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Aiden Psczulkoski

Professor Reynolds

Composition II

24 March 2021

The Benefit of Certain Insurances On Cancer Treatment and Hereditary Cancer

Cancer is a deadly disease that is ranked second overall as the leading cause of death in

the world. Around 10 percent of these deaths are caused by genetics and are hereditary cancer;

cancers that are passed down from a person’s parents. Hereditary cancer occurs because of

mutated genes that often suppress tumors. Because these genes are affected, they are unable to

fight these tumors resulting in a higher chance of cancer occurring. These affected genes,

however, can be found by utilizing genetic tests which can be expensive, with the potential cost

being thousands of dollars depending on insurance coverage and the type of test administered.

Cancer treatment and hereditary cancer testing should be covered by insurance because it allows

individuals to know whether they have genes that can lead to cancer, private insurance

companies greatly reduce the cost of medical care and encourages individuals to go and follow

through with medical appointments, and private companies that insure individuals decrease the

risk of death in cancer patients.

Hereditary cancers can occur because of mutated genes. Affected genes, such as BRCA1,

BRCA2, TP53, and many others can be the primary cause of hereditary cancers. BRCA1 and 2

are two gene mutations that affect patients, and they cause a higher risk of breast and ovarian

cancers (Petrov). The TP53 gene, when mutated, makes it so that those afflicted with the

mutation have a 70-100 percent lifetime chance of getting cancer, as well as getting cancer at a

younger age (Omran). Because of mutations in genes like these, families that have had cancer in
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the past have a better chance of passing these mutated genes on to their children. Knowing this

information is crucial to those with cancer in their family history because it will give them an

idea of their likelihood of cancer. This is why it is so important to have private health insurance

to cover the cost of tests for those who would be at a higher risk of hereditary cancer. It is also

vital that insurance pays for cancer treatment because those who are insured by private

companies live longer lives (Jessen). Not only will they live longer lives, but these patients will

also live better lives. While they are battling cancer they will have more money in their pocket

since their treatment is covered by private insurance.

BRCA1 and 2 are genes that have mutated in an individual that can lead to higher risks of

developing ovarian and breast cancers, as well as prostate and pancreatic cancers and melanoma

(KE). These genes are passed on from a person’s parents, and according to the National Cancer

Institute, If a child’s parents have a hereditary cancer gene, there is a one-in-two chance of

passing that cancer gene on to their child (National Cancer Institute). This means that if either

parent has a mutated BRCA1 or 2 genes, that parent will have a fifty percent likelihood of

passing this mutated gene on to their children. BRCA1 and 2 will increase the likelihood of

getting cancer in the future, which makes it important to be involved in genetic counseling and

testing if someone has a history of cancer in their family.

Many other genes can contribute to a person developing cancer. One gene, TP53 when

mutated, also called La—Fraumeni, increases the chance of getting cancer to 70-100 percent in

someone’s lifetime, and especially at younger ages, with the median age around 25 for those

affected with mutated TP53 when cancer usually develops (Omran). This gene mutation is also

hereditary and is passed on similarly to that of the BRCA1 and 2 genes. Because the gene, if

mutated, makes cancer occur earlier in a person, then that would make it crucial to have these
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genetic tests in order to find out if someone has the genes. The TP53 gene can cause tumors in

children and a vast number of cancers in adults, especially breast cancer. (Omran). Because this

cancer-causing gene can result in damage to a family, especially if a child or young adult is

diagnosed with cancer, it is vital that those individuals are tested for the TP53 gene. This will

allow the parents and the child to take precautions and do their best to maintain a healthy

lifestyle in order to prevent cancer as best as they can.

Genetic counseling is the use of family history to assess how likely someone will have

hereditary cancer, while genetic testing is when a DNA sample is taken from an individual and

tested for certain cancer-causing genes (Hayes). With the many consequences that come with

genetic cancer, it is necessary to test to see if you will be affected by it. By utilizing genetic tests

and consultations, one can understand if they are going to have an increased chance of getting

cancer and that certain precautions can be made and actions can be taken to decrease the

probability of cancer in the future. Genetic tests have been proven to be helpful for those dealing

with cancer or other diseases, but the problem is that they can be expensive. According to

Lawrence, genetic counseling can cost $213 on average, while the combination of the

counseling, testing, and disclosure of those results totaled more than $2,000. These costs are only

from the testing required to see if one has hereditary cancer. This cost goes up dramatically when

one has to pay for the treatment as well. Genetic testing and counseling alone can cost thousands

of dollars without insurance, which can add a lot of stress to families if they are struggling to pay

for these costs.

Adam Wishart, a filmmaker, focuses on the cancer drug Revlimid and those who are

affected by the decision of whether this drug is approved or not (Wishart). Revlimid is a cancer

drug that is used to treat multiple myeloma. Multiple myeloma is when cancer forms inside of
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the white blood cells in the body. Revlimid is estimated to cost families 50,000 pounds in the UK

annually (Wishart). This price was shown to cost too much for many families. The National

Health Service (NHS) offers patients medicine. This company, however, works on a finite

budget, and the medicine that they offer is approved by the government organization the National

Institute for Health and Clinical Excellence (Wishart). This group decides what medications are

affordable. NICE decided that they can afford to provide Revlimid to patients who are suffering

from multiple myelomas, making them affordable to patients in the UK (Wishart). This shows

the importance of insurance or insurance-like entities. The NHS offers Revlimid for free in the

UK, while in the US it has an estimated retail price of over $126,000 for a 12-month supply

(Faden). This is also true for many other cancer treatments in the UK, where the expensive

prescription cancer medication is free, while those in the US are spending tens of thousands of

dollars for these same cancer drugs with Medicare insurance plans or no insurance plans.

Fig 1: A graph from a study by Fader titled, “ Expensive Cancer Drugs: A Comparison between the United States

and the United Kingdom” shows the comparison between costs of different expensive cancer drugs in the United

Kingdom against different medical plans in the United States.

This is an example of how insurance or organizations that offer similar things to insurance can

make cancer treatment affordable for families and save on the out of pocket costs.
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Many studies have been performed across the world about specific conditions that cancer

can lead to or worsen. A study based in Korea analyzed a group of individuals who were

afflicted with cancer, specifically advanced cancers (Hong). This advanced cancer can spread to

the bones, which can cause a lot of pain in these patients because it is destroying the bone

structures. Hong explains that these cancers are able to reach the bone because patients are living

longer with existing cancer. This is good, but it allows cancer to spread further if not completely

taken care of. These bone conditions are called bone metastases or skeletal-related events.

Hong’s study showed that among patients across the world that had bone metastases, around 45

percent would develop skeletal-related events (Hong). Many different types of cancers are found

to cause skeletal-related events. For example, 50 percent of patients with lung and liver cancer

would develop skeletal-related events (Hong). Compared to the patients in the Korean study,

only an average of 33.4 percent of patients developed skeletal-related events, and according to

Hong, this would be because of the healthcare provided to the population of Korea along with

their healthcare practices (Hong). Around 97 percent of Korea’s population is covered by health

care. With this information and the evidence showing that nearly 20 percent fewer cancer

patients develop skeletal-related events in Korea, Hong makes the conclusion that healthcare was

the main cause for this positive change. By having this health insurance, individuals are able to

afford their cancer treatment and care. This allows them to have more spending money for their

own lives, and to pay for treatments and further testing if it is needed. This is a direct example of

how important it is to have insurance to cover the costs of treatment for cancer because it

prevents further complications of cancer such as bone metastases and spinal-related events, both

of which increase cancer’s lethality.

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There is an association between an improved lifestyle and insurance. Without insurance,

it is shown that individuals will avoid or postpone health care if they are unable to afford it.

Around 25 percent of the United States population claims to have postponed or avoided going to

a medical appointment because of skyrocketing prices in doctor’s visits (Sainato). The

Guardian’s Sainato interviewed many different families about how high medical costs have

affected them. One of these people, Susan Finley, was laid off and left losing her primary source

of income and her insurance coverage. According to Finley’s family, Susan was found dead 3

months later after she avoided the doctor with flu-like symptoms (Sainato). The Guardian states

that over, “45,000 Americans die every year as a direct result of not having any health insurance

coverage. In 2018, 27.8 million Americans went without any health insurance for the entire

year,” (Sainato). With this many people left uninsured, many will be unable to afford medical

care if they were to experience an emergency. People may be avoiding insurance because it is

expensive, or they believe that they won’t have any medical emergencies. Sudden medical

complications will then put individuals under high stress due to the high or unexpected prices.

Even people with insurance will avoid going to the doctor because of high prices. Gretchen

Miller was diagnosed with oral cancer and received surgery to remove it. After her surgery, it

was recommended to have annual checkups to see if it would return (Sainato). Miller avoided her

checkups for 4 or 5 years because of a $5,000 deductible that she had to pay (Sainato). These

prices also seem as if they will continue to climb. According to Hayes, from 1998 to 2002,

Medicare cancer drug costs rose from $1.2 billion to $3.8 billion (Hayes). These prices are still

expected to rise even more. This shows that even with insurance, medical bills can still be very

expensive, thus making it important to have the correct type of insurance that will suit the

specific person and their medical needs.

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A study conducted by Walter Jessen elaborates on these ideas. Jessen found that if an

individual was uninsured, they would likely report having no health care visits within the past 12

months (Jessen). These visits become especially important when it comes to consultations

regarding serious diseases like cancer. Cancer consultations can discuss environmental risks and

lifestyle choices that individuals have in order to help prevent developing cancer by changing

one’s surroundings and actions. These would include things like living in polluted areas,

smoking, and being overweight. It was found that those who were privately insured or insured by

Medicaid would have these appointments, and would be given advice about these certain risks.

Those who are uninsured did not go to these appointments due to the cost, rarely had this

understanding, and have a higher risk to continue these risky lifestyle choices. This is directly

related to hereditary cancer testing because those who are uninsured will not have checkups to

learn about these lifestyle risks, and they also will not have a genetic consultation regarding their

family history. This becomes especially true if one’s family is affected by young occurrences of

cancer, has it generationally, or has similar cancer types. All of these are signs of hereditary

cancer (American Cancer Society), and if someone is unable to pay the price for a genetic

consultation, they may be unable to properly prevent or prepare for genetic cancer until it has

already developed. Jessen also made the discovery that cancer patients who aren’t insured, or if

they are insured by Medicaid are “1.6 times more likely to die in five years than those with

private insurance,” (Jessen). These individuals are more likely to die due to the fact that those

who are privately insured will be able to pay for their medical visits, and therefore will be able to

be diagnosed with diseases such as cancer at an earlier stage than those who are uninsured or

who are insured by Medicaid. The opposite is also true. Those insured by Medicaid and those

who are uninsured will go without having cancer consultations and will be diagnosed at a later
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stage of cancer (Jessen). This later diagnosis or lack of diagnosis will make it far more difficult

to treat cancer, resulting in the increased death rate within that five-year period. Not only do

uninsured individuals have problems affording medical care, but they also have problems that

prevent them from receiving medical care. A study by Jessen found that 13.9 percent of

office-based physicians would not accept new cases from individuals that were insured by

Medicare. Office-based physicians also would not accept 25.5 percent of cases if an individual

was insured by Medicaid. On top of this, Jessen also found that 40.3 percent of charity cases

would not be accepted by office-based physicians (Jessen). This means that uninsured

individuals can’t be admitted by office-based physicians because they do not have the capacity to

take them as patients. This is also because private insurance companies pay approximately two

and a half times what government insurance companies like Medicaid would payout on similar

health care resources (Whaley). This is another important reason it benefits to be privately

insured. If private insurance companies pay 250 percent of what Medicare would pay, then

physicians and hospitals make more money. Privately insured people, therefore, have a better

chance of receiving medical care and for a lower price than those with certain government

insurance or no insurance.

Not only do individuals need to have access to medical care and testing, but they also

need to be aware that these services are available to use. Su-Ying Fang studied a group of 430

women from Taiwan, around half of which had a history of family cancer. These women would

generally be affected by the BRCA1 and 2 genes that increase the chance of breast cancer

(Fang). As described in the study, Taiwan’s genetic testing and counseling methods are being

developed and are not well known. Most women in the study, 75.3 percent, had never heard of

genetic testing before (Fang). This was the main reason that these women have never considered
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genetic counseling or testing. These women, after learning about their option for genetic testing,

were found to have a positive outlook on using genetic testing due to their family history. It was

also found that if the individuals in the study had positive views toward genetic counseling, they

would also have a better chance to consider the use of “cancer risk management strategies,”

(Fang). There are many different treatment options that, if affordable, can be effective in treating

cancer.

Many cancer treatments are available to those who need them. These can include

common treatments such as surgery, chemotherapy, and radiation, as well as some different

treatments such as cryoablation where the cancer cells are frozen and killed, drug and hormone

therapy, and clinical trials (Mayoclinic). There are also new non-toxic treatments that are being

developed that involve different hormonal treatments and supplements, and it was found that

these supplements matched with a ketogenic diet can be just as effective as toxic cancer

treatments, such as radiation (Berg). Dr. Berg also explains how these nontoxic treatments allow

individuals to treat themselves at home, rather than having to visit a doctor (Berg). This will save

individuals a lot of money, because this will only require patients to utilize specialized diets,

enzymes, and nutritional supplements, rather than visiting a doctor to test, prescribe medicine or

administer surgery. These are viable options for those who are battling cancer but can’t afford the

normal treatment options. These traditional options are still very effective, but without insurance

can raise a large bill for cancer patients. This further supports the need for private insurance if

these traditional options are best.

There are many reasons to have private insurance companies, but others may think

otherwise. Not all insurance companies will cover every healthcare need, and therefore may not

be effective in dealing with cancer for a specific individual. Because of this, one might ask, why
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should I have insurance if the costs won’t be covered? TruGenX states that different insurance

companies will cover different testing and treatments at different rates (Cannavo). This makes

choosing an insurance company difficult because people aren’t aware of the different health

conditions or complications they will face in the future. This is a good point, but according to

Jessen, being uninsured with cancer, or even being insured by Medicare with cancer, increases

the chance of death by 160 percent in 5 years (Jessen). This point alone makes it worth

purchasing insurance, especially private insurance which prolongs the life of cancer patients.

Ultimately, what kind of insurance someone buys has to be best for that person. If a person has

certain problems within their family or has different predispositions to diseases, selecting the

correct health insurance that will provide the most coverage is crucial. Having insurance is

proven to be more beneficial than not having it, explained by The Guardian's Jason Cannavo. He

found that families that were left uninsured or left facing large medical bills would avoid their

scheduled checkups, and they would also avoid paying for important tests to see if a disease is

present or has returned (Cannavo). This is very important because if one avoids medical

treatment, they will find out they have cancer or other diseases in late stages where it is more

deadly and less manageable. This may also mean that they don’t visit the doctor entirely like in

the case of Susan Finley, who avoided going to the doctor for flu-like symptoms because the cost

would be too great (Cannavo). For these reasons, having insurance has more benefits than it does

negatives. Private insurance increasing the length of one’s life far outweighs having to pay the

cost of that private insurance.

In conclusion, private insurance companies are crucial to being able to afford medical

care and cancer testing, and also improving the lives of those afflicted with life-threatening

diseases. Having information and the ability to afford genetic testing is crucial to knowing if
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someone has hereditary cancer or not. Hereditary cancer genes such as BRCA1, BRCA2, and

TP53 are commonly mutated genes that can be passed down through a family. Knowing that one

has hereditary cancer can allow one to take the necessary precautions to avoid cancer or to make

the battle easier. This is especially true if the genetic tests are covered by insurance, saving the

individual money. These private insurance companies greatly help cover the cost of medical

visits, tests, and treatments, which allow individuals to spend less money out of pocket on these

appointments. This increases the likelihood of finding something wrong with a patient, and if

there is a problem, the problem can be stopped or prevented in the early stages of the disease.

This is unlike those who are uninsured or are insured by Medicaid, who will often avoid the

doctor’s office because the price is too expensive for them. Because privately insured patients are

able to visit the doctor more often and can catch problems earlier, these problems can be

diagnosed at an early stage. Treatment can then continue soon after, increasing the lifespan of

those who are privately insured. All of these facts show the importance of being insured by a

quality provider that will increase the length and quality of life of an individual.
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