Posts filed under 'breast cancer'
Preventive medicine has been around for a long time. In most cases that takes the shape of being on medication for borderline cholesterol or blood pressure issues. In some cases where women have a better than average chance of having breast cancer, radical mastectomy is considered to be not just a cancer treatment, but preventive medicine.
Women who come from a family with a history of breast cancer, or who have the known breast and ovarian cancer genes BRCA1 and BRCA2, there is a much higher than normal risk of them having breast cancer. For many women, knowing that breast cancer can kill, removing the breasts seems like a viable alternative to the uncertainty.
Breast cancer is the second most common cancer among women, but much deadlier than the most common, skin cancer.
Another preventive approach is through lifestyle changes. Everything from increased exercise to increased awareness concerning breast exams can be either preventive or help you in the effort to catch cancer in early stages where it is very treatable and curable.
From a life insurance standpoint, a preventive mastectomy would likely not lead to any different rates than the family history itself. If the procedure is due to genetics it would likely be treated the same as early stage breast cancer which would mean than standard or better rates should be available.
Bottom line. Tough decisions. A radical mastectomy is, well, radical and it is not a guarantee that you won’t get breast cancer. Even the smallest amount of breast tissue that is left can still get cancer. Just a tough decision.
October 1st, 2008
Our family is going through an issue that, after some thought, I’ve decided is worthy of discussion in the context of life insurance. Like the breast cancer I’ve discussed that my mother is just completing treatment on, while I’ll use my parents as an example, they are just that, an example of a problem that is pervasive and can absolutely impact your ability to get life insurance at the best rates possible.
They have outgrown the expertise of their longtime general practitioner and because of that they are not getting the kind of follow up that an insurance underwriter would like to see in order to consider someone for better rates.
When your medical life becomes more complicated, whether that is from gastro intestinal issues, sleep problems or even high blood pressure, quite often your primary care doctor will give you a referral to a specialist. The problem arises when they don’t refer you and just treat symptoms even though they have stepped outside their area of expertise, general medicine.
This complicates things from a life insurance standpoint because underwriters can see that you are not getting the proper advice and treatment. They can see that the doctor is prescribing medication and that they aren’t doing the proper followup tests. An example from my own family is the prescribing of Coumadin with the followup blood tests, the PT-NR, that should be done monthly to monitor your blood clotting ability. The doctor prescribed the medication and hasn’t been doing the followup tests. If my Dad was younger and applying for life insurance, he would be declined simply because he wasn’t getting the treatment and followup he needs.
My Mom has always had a hard time sleeping and the same GP, rather than referring her to a sleep specialist, has chosen to treat her himself. Unfortunately that treatment has been a real hit and miss, try this and try that type of approach. He has gone through several medications and some of those were inappropriate for someone her age. A life insurance underwriter would decline her because of this inconsistency.
There is simply a time when you, as a patient, need to realize that your doctor has stepped out of their box of expertise. It can drag a medical problem on for too long. It can make it worse and it can impact your ability to get life and health insurance.
Bottom line. This isn’t about your doctor and the relationship you’ve had for years. It’s about the care you need and deserve. It’s about resolving health issues in an expedient and professional manner.
September 25th, 2008
In a post yesterday I mentioned that the course of treatment for breast cancer that my mother is just completing included six weeks of radiation therapy. My dad forwarded an article to me today from the clinic where she is being treated that talks about a more intensive and compacted radiation therapy used for patients when the cancer is a low grade, insitu, type of cancer that hasn’t spread.
From a life insurance standpoint it would bring the same result, a likely standard rate after one year.
Bottom line. Again, with detection and treatment options expanding all the time, survival and insurance rates will continue to improve. That and I’ve got my dad working for me for free. What a guy!
September 18th, 2008
I haven’t talked for a while about my mother’s progress in fighting the breast cancer she was diagnosed with about 3 months ago. Kind of a disclaimer concerning this is that while I am using my mother as an example of how the different aspects of breast cancer are considered in reference to life insurance, I’m not just talking about my mom and in her case she is well past the point of needing to buy life insurance.
What I have been attempting to do with her example is to put into perspective what someone younger facing a similar diagnosis and prognosis might encounter in their quest for life insurance.
From a pathological standpoint what she has been dealing with is a stage 2 lump in the breast that upon removal and biopsy of lymph nodes in the area, was found to have spread to a number of the lymph nodes near the breast. An MRI didn’t show any metastasis or spread to other areas of the body.
The treatment prescribed was radiation in the breast/lymph node area where cancer was found. That was a six week series of treatments and she has almost completed that. Because of her age chemotherapy was not used. Instead she is taking an oral drug that has much the same impact without the hard hitting side affects of chemo. In a younger woman the treatment would have likely been chemotherapy.
So, from a life insurance standpoint using the younger woman example, she would be considered a postpone for at least one year after treatment. At that time, given no recurrence, insurance would likely be offered with an extra charge until she was five years out from treatment. Higher stages and grades would be treated differently, either incurring a longer postponement of a higher extra charge. If the cancer is stage 0 or 1 insitu, standard rates would likely be available after one year.
Bottom line. Breast cancer, especially with so much of it being detected a early stages and grades, is a very survivable and insurable cancer. If life insurance is something you know you will be wanting to look at and you’ve had or are going through treatment for breast cancer, consult with an independent agent about what you need to do and what you can expect.
September 17th, 2008
It’s been a few weeks, but I wanted to bring an update on my Mom’s breast cancer process. As I’ve mentioned before, this isn’t really about my Mom, as she is past her life insurance buying days, but rather about the process and how her scenario might impact the quest for life insurance for a younger woman.
After a full body and bone scan it was determined that if any of the breast cancer had left the right breast and adjacent lymph nodes, it was an undetectable amount. This is good news knowing that it hasn’t traveled and set up shop (metastasized) somewhere else. This is not to say that cells haven’t migrated, but at this point as she starts treatment if there are cells that have migrated, they are random as opposed to organized.
Her oncologist has recommended 6 weeks of radiation therapy that will be aimed at the right breast and adjacent lymph nodes. She is about a week into that treatment and suffering no ill effects.
Because of her age, 84, the oncologist has put her on oral medication, Femara, rather than attempting to do a course of chemotherapy. Someone younger might do chemotherapy, but the oral medication at her age is considered adequate to hold any stray cancer cells at bay.
Life insurance underwriting in this case would be looking favorably at the apparent lack of metastasis. A woman would likely be able to start getting offers on life insurance about a year post treatment. The further out from the treatment with no recurrence, the better the offers will get.
Bottom line. With early detection methods continuing to improve and treatment options getting better all the time, early stage breast cancer is ultimately going to be much more insurable than it has in the past.
August 13th, 2008
For all that have been following my posts on breast cancer, and specifically by mother’s breast cancer, I thank you for your prayers. As I have mentioned before, my Mom is not in the market for life insurance, but I believe that her experience and process offers valuable insight into what women with her level of cancer can expect, and what I can offer is a translation of her experience to younger women who are in the market for life insurance.
Mom met with the radiation oncologist at Rocky Mountain Oncology today and discussed all of the options. As we had guessed, it seems the most important step will be radiation treatment of the area (the breast and adjacent lymph nodes), where they did find malignant cells. Without stopping the cancer at its’ source, according the the oncologist, there would be a very good chance of it recurring within months. The radiation is localized by computer technology to where each treatment takes only a matter of minutes. She will need to do this 5 days a week for 6 weeks.
The other recommendation is an oral medication that will help slow down any cancer cells in the rest of her body. In a younger woman the choice might have been chemotherapy, but at 84 there is some concern about the treatment being as risky as the cancer.
This is not a high grade cancer so her prognosis is good. In a woman looking for life insurance, she might expect to be able to obtain insurance in as little as 1 year post treatment and standard rates in as little as 3-5 years post treatment.
Bottom line. While it may not be time to buy insurance, visiting with an independent agent not long after diagnosis can give you a good idea of the thresholds that need to be met in order to get back to good rates.
July 8th, 2008
As discussed last week, in an effort to kind of lay out the process that a woman goes through when diagnosed with breast cancer, my Mom has been gracious enough to let me talk about her experience. I believe there is some very real relevance in that, if my Mom was a little younger, her diagnosis would be the type of diagnosis that would likely lead to a good likelihood of reasonable life insurance rates post treatment.
Although her treatment may vary from what someone in their 40’s or 50’s might have recommended, I will try to note where those variances occur and how they might differ in a younger woman. As mentioned last week, she underwent a biopsy of several lymph nodes to see if the cancer had spread beyond the breast.
The initial test is called a sentinel node biopsy. Sentinel nodes are those lymph nodes that are the first in line to filter fluid coming from the beast. This is determined by injecting dye into the breast and then tracing where it goes first. In the case of my mother, 6 sentinel nodes were identified and removed for biopsy. 4 of the 6 were found to contain malignant cells.
Since the lymph system was involved, a further biopsy of numerous lymph nodes was done. All of those came back negative for cancer. At this juncture the next step is a visit with a radiation oncologist who will discuss her radiation treatment. She will also meet with a medical oncologist to discuss options such as chemo or drug therapy. This is one of those points where recommendations may vary due to age. A younger woman might get a recommendation of chemotherapy followed by drug therapy. Mom is 84. Chemotherapy is well known for its’ ability bring a young, strong person to their knees both physically and by undermining their immune system. I suspect that chemotherapy will not be recommended.
When my Dad was dealing with bladder cancer last year he was given a dose of chemotherapy and his immune system couldn’t recover quickly enough to be able to continue regular treatments. They suspended the chemo, not wanting to put him at further risk due to the treatment. Thanks to great doctors and a lot of prayer he is doing great.
When a life insurance underwriter considers a breast cancer survivor, he or she will be looking at how far the cancer spread, the stage and grade of the cancer, and the prognosis one to two years post treatment. If the cancer is confined to the breast, that might just be radiation. If it spreads at all it will likely be chemotherapy and radiation. In general today the initial treatment is followed by an ongoing hormone therapy with a drug such as Tamoxifen.
Bottom line. Getting through the breast cancer process is tough at best. My Mom is fortunate to have a great support system and plenty of people praying for her.
July 1st, 2008
Thank you again for all the prayers on my Mom’s behalf. She had a sentinel node biopsy of the lymph nodes yesterday and it showed that cancer had in fact migrated from her breast at least to the nearest lymph nodes. I will continue to follow her process in this forum, not because I have a need to focus attention on my mother, but because her process is one that is shared by a few hundred thousand women every year in our country.
She will be referred to the same cancer clinic that my Dad went to when he was dealing with bladder cancer (still in remission). I called there this morning with a question. My question revolved around the fact that cancer of the lymph nodes is mcommonly known as lymphoma, so if cancer moves from the breast into the lymph system, is it still breast cancer or is it lymphoma. The answer is that it is still breast cancer and apparently that is an important distinction when it comes to treatment.
The lymph system is interesting in that it is an extremely important part of our immune system, helping to fight disease including cancer. But, because of the extensive nature of the system, it can also be responsible for being the vehicle (or highway) that allows cancer to spread throughout the body.
The next step for my Mom will be meeting with the doctor on Monday to get the results of the pathology of the cancer found in the lymph nodes. She should, at that time, be referred to the oncology team that will make a recommendation for treatment.
Bottom line. The good news for the hundred of thousands of women who are in this boat is that the treatment has come a long way and survival rates are excellent. With those survival rates, for those who are in the market for life insurance (unlike my mom), within a year post treatment a woman should be back in the hunt.
June 27th, 2008
I just received the pathology report that I mentioned in yesterday’s post from the lump removed last week from my Mom’s breast. As I mentioned, with this type of cancer this report is step one of two, with a biopsy of one or more lymph nodes next week being the second half of the picture. The combination of the reports will drive the doctor’s recommendation for treatment.
From the pathology report there were three findings:
1. Infiltrating ductal carcinoma (3.2 cm) moderately differentiated (grade II/III)….
2. Focal angiolymphatic and perineural invasion noted
3. Surgical margins free of malignancy
With a bit of studying I found that infiltrating ductal carcinoma is the most common type of breast cancer and in a nutshell it is a cancer that has penetrated the milk duct walls, as opposed to in situ which has not penetrated the duct walls. Even though the cancer cells have broken through the duct walls, the cancer often remains localized. That is to say that just because it is infiltrating versus in situ doesn’t necessarily mean it is a more aggressive cancer.
Item 2 kind of caught my attention. As a layman it kind of sounded like the cancer had invaded the lymphatic system. Again, with a bit of study it seems that the wording, from a pathologist’s view really just means that the cancer has the potential to have spread to the lymphatic system. That is the reason for next week’s biopsy.
Again, if my Mom was in the life insurance market, so far the news is good. The lump was small at 3.2 cm. The surgical margins were free of malignancy. With a good lymph node biopsy next week, she could be on the road toward good rates, post treatment of course.
Bottom line. Breast cancer in women and prostate cancer in men are the types with the highest success rate for getting affordable life insurance post treatment. In a best case scenario there will be a one year waiting period after completion of treatment. The success rate with life insurance and the high survival rate are primarily due to improved screening and treatment methods.
June 18th, 2008
I wrote a post about breast cancer last week. I was on the way to Wyoming as my Mom was preparing to have a lump removed from her breast. Thank you for your continued prayer.
I haven’t received a copy of the pathology report yet but the lump was confirmed to be cancer. As is standard in this situation, the next step will be a biopsy of the lymph nodes. She is scheduled for that next week. From what I’ve been told so far it sounds as though the doctor will perform a sentinel node biopsy.
As I’ve noted in several posts and articles about cancer, from both a medical and life insurance point of view, the stage and grade of the cancer are critical pieces of information. At this juncture of the process, having biopsied the mass that was removed, the pathologist should have a clear indication of the grade of the cancer. The grades are 1 through 3 with 1 being the best and 3 being the most aggressive.
Although they could make an assumption of the stage of the cancer at this point, the biopsy of the lymph nodes will provide more definitive information about whether the cancer was contained “in situ” or has spread. Once the stage and grade are established, treatment options can be discussed.
Bottom line. Caught early, breast cancer has a very good survival rate. This bodes well for women who will be purchasing life insurance post treatment as well as for women, like my Mom, who have reached a point where there is no real purpose for additional life insurance. The keys for good rates on life insurance are a low stage and grade, one year post treatment, and a good independent agent. I hate to beat up on these guys all the time, but you really don’t want to apply for life insurance after breast cancer through your local auto and homeowners agent. The outcome will be adding insult to injury.
June 17th, 2008
Previous Posts
