she could think of asking for help. She's written to South Dakota's congressional delegation, state lawmakers and the Sioux Falls Education Association, the union for public school teachers in the city.
Pam Oberembt, SFEA president, has become an advocate for Blunck in the last few days. She's asked the Sioux Falls School District to contact the insurance company and figure out why the proton beam treatment isn't covered.
"My heart goes out to her ... the only thing I can think of based on what she sent me ... is the fact that (the treatment) is new, and it hasn't been tested enough to know the validity," Oberembt said. "I don't think it's anything that slipped through the cracks."
Blunck doesn't want to cast blame. She just wants the best treatment for her situation, and to make sure others under the same insurance plan know the gaps if they ever find themselves in her situation. And at this point, she's not afraid to rock the boat.
"This cancer can kill," she said. "People have died from it. So, what do I have to lose?"
A silver lining
Blunck hasn't seen her students since her cancer diagnosis, but she has seen an outpouring of love from them.
She's got a box of homemade cards from her elementary- and middle-school orchestra students, and her colleagues in the music department created a GoFundMe page to help fund her travel, lodging and medical expenses. It has raised more than $10,300.
"It makes me want to cry, but in a good way," Blunck said.
When she last was in her classroom on Jan. 5, she guessed she'd be returning in six to 12 weeks after the tumor was removed. Now, she won't return for the remainder of the school year.
She'll still get paid, though, with the help of donated personal days from her co-workers and an additional donation of 30 paid sick days from the Sioux Falls School District. And in a whirlwind of doctor appointments, trips to Mayo Clinic and insurance frustrations, those gestures mean a lot.
"The insurance company will be as they will be, and things will go as they will go," she said. "But to know that I have so many people rooting for me ... this outpouring is so amazing."
Follow Megan Raposa on Twitter: @mlraposa