Posts filed under 'basal cell carcinoma'
Skin cancer is the most common cancer among both men and women in the US. Life insurance underwriters have shown a lot of movement on their underwriting guidelines for skin cancer over the past several years. Unfortunately, until recently, it didn’t seem to be in any clear direction.
Probably the best news has been in the risk evaluation of low stage melanoma. Melanoma is the least common skin cancer but accounts for 75% of skin cancer deaths. But, what we’ve seen recently especially in stage 1 and 2 melanoma , is a tendency to get back to standard rates quicker after surgical removal of the cancer. While higher stages may incur a flat extra for a longer period, lower stages can generally be seen within a year with no recurrence.
The other significant shift in skin cancer underwriting has come in basal cell carcinoma and squamous cell carcinoma. In the past these two generally flew under the underwriting radar because of the relatively low mortality risk. A few years ago a study indicated people with multiple basal cell carcinomas were at increased risk of acquiring melanoma. This led to an underwriting swing away from ignoring basal cell to offering no better than standard for people with multiple instances. This stance has also softened somewhat with further studies showing the connection to be more vague than first thought.
Bottom line. Once again, this is not an area where your car insurance agent is going to shine, and I wouldn’t depend on large internet agencies to really dig in deep and get the job done as it should be. A knowledgeable independent agent should be able to ferret out the best opportunities for low rates with your particular history of skin cancer.
July 29th, 2008
In my experience it is the guys in this world that not the brightest lights on the block when it comes to preventive measures like using sunscreen, wearing hats and not overexposing themselves to the sun. I would put my money on men to be the first sex to be overwhelmed and become extinct due to skin cancer.
Growing up on a golf course or at the lake, I know that sunburns were worn and compared like badges of honor. Losing multiple layers of skin over the course of a summer was a job well done.
Now an alarming study shows that men, for all of their brainless effort for the last 30-40 years, are being left behind when it comes to increases in the number of new melanoma cases. Since 1980 diagnosis rates in younger (15-39 year old) men have remained level while the number of younger women diagnosed has risen 50%. Melanoma is the most dangerous of the three types of skin cancer.
This is especially foreboding since most skin cancer is diagnosed at older ages. There were a couple of factors noted that may have contributed to this disparity in the rise of melanoma cases. First, woman are more likely to wear sunscreen and because of that, may expose themselves to more sun because they feel protected. The other culprit could very well be tanning beds. Not a lot of guys hang out in the UV sandwich looking things.
From a life insurance standpoint melanoma is a serious subject, and for good reason. Unlike its’ less potent cousins basal cell carcinoma and squamous cell carcinoma, melanoma kills. Depending on the stage, grade and depth, it could easily be three to five years after treatment before reasonable rates are available and melanoma is one of those health issues that may very well prevent you from ever getting better than standard rates again.
Bottom line. It remains to be seen what these statistics in “younger women” foretell 20 years down the road. Time to rethink our rethinking of our relationship with the sun.
July 11th, 2008
The word cancer used in reference to anything to do with life insurance usually conjures up visions of declines and huge rates. In that regard skin cancer is something of a different animal.
Skin cancer is the most common cancer in both men and women, mostly thanks to the fact that most of us had no idea that sun could be harmful 30 and 40 years ago as we religiously broiled ourselves at Memorial Day lake parties. There are three types of skin cancer.
Basal cell carcinoma, sometimes called non-melanoma skin cancer is the most common. It is most frequently seen in light complected people. Basal cell has about a 95% cure rate, so it isn’t the most feared cancer by any stretch, but recent surveys have shown that multiple basal cell instances put a person at higher risk of more dangerous skin cancer. This fact has not been lost on life insurance underwriters who, as recent as five years ago, didn’t rate basal cell at all, not even multiple instances. Now, while most companies will let a single instance slide, multiple instances may bump a person to standard rates.
Squamous cell carcinoma is almost identical to basal cell except in one aspect. Basal cell, in the 5% of cases where it becomes a problem, generally goes deeper into the skin and can sometimes reach the bone, but it doesn’t spread to other areas of the body. With squamous cell, the cure rate is essentially the same, about 95%. The issue with the other 5% in this case is that squamous cell can spread to other parts of the body. Underwriting on squamous cell will depend on the stage and grade and if it has spread. If it is a low stage and grade with no spread, often preferred rates can be done if there is a single instance. Multiple instances would be standard rates best case.
Melanoma is the last of the skin cancers and although it represents only a few percent of the total skin cancer occurrences, it is responsible for 75% of the deaths. Underwriting melanoma is a whole different ballgame. With a low stage and grade melanoma, the best case would be a rated policy (higher than standard) when you’ve reached one year post treatment. That is best case. Remember, with cancer it is all about stage and grade. I’ve seen melanoma history get no better than standard 10 or more years after treatment.
Bottom line. Skin cancer is not an issue that you want to tackle without an independent agent. Most life insurance companies will be more cautious than I have described.
May 28th, 2008
Guys! The boogie man isn’t under the bed, but rather right below our belly buttons, just about a finger’s length up our rear ends. I’m talking about the prostate gland and the fact that 1 in 6 men will get prostate cancer in their life time.
Prostate cancer is the second most common cancer right behind the skin cancer trio of basal cell carcinoma, squamous cell carcinoma and melanoma. While a statistically huge number of us will be diagnosed with prostate cancer, the good news is that the survival rate is very good, with only about 1 in 8 who are diagnosed actually dying from the cancer.
It is this survival rate, driven by early detection and effective treatment options, that makes prostate cancer one of the easiest for life insurance underwriting. The earlier the cancer is detected, the lower the stage and grade and the better the treatment results. With more and more men getting regular PSA tests, expect that survival rate to climb in the future. By the way, my most recent health fair results showed my PSA at .9, down from 1.1 two years earlier. Safe for now.
I’ve review a lot of articles about prostate cancer and how to avoid it. This one I read just recently is kind of like just doing what your mother said. Eat your vegetables! Sure can’t hurt and it tastes good too.
Now, back to the subject at hand. As a baseline underwriting view, if your cancer is diagnosed when the PSA is 10 or less and the biopsy shows a stage of T1 or T2 with a Gleason grade of 3+3=6 or better, depending on treatment results you could be back from the brink of uninsurable to close to standard rates in a year. That scenario would be if treatment was a radical prostatectomy and your PSA was at 0 for a year. With other treatment options the time frames can change.
Bottom line. Good news. Ultimately very survivable and very insurable. Talk to an independent life insurance agent about it today. Make sure you have a copy of your biopsy and that you know all of the relevant test results. The more information you can provide, the better the chance of finding good rates.
May 23rd, 2008
If you’ve been around life insurance long enough you begin to see that there are companies whose underwriting guidelines kind of float on the breeze and then there are those who truly do their homework and strive to make reasonable decisions.
I have commented in previous posts about the shift that happened a few years ago with a lot of the “float on the breeze” companies. A study came out that indicated that people who had multiple incidents (more than one) of basal cell carcinoma, the most innocuous of skin cancers, had a higher risk of having melanoma, the deadliest of skin cancers. At least this study was cited to me by underwriters. The nearest article I could find that leaned in that direction merely indicated that if you’ve had basal cell once, there’s a 30% chance you will have skin cancer again within 5 years.
Suddenly, basal cell carcinoma went from an unrateable event to an issue that could kick you down to standard rates or worse with many companies. What these companies did was seize the bad news in a study and throw out the logical good news.
The good news in this case is that just about everyone who has skin cancer once, whether basal cell, squamous cell or melanoma, will likely become something of a fanatic about seeing the dermatologist at least annually and doing self checks way more frequently than that. That means that even if there is a slightly higher chance of melanoma, in all likelihood it would be caught early enough that it would be successfully treated.
This is where Prudential again stands out. They seem to understand the dynamics of the situation and if a person has had multiple squamous cell carcinomas or basal cell carcinomas, as long as they are checked regularly, their best rates can still apply.
Bottom line. If you have had any type of skin cancer and are shopping for life insurance, use an independent agent that knows where companies stand and know where to take your business for the best chance of success, and more importantly where not to take your business.
January 4th, 2008
While it may be too late for those of us who grew up in the 50’s and 60’s, wearing our sunburns with pride, using sunscreen can certainly cut down on future cases of skin cancer.
We have gone over the life insurance underwriting differences of the three types of skin cancer in previous posts, but just to re-summarize, there is basal cell carcinoma, squamous cell carcinoma and melanoma.
In general one instance of basal cell or squamous cell can still get you best rates with several companies. Multiple instances can still get you better than standard rates with a few companies, but standard rates seems to be the low spot where most companies are settling.
With melanoma it’s all about stage and grade. A very low stage and grade could bring standard rates a year after treatment. A middle of the pack stage and grade could be standard rates after 3 to 5 years. During that period the company would charge what is called a flat extra. That is a dollar cost per thousand dollars of insurance per year. For instance, on a $100,000 policy with a $7.50 flat extra for 5 years, you would pay the standard rate plus $750 for the first 5 years. After that you would pay the standard rate.
A high stage and grade, if it didn’t kill you, will likely be uninsurable for some years and then it will have a flat extra after that.
With all that said, avoiding skin cancer is really the best idea. Sunscreen really beats going to the beach in long pants and a long sleeve shirt with a hat and gloves and shoes. So, SPF 60 and you’re good to go, right?
Not according to the FDA, quoted in a New York Times article today. According to studies by the FDA, SPF 30 blocks out 97% of the harmful sun stuff. So, being the rocket scientist that I am I come up with SPF 15 blocking out 48.5% and SPF 60 blocking out an astounding 194%. Apparently they don’t use rocket scientists to make sunscreen. The study showed that SPF 15 blocked out 93% and SPF 60, which the FDA recommended be labeled SPF 30+, only blocks out 97-98%.
Bottom line. Use your sunscreen and more sunscreen is better than more SPF’s. And, if you’ve had skin cancer, don’t buy your life insurance off the shelf. Find an independent agent who can cut through all the underwriting jungle and find the best possible rate for you.
August 7th, 2007
Skin cancer is probably one of the most common forms of cancer, especially here in the sunny southwest and growing up in the Rocky mountains as I did with very little between us and the sun’s uv rays. Sunscreen didn’t show up on the scene until I was in my 20’s and with sun being the cause of more than 90% of skin cancer, that puts many who grew up in uneducated and unprotected times at risk.
There are three types of skin cancer. Basal cell carcinoma, squamous cell carcinoma and the most vicious of the three, melanoma.
Basal cell carcinoma is the most common of the three and accounts for about a million new cases of skin cancer each year according the the Skin Cancer Foundation. While basal cell in fairly detectable and treatable, left undetected and untreated, “it can be resistant to treatment or locally aggressive, damaging the skin around them, and sometimes invading bone and cartilage. When not treated quickly, they can be difficult to eliminate. Fortunately, however, this is a cancer that has an extremely low rate of metastasis, and although it can result in scars and disfigurement, it is not usually life threatening”, according to the Skin Cancer Foundation.
From a life insurance standpoint, companies seem to be split on how seriously they view basal cell. Just a few years ago it was not a rateable issue at all, even if you had several instances of basal cell over the years. Now, most companies will not offer preferred rates for multiple instances. This seems to have risen from a study that shows that people that get skin cancer have certain traits that make them susceptible to more instances. Multiple instances seem to increase the chance of developing a melanoma. Many still offer their best rate if there has only been a single instance. On the upside for both the life insurance companies and the customers, once a person has been diagnosed with skin cancer, they tend to get very regular checkups which is one of the keys to early detection and successful treatment.
Squamous cell carcinoma is the second most common form of skin cancer with about 250,000 new cases each year. Like basal cell, detected early, it has a very high success rate for treatment. Again, life insurance companies in general aren’t too brutal if there has only been one case, but multiple instances will be looked at more carefully. This is another instance in which a good independent agent should be engaged to help. With companies literally all over the underwriting map on basal and squamous cell carcinoma, you need an agent that knows where and where not to take your business.
That brings us to melanoma and just why life insurance underwriters take this form of skin cancer very seriously. Again, turning to the Skin Cancer Foundation, they define melanoma this way. “Melanoma is the most serious form of skin cancer. However, if it is recognized and treated early, it is nearly 100 percent curable. But if it is not, the cancer can advance and spread to other parts of the body, where it becomes hard to treat and can be fatal. While it is not the most common of the skin cancers, it causes the most deaths. The American Cancer Society estimates that in 2007, there will be 8,110 fatalities, 5,220 in men and 2,800 in women in the U.S. The number of new cases of melanoma is estimated at 59,940; of these, 33,910 will be in men and 26,030 in women.”
While death is a fairly rare occurrence with the first two types of skin cancer, melanoma is a seriously invasive cancer unless caught very early. Even if you have survived melanoma, insurance underwriters are cautious in their underwriting decisions for several years after successful treatment.
Bottom line. Those of us that grew up pre-suncreen and pre-skin cancer awareness, should get checked by a dermatologist on a fairly regular basis. Those of you who grew up in an era when we knew more about the risk should protect yourself.
July 21st, 2007
Life insurance giant AIG, American General led the way for years in offering the best deals for private pilots looking for life insurance. They took over the market and dominated for several years……and then they bailed. From my perspective it looked like they had a few claims, some of them worth several million, that they feared was going to somehow collapse their $700 billion dollar empire. They pushed the idea that they were there for pilots and then ran from it at the first sign of checks going the wrong direction for them.
There are other companies that were there before AIG and are still there. Pilots can still find dependable, affordable life insurance through North American, Genworth Life and Annuity and ING Reliastar. It’s not really like these companies stepped in and adopted private pilots. It’s more like when AIG was flaunting low rates, pilots and some agents may have forgotten those companies that had been there for them all along.
There is nothing basically wrong with a life insurance company changing their underwriting criteria, especially in the face of a new or unexpected mortality experience or assumption. Look at all the companies that changed their stance on multiple instances of skin cancer when a study came out showing that multiple instances of basal cell carcinoma or squamous cell carcinoma could lead to a higher probability of melanoma.
It’s certainly OK for these companies to cover their wealthy little behinds. They need to stay wealthy enough to pay claims. It’s just this agent’s opinion that American General over reacted to what they knew was coming. If you try to claim all of a market (private pilots) and don’t expect any of them to die, someone didn’t do their homework up front.
July 2nd, 2007
I just learned today that due to pressure from reinsurance companies, many life insurance companies will be charging higher rates for women who have had gestational diabetes. Again, why do you want an independent life insurance agent?? While many life insurance companies will now charge a higher rate for up to 10 years after a woman has gestational diabetes, not all of them will. Just like type 1 diabetes and type 2 diabetes, it pays to have an agent who knows which companies have their head screwed on right.
This is a huge change as gestational diabetes was, in the past, considered a non issue from an underwriting standpoint as long as it resolved itself after the pregnancy. This caught a lot of agents off guard like the change in the stance on multiple basal cell carcinoma did a few years ago.
I will be researching the gestational diabetes issue to see if I can determine the logic and will share that with you when I get an answer. Can’t promise it will make sense or bear any semblance of reality, but I will get an answer.
Just a heads up from something I ran into today. Many life insurance quote websites only ask about health issues for the past 10 years. READ MY LIPS!!!!! That doesn’t mean that health events more than 10 years ago won’t impact your rates. Again, another reason to have a good agent who asks, “Have you EVER been diagnosed with or treated for”. I talked to a client today who answered no honestly to the 10 year question, but had two run ins with cancer prior to that. That is relevant!!
May 16th, 2007
The various skins cancers and the way in which they are viewed by life insurance underwriters continues to evolve. The three primary skin cancers are basal cell carcinoma, squamous cell carcinoma and melanoma.
Not even five years ago it was a given that basal cell carcinoma just didn’t affect your life insurance quote at all. It was considered insignificant from a mortality standpoint, simply because no one dies from basal cell carcinoma. Squamous cell, while more serious than basal cell, in most cases doesn’t carry any real significant mortality risk. Both of these skin cancers are also called “non melanoma” skin cancer.
On the other end of the skin cancer spectrum is melanoma, a cancer known for its’ tendency to spread quickly and metastatize throughout the body. Defintely a mortality issue.
Now, to complicate the underwriting issue, comes a study that shows that people who have multiple basal cell or squamous cell carcinomas, have a higher than average chance of having a melanoma. This has caused many companies to take a new look at their old underwriting. As I mentioned earlier, the general rule of thumb was that basal cell carcinoma was a non issue in underwriting. With most companies, five years ago, a person could expect the best rate class even with multiple instances of basal cell.
New thinking from underwriters is that multiple instances should now incur some rate change due to a higher risk of melanoma. Not all companies are on board with that, but the trend is in that direction. This is where an independent agent is a good idea. The more companies you have to choose from the better the likelihood you can still get the best rates.
My personal opinion on this is that the companies that have freaked out over the study are forgetting something very important. Undiagnosed melanoma is generally the killer. Someone has never had a skin cancer problem and they kind of ignore it and then, by the time they think they should have it checked out, it’s too late. If someone has had basal or squamous cell carcinoma and especially someone who has had more than one, they are likely to get regular checkups from a dermatologist. The likelihood of a melanoma sneaking up on them and doing any real damage is actually pretty slim.
Bottom line. If you’ve had skin cancer and are shopping for life insurance, bring all the facts and even the pathology reports to your insurance agent. The more infomation they have the more likely they are to be able to find good rates.
April 14th, 2007
