All of us guys, and women who are into reading about men’s health, have heard that men are for more likely to die with prostate cancer than from it. So what does that really mean? 1 out of 6 men will be detected with prostate cancer in their lifetime. Most of those will survive because the majority of prostate cancer is found and a relatively low stage, 1 or 2, and grade, Gleason grade 5 or 6.
But those are statistics for those who are actually diagnosed with cancer while living. Prostate Oncology Specialists make the claim that the percentage of men who actually have prostate cancer is almost as easy as putting a percentage sign after their age. In other words of men who die at age 75 of unrelated causes, 75% have prostate cancer in their system to some degree. My father who died at age 86 from bladder cancer very likely had prostate cancer as well, but it just didn’t have any effect on his mortality.
Another study, and I only include this because I find our country’s obsession with erectile dysfunction humorous, showed that men with ED were no more likely to have prostate cancer than the general population. That should be a relief for the millions who fund the ED industry and as an offshoot make sure we and our children are well aware that an erection lasting four hours or more can be dangerous.
So, if you’re diagnosed with prostate cancer you have a choice to make and one of those choices is to do nothing but keep an eye on it. A study concluding last year showed there is almost no difference between the mortality of those who choose radical prostatectomy, the most aggressive treatment, and those who chose to follow a watchful waiting regime. In the study of over 700 men, half received prostatectomies and half were just monitored. Of the few that actually died from prostate cancer, they were evenly split between the two treatment options. Studies continue to show in low stage and grace prostate cancer, active surveillance or watchful waiting has almost exactly the same results as aggressive treatment.
While a few life insurance companies have watched this evidence mount and have danced around the fringes of allowing some underwriting favor, the truth is that overall the companies are still afraid to stick their toe in the water in spite of the overwhelming evidence that approval is a prudent choice. A step further, approval at the same rate as those who choose aggressive therapy would be prudently done at the same rate class. They just can’t wrap their heads around that PSA that initially brought the cancer to everyone’s attention still being there.
There are days when the life insurance industry seems to be in lockstep with what I call reasonable modern medicine. I find watchful waiting to be reasonable, cost effective and successful. I’d like to see more companies do real mortality studies on the situation and change their underwriting. What I don’t find reasonable is spending hundreds of thousands or millions of dollars in attempts to prolong life. I have to completely own this as my opinion. I had a friend that “survived” six years with multiple myeloma, but had no quality of life and spent millions trying to beat an illness that he was told couldn’t be survived. He almost died a dozen times and in between those times he suffered horribly from both the disease and the treatment. Sorry. Chasing my own rabbits for a minute.
Bottom line. For now the best route to affordable life insurance with prostate cancer is through aggressive therapy that can make the underwriters feel good because your PSA will go away. Some day soon I hope more companies will understand that the PSA is not the infallible barometer of life expectancy they believe it is. If you have questions or have been treated unfairly due to prostate cancer even when you’ve gone through aggressive treatment, call or email me directly. My name is Ed Hinerman. Let’s talk.