Cancer Day - February 4

A diagnosis of cancer is not easy to accept. Besides the physical aspects of the disease, there are psychological issues as well to handle. Patients become depressed, cut off ties with family members or sometimes go into denial. The incidence of suicide especially among males can be high.Suicide risk is highest in the first month of diagnosis, and remains high until two years after it.

There needs to be more awareness on the financial burden of cancer as well. A recent study shows that patients who go bankrupt as a consequence of cance costs tend to die earlier and in higher numbers.

In a study that linked data from the SEER Cancer Registry with bankruptcy records for the state of Washington, the risk for death was 80% higher in cancer patients who filed for bankruptcy than in those who did not. Among those who did not declare bankruptcy, between 30% and 45% had to re-mortgage or sell their houses and other assets. Some had to borrow money from friends or other sources. Financial constraints were postulated to hasten death by causing stress, making patients forego or delay treatment, and preventing them from finishing the planned treatment.

For those who survive, life is not plain sailing at all. Most survivors face high economic burdens. The researchers defined total economic annual burden as direct medical expenditures plus productivity losses (employment disability, missed work days, and days spent in bed).

For individuals described as “non-elderly” (18 to 64 years), colorectal cancer was associated with the highest annual costs (US$20,219), followed by breast cancer (US$14,167) and prostate cancer (US$9,280).

Among the elderly population, defined as those 65 years and older, the total economic burden of colorectal cancer was highest (US$19,051), followed by prostate cancer (US$16,851) and breast cancer (US$14,391).

Looking at our local population, problems may arise due to people not having medical insurance or to clauses in their insurance policy. Despite paying their premiums religiously year after year, some patients find out too late that they are not covered by their policy.

Most insurance companies do not pay for treatment of “carcinoma-in-situ” cases, where the cancer is still at a very early stage with an almost 100% cure rate. Patients who underwent major operations to treat this were told they had to pay for the costs out of their own pocket on top of still having to pay the required premium. This is really adding salt to the wound.

Rumours now abound that insurance companies are trying to remove cervical cancer and the precursor stages from coverage. The reasoning is that most cervical cancers are due to the Human Papilloma Virus (HPV) with the main mode of spread being through sexual intercourse. They argue that it falls under sexually transmitted disease (STD), which is in the list of diseases NOT covered by medical insurance.

Cervical cancer is the third main cause of death among Malaysian women. The patients who can be in their 20s or 30s when diagnosed are in the prime of their life and usually have small children. Their death will affect the whole family and community, so denying them treatment is truly very cruel.

Some drug companies do try to help by giving certain cycles of free treatment to patients. Despite that, the costs are still high and not many patients are able to enrol in these programmes. Hospitals such as University Malaya Medical Centre have set up funds for cancer patients. We need donors to continue helping out financially.