Posts filed under 'melanoma'
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
Melanoma, the deadliest of the skin cancers, has been at the fore front of treatment innovation for some time. Scientists have long believed that, given a way to rev up a person’s natural immune system, melanoma could successfully be fought off without more aggressive types of intervention.
A new look at this has scientists peering through another door. Rather than trying to bolster a person’s immune system, there is some evidence that blocking T1 regulatory cells, cells that get in the way of a bodies natural defenses, may be the answer. One scientist likened the approach to permanent chemotherapy when your immune system is allowed the wage battle full time against the cancer. Chemotherapy with no side effects.
Melanoma is a particularly worrisome disease. Advanced melanoma has an average life expectancy of nine months, and less than 20% survive more than 2 years. In one study done using this new treatment, 24 of 25 patients were still living after 17 months.
Bottom line. Melanoma is a killer and anything that can be done to provide a better prognosis is bound to have an impact on life insurance underwriting. Right now melanoma is, rightly so, in the same underwriting classification as some of the other high mortality cancers. It can take as long as 10 years after successful treatment to get back to standard rates. A large swing in the survival rate could change all that.
November 12th, 2007
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
Another overly diligent life insurance shopper shot themselves in the foot today. Remember, three things can happen while you are looking for the best possible rate. One of them is good and I’ve seen people even turn that one against themselves.
1. The good one. Nothing happens. You just keep shopping and shopping and shopping and you finally settle on the one you want and you apply for it. You’re still in great health and you’re obviously not dead, so you’ve done your job. Well……sometimes. You see, most people who haven’t been around life insurance much think they are good to shop or good to wait until they buy until their birthday. Everyone knows that life insurance goes up with age, right? No! Most companies use the age nearest method to compute your insurance age. So, if you are 49 and 183/365th’s, you are really 50 with most insurance companies. I’ve seen plenty of diligent shoppers have to make their purchase at an age one year older than they needed to.
2. Your health changes. I just had a client who shopped it until he finally came to the conclusion that mine were in fact the best rates. He called up to apply and asked if it made any difference that they had found a melanoma on his back the week before. This guy had been trying to beat my rates for 2 1/2 months. He will now never see rates like he could have had and it will be some time before he can get an offer at all, depending on the pathology results of his cancer.
3. You literally shop until you drop. I’ve had far too many calls from widows or children who found quotes and a business card in the deceased’s important papers. The papers weren’t important enough to do anything about. Still thinking about it!! Waiting for one more set of quotes!! Trying to lose 10 pounds!! None of those things provide protection for your family.
Life insurance isn’t like a car or a house. If you buy one of those and make a bad choice, you are either going to lose money or you are just stuck with something you don’t want for a long time.
With term insurance you can get something in force and then shop around, lose some weight, think about it, whatever. If you find something better, you can apply for that and if it actually turns out to be a better deal, drop the first one and accept the better deal. No penalties. No loss.
I would suggest that if you are going to purchase with the idea of covering your family until you make sure you have the best deal, pay for it monthly or quarterly. If you pay annually, in some states the insurance companies are not required to refund unused premium.
So, do the right thing. Cover your family first. Enthrall yourself with your shopping prowess after that.
June 25th, 2007
How often do we hear it? A friend or family member has had a heart attack or been diagnosed with cancer at an age that is just, well….wrong! We expect health problems and death when someone gets into their 80’s. It’s not nearly so common in their 50’s and 60’s, or even 70’s anymore. But there’s that once a year shocker where somone we know that is in their 30’s or 40’s has some serious health issue diagnosed. Quite often we hear about their death. The question is, if they knew it was coming, would they consider life insurance differently?
I’ve been there and understand that bomb proof, immortal feeling at that age. We see bad things happen to the wrong people at the wrong age all the time and, because we have a shield of immortality (or denial) around us, we think we are somehow living in a different world. Certainly it could happen to them, but not to us.
Consider for a minute that there is something that would cost less than a dinner out every month. Life insurance can be that inexpensive and in will ensure the future of your family in the event you happen to get being one of them. It can not only insure you now, but it can also guarantee, or lock in your insurability for later years when the chances of health problems increases. Wouldn’t it be great to know that you were still insuring your family’s future for the cost of a dinner a month when you had recently been diagnosed with type 2 diabetes, breast cancer or melanoma. Once you have that great rate, it can’t be changed just because your health does.
Maybe life insurance isn’t the most popular subject, but it’s one that should be discussed earlier rather than later. Better that business partners set up a buy/sell agreement and buy business life insurance when they are both healthy. Better that a husband and wife discuss the real needs and make a purchase that will ensure financial security while they are young. I personally think buying juvenile or children’s life insurance with a guaranteed insurability feature is a tremendous gift. One they may not understand for years, but one that can make a huge difference for them down the road.
Like I said yesterday…..it’s time to talk about it. Too much is left undiscussed and as a result, not acted upon. How about we have a very frank discussion for the forseeable future about this whole idea of pulling all of our collective heads out of the sand and taking a look a reality? I’m up for it!!
May 3rd, 2007
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