Prostate Cancer. What Underwriters Don’t Want To See!

We’ve covered a lot in the past on the life insurance underwriting of prostate cancer. Prostate cancer is one of those good news/bad news events in the cancer world.

Prostate cancer is the second most prevalent cancer among men, surpassed only by skin cancer. It also has the distinction of being a very survivable cancer in most cases. Because of the high survival rates, it also has the distinction, within certain boundaries, as being a very insurable cancer once treatment has been successfully completed.

First let me review what would be presented as an optimal case for underwriting and then I’d like to share a few things that will drive underwriters in the opposite direction.

Prostate cancer stage and grade are two key factors. The grade, sometimes called the Gleason score, is on a scale from 1-10. Optimally, for standard or better rates, the Gleason score should be 6 or less. 7 becomes problematic and above that is rarely insurable. Combined with a low stage 1 or 2, that’s half the battle.

The other half of the battle is what was your PSA at the time of diagnosis and what is your PSA post treatment. Again, optimally your PSA should be 10 or less at the time of diagnosis and if the treatment is a radical prostatectomy, it should be a statistical 0 afterward. With a radioactive seed implant therapy the PSA can be as high as .5 post treatment.

So, what kinds of things can ruin the chances of a good approval? I am working a current case that highlights one of not more of those. First, the client had a PSA over 21 at the time of diagnosis. The pathology showed a Gleason score of 7 and a stage of 3. He had a radical prostatectomy and as would be expected his PSA vanished post treatment. The killer. Two years later his PSA returned and climbed almost to 1.0. In the absence of a prostate, the underwriter has to assume that some cancer was missed and it is coming back.

In this case he then had radiation treatment and it, over the course of a year, drove the PSA back down to where it should have been. But worrisome to the underwriter is where the new cancer came from and is there more than has gone undetected.

Bottom line. There is no such thing as a shoe in approval when dealing with cancer, but success on prostate cancer is pretty common. Just make sure when presenting your request to an independent agent that you know the numbers. Stage and grade and diagnosis and post treatment PSA levels.