Posts filed under 'cancer'
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
Assuming survival, which is a pretty good bet with prostate cancer, a life insurance underwriter uses a set of criteria to evaluate the mortality risk of any given cancer survivor. It is this assessed risk that is translated into a rate per thousand dollars worth of insurance that a person must pay to be covered.
Prostate cancer is the second most prevalent cancer in men with nearly 250,000 men being diagnosed each year. The good news is that only about 1 in 37 men actually die from the cancer. Since most prostate cancer is confined to the prostate gland, and the most common treatment is removal of the gland, the survival rate is very high.
Life insurance underwriters look at prostate cancer from a couple of perspectives, and each of those is given a different spin depending on treatment options chosen. Optimally, a man should be able to get standard or better rates in most cases a year after successful treatment.
Underwriters first look at the PSA (prostate specific antigen) at the time of diagnosis. It varies from company to company, but for the best underwriting the PSA at the time of diagnosis should be 10 or under. Under 4 is considered normal. A PSA higher than 10 usually indicates either a faster growing cancer or someone who has not actively monitored their PSA.
The other factor that is critical is the grade of the cancer as indicated by the Gleason score. For the best consideration the pathology report should indicate a grade of no more than 6. I’ve compared the Gleason grade to the Richter scale in the past. A Gleason grade of 6 is very insurable in most cases, a 7 only at very high rates and an 8 or above usually not at all.
So, assuming a diagnosis level PSA of less than 10 and a Gleason 6, the last factor underwriters look at is the post treatment PSA. With a radical prostatectomy, the surgical removal of the prostate, a PSA of 0 is the expected result. If after one year the PSA is still at 0, standard or better rates should be available. The other primary treatment is radioactive seed implant. Rather than removing the prostate, one or more radioactive seeds are implanted in the prostate effectively killing the cancer cells. With this treatment, since the prostate is still there, a PSA that has been at .5 or lower for at least a year is the underwriting goal.
Bottom line. Prostate cancer is highly survivable and is also very insurable in most cases. If you have had prostate cancer and are looking for life insurance, seek out a knowledgeable independent agent and come armed with the knowledge of the different factors that will be scrutinized.
August 6th, 2008
Guys, we’ve talked about this before, an area where women don’t even have to struggle at all to make us look like morons. Unfortunately far too many men find out the value of an annual physical, a regular checkup, when they discover that they have a serious health issue that might have been avoided or at least discovered earlier if they had a relationship with their primary care doctor.
I don’t have to search far to find the truth in this. In just the last 10 years, the number of men who have applied for life insurance through me only to get declined because of medical information they should have known has been, well, larger than most men would guess. The medical exam and lab tests that come with applying for life insurance are quite often the first thorough workup men have had in years. To their dismay it often answers the question about why they haven’t been feeling up to par lately.
All of these things are simple and relatively inexpensive to test for when you consider the high expense of treating the aftermath when things get out of control. Probably the most common thing that pops up is high cholesterol, a leading cause of heart disease. Caught early, minor lifestyle changes can usually turn the problem around. When the problem is discovered after things are out of control, it is often a far more serious matter.
Diabetes is a fairly common discovery on insurance exams. Again, any kind of regular checkup would have revealed a level of pre diabetes that could have been treated with lifestyle changes. It is not an unusual occurrence for men to discover that they have prostate cancer due to an elevated PSA on their insurance exam.
One issue that pops up with regularity that doesn’t even require an exam is the discovery that both men and women find out that they weigh significantly more than they thought they did.
All of that is to say that having regular visits to your doctor, for obvious reasons, is something that insurance companies like to see. It is safe to say that the majority of life insurance companies, if you are over age 50, would prefer not to even consider your application if you haven’t seen the doctor in the last 2 years. There is only one company I know of who will consider your application under those conditions if you are over 60.
Bottom line. Guys would prefer not to see doctors unless they are dying. This really presents a poor risk to insurance companies. Since insurance companies aren’t likely to change, men, maybe we should consider conceding to women that they are right on this issue.
August 4th, 2008
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
We’ve blogged long and hard for years about the obesity epidemic in our country and the high cost the participants are paying in added health problems, shorter life spans and higher life insurance premiums. So, not that we had anything to do with it, but hats off to those New York restaurants that are now posting calories along with price on their menus.
Our country has worked long and hard figuring out how to market fat and calories under cute names and making quick and easy a dietary choice that seems to have sucked the common sense out of our nation’s health consciousness. That is not to say that there weren’t poor choices to be made 40 or 50 years ago, but with today’s marketing machines in full gear, fit as a fiddle may have to be updated to a cello.
So what’s the big deal about obesity? Clearly, with a few exceptions, it’s a lifestyle choice that’s been made and you make your bed and lie in it, right? If obesity was the end result, from a life insurance perspective it wouldn’t be such a tough hit. Weight alone will keep you away from the best rates, but it still leaves you affordably insurable.
The problem is that the weight, the obesity, is the start of an almost certain downhill health slide and studies seem to indicate that unchecked obesity doesn’t leave you in a place where you wonder if you’ll have health problems, but rather how bad will they be.
Bottom line. If you’re tipping the scales in the wrong direction, you may want to consider purchasing adequate life insurance before the health problems start happening. Once you come face to face with diabetes, heart disease or cancer, the task becomes much harder.
July 21st, 2008
At least a dozen times a week I get an opportunity to review someone’s current and historical health with them. I’m on a fact finding mission with the goal of getting each person the best possible life insurance rates they can expect in their unique situation.
Sometimes there is literally nothing relevant to life insurance in a person’s own or family history. Sometimes there is plenty to discuss about both past and present health. It’s at this juncture when clients are put to the test concerning their knowledge about the health issues they have gone through or are presently dealing. A surprising number, or at least it’s always surprising to me, kind of generally know about their health but don’t know what risk factors it presents for them or how to measure whether or not they have their situation under control.
When my doctor tells me something new about myself, I’m a pretty curious guy. And with Google I can find out plenty of information in about .23 seconds. A good example was recently when I had a blood test result from our local health fair come back with a high TSH reading. With the help of Google I found out that TSH stood for thyroid stimulating hormone and that a high reading meant that it was possible my thyroid wasn’t working up to its’ capability. I visited a doctor and had it retested. It turned out to be a false positive test so everything was OK, but the point is that I knew what was going on, what it meant in the whole scheme of things and if it had turned out to be a positive test, what type of treatment and prognosis I could expect.
When I talk to someone with diabetes and they don’t know what their hbA1c is, it really makes me wonder if they care about their health. This is a critical test in life insurance underwriting and a critical test for measuring control of diabetes. How can a doctor not educate a patient and how can a patient not educate themselves on aspects of their disease that are as important as this?
It never ceases to amaze me that someone can go through something as traumatic as cancer diagnosis and treatment and come out of that process not knowing beans about the cancer they had. How do you know if your doctor is discussing all the options for treatment with you if you don’t know what all the options are? How do you know what the options are if you don’t know the stage and grade of your cancer? For all the bad things that might be said about the internet, it has put a world of knowledge at our fingertips.
It surprises me that someone who has had a heart attack or has undergone cardiac surgery will have a follow up stress test and take the doctor’s synopsis that the “results were good” as relevant. How can you have a test like that and not question the results and know what each result means? Were my results good compared to a person who has never had a heart attack? Good compared to a person who has had a heart attack with my family history? Good compared to your last patient who had a second heart attack and died a year later?
Bottom line. An independent life insurance agent can ferret out the good deals for you if they have all of the relevant information. Without it it’s a roll of the dice. Quite often the information you provide will lead to or rule out specific companies. Two things. If you’re going to shop for life insurance, take the time to know about your health issues and, if an agent asks you to do some homework for specific information, do it. If they are asking for specific information they probably are an above average agent with an above average chance of getting you what you need.
July 20th, 2008
This is an area involving life insurance that is receiving more and more attention and a topic where the troops (life insurance agents) are definitely divided. A life settlement involves the sale of your policy to a third party. The third party takes over ownership, future premium payments and becomes the beneficiary of the policy.
Why would a person consider a life settlement? Two reasons really. This generally involves term insurance and a person may simply not need the policy anymore. If a policy was, for instance, purchased to cover a key person in a company and that person has retired, the company may wish to recoup some of their premium payments through the sale of the policy.
The other reason is simply that the owner of the policy needs money and sees the sale of the policy as an easy way to get cash. This can be an unfortunate choice when long term family protection is bagged for a short term cash fix.
A few things about life settlements. First, the policy has to be within the conversion period. The new owner needs to be able to convert the policy in order to keep in force until your death. Second. You really need to be sick to get any significant amount of money out of a policy. A healthy 65 year old, if they are offered anything at all, won’t be offered much. I have seen this process of elimination work and the companies who do life settlements evaluate a case and determine, at least to the satisfaction, how long they believe you will live, down to the year and month. They then base their offer to you on the face amount, minus what they will have to pay in premiums on the converted policy, minus a healthy (very healthy) profit.
In most cases, in my opinion which happens to coincide with a large number of financial advisers, if you are sick enough to get a worthwhile life settlement, you are better off converting and keeping the policy yourself. Your family will net more benefit almost every time.
Then there is my own bit of discomfort with life settlements. Life insurance is all about mortality assumptions based on statistics that have been built up over long periods. Underwriters use assumptions when deciding rates for people with heart disease, diabetes or a history of cancer. My discomfort with life settlements is that there are no mortality studies that I’ve been able to find for people who sell their life insurance policies to a third party.
This country harbors one of the greediest corporate mindsets on the planet. If a life settlement group has a large block of business and profits aren’t where they need them to be, who’s to say, especially in today’s unemployment situation, that $500 here and $500 there might not hasten the mortality experience a bit. I’ve had plenty of viatical and life settlement agents tell me that assumption is hog wash and I would suggest that they allowing their greed for the sale to overwhelm their common sense. People get rubbed out in this country all the time for a lot less than hundreds of thousands or millions of dollars.
Bottom line. As for me and my agency, we will not recommend or participate in life settlement business.
July 17th, 2008
Eat your vegetables! They’re good for you!…….Yes Mom. Actually it didn’t come down quite like that for me. Most vegetables I grew up with were some strange strain that came in a can. A distinctly different species from what comes out of a garden. Any doubts could be laid to rest by sampling canned or fresh cooked spinach, canned or fresh mushrooms, etc.
For a very long time now groups have been beating the “eat your fruit and vegetables to ward off cancer ” drum. It makes sense. With so much food out there that is obviously bad for you (yes, I’m thinking McDonalds) there is some logic to be toyed with. If one food can kill you there’s a good chance another can save you.
Now a modest study of 100,000 people comes along and blows the wall down. There simply isn’t any conclusive evidence that fruits and vegetables, or the amount of them has any impact on cancer. I have to admit that I’m really not particularly put out by this news since I like fruits and vegetables and eat them regularly anyway, and never did do it because I thought it would save my life. But think of all of those vegetable haters that have been gagging down broccoli for years. What a drag.
Bottom line. This really didn’t have much to do with life insurance, other than really all health matters impact mortality and life insurance premiums, but for a Friday I felt it was worth sharing.
July 11th, 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
There aren’t many weeks that go by without hearing from someone who has finally figured out that they should have life insurance…..because their own mortality has been flashed before their eyes. This can come in the form of losing a friend or loved one or perhaps being in an accident and coming out with that thought in your head that, “Oh my God, I’m alive and probably shouldn’t be”.
Those are the easy ones to deal with. A wake up call with no harm done. But all too often the wake up call is because of some dramatic change in our health. People who have been diagnosed with cancer or who have had a heart attack tend to have a sudden, often fervent desire to look into the life insurance that they have been ignoring for years. They realize that they have blown the chance at getting good rates on the protection they now want and are desperately hoping that somehow this one health scare will be looked at by life insurance underwriters the way one speeding ticket would be looked at by an auto insurance company.
We all look for those second chances in life. Unfortunately, when it comes to the best rates that a life insurance company offers, with serious health issues there really are no second chances out there. If you are easily jolted into action by something minor like your cholesterol being a little too high, or with a few companies, your slightly high blood pressure needing a little medical nudge to get back to normal, you’re still in the running. Just about anything more serious than that will bump you at least one rate class, if not more.
So, and this is what all Americans really want to know, how do you beat the system? First and foremost you need to have a serious talk with yourself about your responsibilities and how, even though you are young and healthy, if something happens you will have failed to take care of those who depend on you. Second, you need to get over (we’ve all been here) that young, healthy feeling of immortality. You may live to be 120 and you may die tomorrow or be diagnosed with a terminal illness next month.
That’s the bad news. The good news is that for healthy people life insurance is probably the least expensive insurance you will have in your portfolio. Get it while you’re healthy. Get it while you’re still a good deal.
Having said all of that, should people with health issues give up on owning life insurance? No! It will cost more than your completely, disgustingly healthy cousin, but for almost everyone it is still available and with the help of a good independent agent, you can get the job done.
Bottom line. Life insurance is a good deal for family protection even when you don’t qualify for the best rates. Where else can $50 or $100 a month buy your family hundreds of thousands of dollars worth of peace of mind? Look into it today.
July 9th, 2008
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