Money talks in cancer

A breast cancer survivor reveals its painful burden on family resources and how having health insurance saved her life.

YOU’VE just been diagnosed with cancer, and the doctor is discussing treatment options. Should cost be a deciding factor?

The prices can be staggering. Consider this scenario: There are two equally effective options to battle cancer, the kind spreading through the body – but one costs RM$60,000 more than the other.

One in eight people with advanced cancer turns down recommended care because of the cost, according to a new analysis from Thomson Reuters, which provides news and business information. Among patients with annual incomes under RM$40,000, one in four in advanced stages of the disease refuse treatment. Do they pay out of their own pockets, sometimes in the thousands of ringgit? Or do they forgo the therapy to preserve what modest assets they may have for their families’ futures?

Cancer care is expensive.

My first encounter with cancer was when my dad was diagnosed with stomach cancer in 1998. Our battle lasted six months before he succumbed to it. But our financial woes lingered long after that.

Dad was a 70-year old pensioner when he was diagnosed with advanced stomach cancer. It was a dreadful disease to have. Upon his diagnosis, we were determined to give him the best medical care possible and do everything we possibly could.

It was a big commitment, and we soon realised that our means to fulfill that commitment were rather limited. The six months after diagnosis was a very trying period for all of us. In those six dark months, all our savings were depleted and credit cards used to the maximum.

I still remember it as though it were yesterday. My family and I were gathered in uncomfortable chairs in the gloomy hospital lounge. It was late in the evening and we were at our wit’s end. Dad had a terrible two days of pain and the doctors informed us that we were fighting a losing battle. “Take him home,” they said, “you’re wasting your money.” We were physically tired, emotionally drained, and financially exhausted.

We had by then exhausted our resources. Yet we were unwilling to take him home ... it sounded so final. We hoped, in his last days, to keep him as comfortable as possible. How were we going to proceed? Our bank accounts were dry and credit cards used to the limit.

We considered many options – mortgaging the house, applying for personal loans, borrowing some money from friends and relatives….

We decided the next morning we were going to do something about it.

But the next morning, dad passed away. It was as though he knew that we had reached the end of our resources. It took us a few years after that to emerge from the financial crisis that the cancer had caused.

We had overlooked and underestimated the financial burden of cancer and its impact on my dad, the patient, and us, the family. An individual does not face cancer alone, a family does. My dad’s stomach cancer had cost him his life. We all miss him dearly. At the same time, the cancer had cost us a substantial amount of money, for my dad did not possess a health insurance or medical policy.

Having witnessed our struggles, my church member, an insurance agent, got our whole family insured. And what a blessing it was.

In 2008, I was in Wellington, New Zealand, working on my doctoral thesis when I was diagnosed with aggressive, advanced breast cancer after a needle core biopsy. Having discussed my options with the breast consultant over there, I decided to return home for treatment.

All the bad memories of the dark moments we had battling with my father’s stomach cancer came rushing back. I remembered the physical fatigue, emotional pain, and the financial drain cancer can cause. I shuddered. It took us so long to climb out of the financial hole cancer had caused and now I was being sucked into it again. I knew financial cancer could mentally kill me faster than breast cancer.

Being a civil servant, I first explored my treatment options in our public hospitals. Because of the large number of patients they were already servicing, I was put on a three-month waiting list. As I explored other avenues, the deciding factor for treatment was cost. Each doctor discussed my treatment options and the cost. It was a grim picture they painted.

By now I was feeling so lost and overwhelmed. I couldn’t think. My family was frantic.

I felt like I was drowning. I was lucky; I had a cushion to fall back on. My health insurance came to the rescue. My medical card enabled me to get prompt treatment, which is an important factor in fighting cancer. My medical card gave me the freedom to find the best doctors and best treatment available in town. My medical card helped save my life.

I soon discovered that there is much more to the cost of treatment than hospital, physician, and medication bills. Out-of-pocket expenses for transportation, food supplements, over-the-counter medications, distractions, telephone bills, complementary medicines, and many other hidden costs can be a significant drain on finances. The total financial damage came close to RM80,000. Because my medical card absorbed the bulk of the cost that was incurred during the treatment, the out-of-pocket expenses were more manageable.

I am so very thankful to my insurance agent who got me insured. Because of my medical card,

I could focus on getting better and not waste my energy worrying about finances and the astronomically expensive treatment.

Having triumphed over my cancer, I truly believe that God, and my dad, are watching out for me. They are doing that through the blessings of family, friends, my doctors, and most importantly, health insurance.

For further information, e-mail starhealth@thestar.com.my. The views expressed are those of the writer and readers are advised to always consult expert advice before undertaking any changes to their lifestyles. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.