Let me start by saying that I’ve got good news and other news when it comes to life insurance underwriting of cancers, whether something simple like early stage and grade melanoma or early stage insitu breast cancer to later stage bladder cancer or colon cancer or lung cancer. Life insurance underwriting doesn’t go by what your doctor says because part of their job, in addition to treating the cancer, is to give you peace of mind about the situation. They have an important role no matter how early or advanced your cancer is, but you need to know that their role would be much tougher if they had to be on the hook for the future of your family. Their job is the here and now of treating cancer, far different than a life insurance underwriter that has to put a mortality assumption to your situation and put their company on the hook based on that assumption.
Underwriters look at stage, grade, treatment and in the case of prostate cancer they track a post treatment PSA level. Staging is generally done by the TNM method where T refers to the tumor size and extent. The size and extent can range from Tins which is a fully encapsulated tumor, insitu to a T4 which is the highest stage and refers to a tumor that is large and has likely grown into surrounding tissue or organs. N stands for the number of lymph nodes that are involved with 0 being the best situation. Anytime cancer is biopsied nearby or sentinel nodes are biopsied as well to determine if the cancer has spread. From an underwriting standpoint 0 is what they want to see because the lymph system goes through out the body and even if the pathologist only finds one node positive for cancer it doesn’t mean they have nipped it in the bud. Even a N1 generally requires at least radiation therapy in an attempt to stop any other spread. Underwriters are likely to postpone an approval for insurance for at least a few years to watch for recurrence.
M stands for metastasis which is when the cancer has spread to other tissues or organs and has attached itself. In this case M1 means that the cancer has attached itself elsewhere and is growing. This generally will require treatment with chemotherapy or in some cases hormone therapy with follow up scans to determine if the distant metastasis is shrinking. So, when I work with a client who has a history of cancer I insist on having a copy of the pathology report so that when I shop for their life insurance I have the exact data to present to underwriters. It’s not good enough to tell them that it was early stage. They will always come back and ask for the actual staging data.
So to sum up what is possible with life insurance, a stage of T0N0M0 or T1aN0M0 can usually be underwritten at a standard or better rate upon completion of treatment which is usually just removal of the tumor. A T1bN1M0 will likely be postpone 2 years from the end of treatment. T2N1M0 can be postpone up to 5 years, a T3 up to 10 years and depending on the cancer and treatment a T4NXM1 up to 15 years before life insurance is offered. Those are generalizations but fairly accurate across the spectrum of different cancer types. The good news is that early stage cancer can be underwritten and approved soon after treatment and the other news is that barring any recurrence higher stage cancers can eventually be underwritten and approved.
Bottom line. The urban myth that any cancer requires a 5 year waiting period or postpone is just that, a myth. Some cancers like melanoma, breast cancer and prostate cancer can be approved for life insurance very soon after treatment. If you have questions or have an early stage cancer that caused a life insurance decline, call or email me directly. My name is Ed Hinerman. Let’s talk.