The case involves the Utah biotech firm Myriad Genetics, which for years has been facing a lawsuit for placing patents on human genes and restricting cancer patients’ treatment options.

The molecular diagnostic company, which is based in Salt Lake City, holds a number of patents on genes related to breast cancer and ovarian cancer, two of which US District Court Judge Robert W. Sweet ruled invalid in 2010, the decision that Myriad appealed. The genes in question, BRCA1 an BRCA2, often appear in cancer patients, sometimes before the cancer has even developed. With methods to diagnose these genes patented by Myriad Genetics, patients are unable to go to any other doctors for a second opinion before seeking treatment.

“Myriad is gate-keeping who can do what research on these genes and they are uniquely aggressive in how they control a patent,” Karuna Jagger, executive director of Breast Cancer Action, told The Guardian. As a result of Myriad’s gene-ownership, other doctors and researchers are unable to develop alternate tests or treatment options, thereby giving cancer patients very few options.

Women with the BRCA1 or BRCA2 genes have no other options aside from taking the Myriad test, which is expensive and not always covered by insurance. Breast cancer survivors are expected to speak before the Supreme Court next week, where they will talk about the costs of the $3,000 tests that their health insurances did not cover.