Posts filed under 'breast cancer'
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
Last year my father, age 85, did battle with bladder cancer. He was blessed with great doctors and literally hundreds of people praying for him. Today you wouldn’t even know that he had been through a fight with a high grade, high stage cancer that takes more lives than it passes by.
Today I leave for Wyoming again. Tomorrow my mother will have a lumpectomy to remove a tumor from her breast. Again, I ask you to pray. All of the previews indicate that the cancer is contained in the lump and unless something different is found during surgery, her prognosis is good.
Breast cancer is the second most common cancer among women, as with prostate cancer in men, only second to skin cancer. With improved screening and more education about self examination, breast cancer is more commonly found these days in early stages. As with all cancers, the earlier the cancer is found the higher the survival rate.
While my Mom is 84 and not likely to be shopping for life insurance, if she were, the news would be good. A lump, or encapsulated tumor, is relatively easy to treat generally by removal of the tumor and radiation therapy. If the biopsied tumor did in fact show it was a low grade tumor and had not spread, a woman could expect that life insurance would once again become affordable as little as a year post treatment.
When you do reach that point of being ready to shop for life insurance, a few helpful hints. Pardon my broken record, but find a good independent agent with a good working knowledge of breast cancer underwriting and a good track record of results. Obtain and keep a copy of your post surgical biopsy so that the agent and the life insurance underwriters know exactly what they are dealing with and quoting. Accurate and complete information will lead to better offers and results.
Bottom line. Breast cancer is becoming more survivable each year and has made enormous strides over the past ten years in its’ treatment by life insurance companies. Start formulating a game plan with an independent agent as little as six months post treatment.
June 12th, 2008
I’ve mentioned before that there is a problem in the life insurance business. Pure and simple, it’s greed. Agents are so protective of a potential sale that they will actually tell a customer they are uninsurable, rather than admit they are the wrong agent for the job and lead them in the right direction. This is particularly true of captive agents whose world revolves around one company and that company’s underwriting opinion.
Very few days go by without hearing from people who are desperate to find affordable life insurance. They have been declined or told they are uninsurable because they have bipolar disorder. They’ve been told they will never get insurance because they’ve had a heart attack or breast cancer. I’ve had clients who are never called back by another agent because they admitted they had been through alcohol treatment or are have type 1 diabetes..
Agents actually tell these people “you will never get life insurance”. What an insanely unprofessional thing for an agent to do. I can only imagine how many clients just give up and leave their family without protection because some lame excuse for a life insurance agent didn’t have the guts to just tell their client to seek out a more experienced independent agent. You can Google up an independent agent in .23 seconds that has experience in exactly your health issue.
If you talk to an agent and they declare you uninsurable without running your information informally through several underwriters, they are either captive or incompetent. If they say they’ve shopped it and you are simply uninsurable and they don’t talk to you about guaranteed issue life insurance, they are captive or incompetent.
The bottom line is that agents very often declare you uninsurable because they aren’t knowledgeable in your impairment or are too lazy to work an impaired risk case. You know what the issues are with your impairment, and if an agent isn’t asking the right questions, you know you’re with the wrong agent. No one said it’s easy, but quoting Rich Fuller from Special Risk Services, an impaired risk general agent for 30 years, “Anyone can write insurance on the super healthy, but the reward is placing much needed insurance for someone who has suffered severe health problems”.
Bottom line. Never take uninsurable as an answer. Do an internet search for an agent with the expertise you need. Find someone who knows the questions, knows the answers and knows where to shop your business, and just as importantly, where not to shop your business.
April 8th, 2008
We’ve often discussed in this forum that one of the most prevalent risk factors associated with obesity is the increased risk of cancer. Scientists are narrowing down some of the worst culprits of obesity and their role in that increased risk.
Processed meats win the prize for the worst thing you can do for yourself if you are trying to control your weight and have decided that, given a choice, you would prefer not to have cancer in your life. In a report that is drawing fire from the food industry, excessive intake of red meat, and to a greater degree, processed meats, are shown to contribute to a significant increase in the risk of cancer of the colon, kidney, pancreas, esophagus and uterus as well as post menopausal breast cancer.
While the report was especially rough on bacon, sausage and pepperoni, it recommended guidelines limiting intake of red meat to just over a pound a week. I gave some thought to my own habits, and while I certainly don’t keep track of that kind of data, I suspect that I run at or below that amount. I remember staying with some cousins of mine who were ranchers several years back and being shocked at the amount of meat they filled their days with. They probably met that weekly recommendation on a daily basis.
Life insurance applications and underwriters don’t ask about your eating habits, although the evidence is generally shown in things like weight, lab results, health issues, etc.
I had a client recently that expressed dismay that the quote I provided didn’t hold up when he weighed 20 more pounds on the exam than what he had stated to me and had indicated on the application. He said that I should make people aware of anything that could possibly effect their rate prior to them applying. I don’t know why that struck me as odd, but it did. Life insurance rates are all about assessing risk. But, for the sake of any future customers, my disclaimer: “Anything that puts you more at risk of disease puts you more at risk of premature death and puts you into a higher rate category.”
Bottom line. It’s all about taking care of yourself and making prudent choices in your life. We can’t expect to waltz through life eating recklessly and piling on the pounds and not have our bodies revolt at some point. If that is the direction you choose, my recommendation would be to get your life insurance before the next toll booth comes into sight. Weight alone can affect your rates, but cancer, in some cases, can keep you from being offered insurance at any rate.
February 14th, 2008
There are so many options to shop for your life insurance needs, each making the claim that they will save you money. Save 70% on your term insurance! Hundreds of companies to choose from! Give us 10 minutes and you could save hundreds of dollars on term life insurance! Shopping for insurance is quick and easy!
Well, if you happen to be young and healthy and happen to have done an impulsively ignorant thing like buy your current whole life insurance through Northwestern Mutual, these claims are not out of line. You can save big bucks because you are spending far too much now. It can be quick and easy because if you’re young and healthy there isn’t much for an underwriter to think about.
But let’s step away from that market for a moment. Let’s talk about you and me. Let’s talk about people in their 50’s, 60’s and 70’s, whose health ranges from less than perfect to down right problematic. Let’s talk about those of you who have diabetes or heart disease. Let’s talk about the reality of finding affordable life insurance if you suffer from depression or bipolar disorder. Let’s get real about the challenge of finding life insurance when you have survived breast cancer or prostate cancer.
The mammoth agencies that make those claims at the top really don’t want to deal with impaired risk (industry term for health problems) business. They make their money by churning out mass amounts of quick and easy, young and healthy, 10 minute business. They don’t want to get bogged down in asking all the questions it takes for them to fully understand your situation. They don’t want to wait for you to produce stress tests and pathology reports that are critical in obtaining good offers. They don’t want to take the time to petition underwriting opinions from dozens of companies. And they really don’t want to spend the time it will take in underwriting knowing there is always the chance that the business might be declined or rated to the point that they will not make a sale. Quick and easy. 10 minutes.
There are a group of agents out there, independent agents, that honestly are experts at impaired risk business. They understand the work it takes and they understand how much it means when they succeed for their clients. As independent agents we embrace the education required to succeed for you. We build relationships with those companies and underwriters that we know will come through for you. We made a choice to leave quick and easy behind a long time ago because anyone can do that.
How do you know you’ve found the best deal? How do you know you’ve found the right agent? If you come away from a first contact with an agent and feel like they understood your health issue and knew what questions to ask, that’s a good thing. If they asked questions that possibly you didn’t know the answers to, believe it or not, that’s a good thing. If you are diabetic and don’t know what you hbA1c is, you should know. The agent that asks for it understands what it is, how important it is to your health, and that you can’t get accurate quotes without it.
Very often a first contact on impaired risk business will leave you with homework to do. I’ve had people back out of the request because they aren’t willing to call or go to their doctor and find out the information it takes to properly present a request for quotes to underwriters. They lose because a request for quotes with a history of cancer that doesn’t include the stage and grade of the cancer won’t get any responses. A request for quotes on someone with bipolar disorder that doesn’t spell out whether it is bipolar 1 or 2 won’t get any quotes.
Bottom line. You will know when your interests have been properly served and you will know when you have the best value, because it will be obvious that the job was done, done right and done completely. If you take health issues to “quick and easy”, you will get exactly what they have advertised, but the chances of your best interests being served are slim to none.
February 13th, 2008
While I generally agree with most family history guidelines that life insurance underwriters use, there are times when common sense simply has to override the guidelines. After all, they are called underwriting guidelines, not rules.
I’ve had to defend family history underwriting on plenty of cases. Probably the biggest bone of contention is when a parent has died of lung cancer or heart disease, and they were obese smokers and the person applying for insurance is a healthy, fit, non smoker. It stretches everyone’s imagination to figure out the true relevance of that connection and why the healthy, fit, non smoker should have to pay more.
But underwriters will make and defend the case that plenty of people smoke heavily all their lives and don’t have heart attacks, so who is to say that the father didn’t have a genetic predisposition to heart disease? Who is to say that those genes weren’t passed along and even though the lifestyles are different, the healthy son has a genetic predispostion to heart disease just like dear old dad.
Having said that, I am jousting with an underwriter right now, with a company generally known for putting common sense in the equation, who wants to whack a client two rate classes because his sister died at age 20 of breast cancer. He is a healthy 54 year old male. There is no defensible potential genetic link.
Now that I have beat the company up, it’s my turn. I got caught doing the very thing that should never be done in this business. I should have never assumed that common sense would prevail. I didn’t get an underwriter to agree to it ahead of the application.
Bottom line. I can salvage all of this and get an approval at the best rate class, but lesson learned. Common sense should have told me don’t count on common sense. Shame on me this time.
February 1st, 2008
In my passion to ensure that the world understands the risks of cancer, obesity and diabetes, I have often referred to heart disease, coronary artery disease, as a collateral health issue. What I have neglected to do is give the number one killer of men and women the singular emphasis it deserves.
Although women consistently note that their biggest health concern is breast cancer, it is heart disease that claims the most lives of any health issue that women face. According to a recent article in Pink Magazine by Michele Cohen Marill, “1 in 10 women ages 45-64 lives with heart disease”.
Probably because men have dominated the heart attack scenes in movies, very little coverage or concern has been given to the fact that women now outnumber men in the heart disease/heart attack statistics. The culprit in this switching of roles seems to be stress, and plenty of it.
We’ve talk many times about the impacts of stress on the body and the article really drives home that point by noting that “a Swedish study found that women are six times more likely to have a heart attack if they have a high pressure deadline at work”.
Oh, that we would all learn that life is just too short for that kind of stress. I understand why we do it. As a business owner I put more than my fair share of stress on myself. I hope I offset that stress with some balance in the form of daily exercise. My daily run is intentionally planned in the middle of my work day. It puts things back in perspective and the health benefits are a bonus. Vacations are critical. My wife and I have promised each other that play will be a part of our busy life.
I guess where I am going with this, is that a busy life, even stress, are OK as long as you find a counterbalance and don’t let it build up.
Bottom line. From a life insurance standpoint, heart disease, and especially early onset heart disease present an underwriting challenge. Bypasses and angioplasties aside, if the root cause isn’t changed, if your health condition isn’t addressed with the same passion that your career has been, you are headed down a road that will continue to worsen and life insurance underwriters will drive home that point in the rates they offer, or the declines they dish out.
As with all health issues, underwriters wants to see that you have made the changes, that you are committed to the treatment and that you have in mind not to add to the wrong side of the heart disease statistics. A heart attack can be just the wake up call a person needs. Even better, avoiding that heart attack by learning what changes you need to make in your life, and proactively taking the road less traveled.
January 21st, 2008
We’ve often discussed that from a life insurance standpoint, breast cancer caught in the in situ stage, confined to a single milk duct, offers the best options for insurability post treatment. Early stage and grade lead to better rates, quicker.
It has been thought that that DCIS is essentially stagnant, but if the tumor contains “motile” cells, the cancer cells start to wander along milk ducts and can potentially start new tumors within the same breast as they go.
This new evidence makes regular screening even more crucial, as skipping a screening could potentially allow time for a confined DCIS (ductal carcinoma in situ) to become mobile and create a larger, harder to control problem. Certainly with the standard treatment for DCIS being a lumpectomy, the idea of numerous sites could raise the level of the needed treatment to a mastectomy that may not have been needed if caught earlier.
“Approximately 16% of DCIS patients treated with lumpectomy alone develop recurrent breast cancer growth within 5 years of treatment.” There is some thought that, even if there is no evidence of migration, if the DCIS contains the “motile” cells, there may be enough reason to consider radiation in addition to a lumpectomy.
Bottom line. As much as it is a imposition to have to schedule and follow through with regular screening, breast cancer, any cancer, caught early can save your life. The difference between early detection and high stage and grade cancer can mean the difference between getting good rates for life insurance in the future and not getting life insurance at all.
January 3rd, 2008
I just did a quick gut check on my blogging efforts over the past year. Who really cares about what I believe and what I know about life insurance? Who reads this and really believes that I can do what I claim?
I have had more than just a little interest in weblogs I’ve posted concerning some of the more difficult illnesses and situations to successfully get affordable life insurance with. I’ve had plenty of people take me up on my assertion that if they’ve been declined, it was probably more the fault of the agent and the company, than their own impairment. Here is a quick list of declines from 2007 that came to me looking for help and now have in force life insurance policies.
- Bipolar disorder
- Type 1 diabetes
- Type 2 diabetes
- Epilepsy
- Breast cancer
- Prostate cancer
- Early onset heart disease
- Heart attacks
- ADHD and
- Gastric bypass
This is exciting for me. I’m not in this business to write life insurance for the young and healthy. While I’m glad to help them out, they don’t need me.
My passion lies with those folks that have successfully beaten or at least controlled a disease, only to be slapped in the face by the insurance industry. My passion is to prove the ignorant life insurance agents representing the ignorant life insurance companies wrong. My passion is to turn declines into in force life insurance.
Bottom line. Thank you, all of you, who dig a little deeper and don’t take no for an answer. I am there waiting for you.
December 26th, 2007
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