Local Cancer Patient Wins Battle With Insurance Company

PITTSBURGH (KDKA) — A KDKA Investigation finds a family that took on a big insurance company and just learned they won.

John Petok struggles to walk and fights for every breath. The 55-year-old is a shadow of the man he was – more than 50 pounds lighter than he was months ago.

Petok has Stage 4 stomach cancer. His medical records give him nine months to a year to live. The one hope, according to his doctors, is surgery that must be done immediately.

“If I don’t have this surgery done within six months to a year, I will not be living,” he said. “I will die from this and I don’t want to die.”

In a letter written by UPMC, Petok’s doctors write: “Significant delays in treatment may result in death from tumor progression.”

In denying the surgery, Petok’s insurance carrier Aetna responds: “Clinical studies have not proven that this procedure is safe and effective for treatment of the member’s condition.”

“We’re working on borrowed time right now,” Ken Fryncko, the family’s attorney, said. “The longer we wait, less likely we have of success helping Mr. Patok expand his life.”

Attorneys for the Patok family filed and lost two appeals, citing study after study suggesting the surgery is effective. The last appeal was what’s called an external review.

UPMC sources and family members confirmed on Monday that after months and a number of appeals, an external review panel has just agreed to allow Petok to have the procedure.

Petok family members are pleading with people in the same position to keep appealing and exhausting all resources.

Aetna released a statement on their decision.

“While our initial determination resulted in a denial for experimental reasons, we expedited an external review to determine whether an outside expert would recommend this treatment for this particular member, given his circumstances and a current view of the medical evidence. As a result of that review, we have approved this treatment. We know the family is going through difficulties and we sympathize. We wish the family and Mr. Petok well.”

Petok is now scheduled for surgery April 15. His doctors suggest this procedure could extend his life five to 10 years.

More Local News
More Health News
More Reports By Marty Griffin
American Cancer Society
National Institutes of Health: MedlinePlus

More from The Inside Story with Marty Griffin

One Comment

  1. Scott says:


  2. joe says:

    we were all behind you and the family, Marty OF KDKA thank you and all the callers that supported john, we all hope you have many more years to live. thanks Marty. the best of the best as a radio host!

  3. David says:

    Best of luck to him! Cancer is even more evil than insurance companies. Wishing him the best.

  4. Bob McBob says:

    Good luck and god speed

  5. Kristin Pell says:

    I just recently lost my step dad in November to the same thing John Petok is suffering from. And they share the name John. When I seen the story on the news tonight it struck my interest so I decided to keep the news on, when the story started and they said what was wrong with John Petok, I could not help but break down and cry. Knowing that we just lost our loved one to that horrible cancer and to see another suffering from the same thing was heartbreaking. My step dad lived 84 days after being diagnosed with Stage 4 Stomach cancer. He would of been a beautiful 70 years old on March 14. I am glad John Petok is getting the treatment he needs and I am glad they fought the insurance company and won, God really has a plan and I am praying for you John Petok. My thoughts and prayers will always be with you and your family. Even though I lost the greatest person in my life, I am glad you are getting a chance at life.

  6. Jason says:

    Prayers for you….God speed.

  7. JoefromPGH says:

    Devin, you don’t know that. Fact is the approval came AFTER Marty aired a program about it.

  8. Daniel says:

    Well at least now I will know to NEVER purchase insurance with AETNA…thanks AETNA for letting us know how you treat your customers!

      1. Voice of Reason says:

        I second that AMEN!

  9. leighann jacoby says:

    its amazing that all of our prayers were answered! looking forward to seeing my cousin john up and moving and smiling again and EXTREMELY happy that his 5 grandchildren get to grow up and know the wonderful man he is! i love you john and petok family and im so happy for you guys!!! 🙂

  10. Janet says:

    Marty is the best of the best radio host. Because Aetna had the right to take 30 days to make up thier minds but with all the e-mails and phone calls (thank you Marty and friends) they pushed it and it happened in just a few days. John is scheduled for his surgery on April 15th. Thanks again everyone.

  11. swin says:

    If Mr. Petok dies, all the folks at Aetna should be charged with negligent homicide.

  12. Doc says:

    He has stage 4 cancer. It has already spread. The surgery will not cure him despite doctors false promises. Probably he will get the surgery and die from complications or recurrence soon after suffering even more in the meantime.

    We do we think we are eternal? No wonder the medical system is broke.

  13. Dr Arlis says:

    Doctors can only offer quality of life, if the chemo is going to take away his strength and energy and all he can do is lay in bed, what kind of quality of life is that? Insurance companies can’t perform miracles

  14. Krissy clark says:

    I know John, and while insurance companies cannot perform miracles they could have approved his surgery and chemotherapy along time ago instead of giving him a death sentence. If it wasn’t for his family going to the lawyers and Marty he could be dead in another 6 months, never getting to see his children, grandchildren and wife again!
    To all those who say he lived his life, put yourself in his shoes or the shoes of his family and friends. Wouldn’t you want to live to spend time with your family or walk your daughter down the aisle?!?

    1. Sara Sams says:

      Krissy I agree with you. The Insurance Companies play GOD and determin who gets treatment. We pay our premiumns we want our treatment. So what if Mr.Petok only gets a few more years from this Surgery it will be time he could not of had with his loved ones. Good Luck Mr.Petko Im praying for a Miracle for all Cancer Patients.God Bless you..

  15. jerry says:

    way to go JOHN<may you leave a long life and prove the insurance company wrong so they can get their wrong doings…….

  16. Laurel says:

    Good for you! I hope you do well!!

  17. Luke R says:

    Aetna needs to be put out of business, this is one of the worst Ins. carriers to deal with.

  18. katie says:

    Can someone please help me understand why this man – – if his life was at stake — just didn’t go ahead and have the surgery??? Why expend all that energy fighting the ins. co….until AFTER the surgery? Why would you let yourself die…..fighting a company?

    I would go ahead and have the surgery if it were reeeeallly all about the surgery — and then deal with the cost — whether I had to pay it or not. I’m glad the man is doing well and got a resolution — but I don’t understand putting your life in jeopardy — if it was really about saving it in the first place.

    Good Luck in the future!

    1. Sara Sams says:

      The reason is if the Hospitals are not gaurenteed payment in some form they are not going to do any Surgery . Thats the way it works now days.. P.S. Some one has to take a stand with these Insurance Companies. Im glad someone finally did. You may want to check the policy that your Hospital carries conserning Payment at time of Service Rendered..Even if you pay your Insurance dont mean their gonna pay for Treatment..

      1. katie says:

        Thanks for your answer. You’re right about the Insurance Companies — they are cruel and do some really unethical and immoral things. I was just curious about why you wouldn’t go ahead and save your own life and not wait for the unethical insurance companies to follow through.

        Thx again! 🙂

Comments are closed.

More From CBS Pittsburgh

Play It
Get The All New CBS Local App

Watch & Listen LIVE