You may think that prostate cancer prevents you from qualifying for affordable life insurance over age 50, but that isn’t necessarily the case. Age and medical conditions will, of course, limit some options. However, under the right circumstances, you can still get quality life insurance from a reputable provider.
For example, if your prostate cancer is responding positively to treatment, you may qualify for a life insurance policy with a surcharge. The same is true for cancer currently in remission.
Better yet, if treatment has successfully removed the cancer or the cancer has not progressed over a given period of time, the surcharge might be removed from your premium altogether. And with breakthroughs in treatment, the chances of containing or even removing the cancer are improving for men.
In other words, over 50 life insurance with prostate cancer is attainable. What you will find here is the information you will need when applying for a policy. We will look at how to prepare for the process, as well as the many questions your underwriter may ask in evaluating your application. The underwriter will likely require the following:
- The date in which you were first diagnosed with prostate cancer
- How the cancer was (or is) being treated
- A complete list of any medications you are taking
- Any available pathology reports
- The Gleason score of any pathology reports
- The date and results of your most recent PSA test
- All other major health problems you may have
While this is not a comprehensive list, having this information available will help to expedite your life insurance application process.
Understanding Prostate Cancer
It is hard to believe that such a small gland can cause so many men so many problems. But let’s review a few facts from WebMD on just how prevalent prostate cancer is:
- 1 in 7 men will be diagnosed with prostate cancer in their lifetimes
- 1 in 39 men will die from prostate cancer
- 80% of men age 80 or older will have cancer cells in their prostates
That is alarming. However, with earlier detection, a better understanding of prostate cancer, and advancements in treatment, the future looks more and more promising.
So what causes prostate cancer?
Well, according to experts at the Mayo Clinic, we haven’t figured that out yet. Doctors do know that prostate cancer, like other cancers, begins when cells behave abnormally. Rather than the cells dying off naturally as they should, they continue to live and grow. This growth forms the cancer tumor.
The biggest problem posed by the tumor is that it can spread beyond the prostate gland and begin forming tumors in other tissue. This is called metastasis, a more advanced stage of cancer.
Again, keep in mind that prostate cancer does not automatically disqualify you for life insurance. So, let’s now look at diagnosis and treatment and how these may affect your application process.
What are your PSA levels?
Your prostate produces prostate-specific antigen (PSA), which is a protein necessary to liquefy semen during ejaculation. Men will have some amount of PSA present in their blood plasma. With a normal healthy prostate, PSA levels should be relatively low. But elevated levels of PSA found in men’s bloodstream is often an indicator of prostate cancer.
Usually, men are given a PSA test along with a digital rectal examination (DRE). The test will measure the amount of PSA in nanograms per milliliter of blood (ng/ml). For example, 2.5 ng/ml indicates 2.5 nanograms of PSA per milliliter of blood.
Understanding what, exactly, is meant by your PSA levels can be a little confusing. There is no magic number clearing a man of prostate cancer, nor is there a particular number that confirms prostate cancer with any certainty. But for the sake of simplicity, the following scores are often considered within typical ranges:
|40-49||0 to 2.0 ng/ml||0 to 2.0 ng/ml||0 to 2.5 ng/ml|
|50-59||0 to 3.0 ng/ml||0 to 4.0 ng/ml||0 to 3.5 ng/ml|
|60-69||0 to 4.0 ng/ml||0 to 4.5 ng/ml||0 to 4.5 ng/ml|
|70-79||0 to 5.0 ng/ml||0 to 5.5 ng/ml||0 to 6.5 ng/ml|
As you can see, typical PSA levels rise with age and vary by race. This is because of the continual growth of the prostate as we age, as well as size differences often associated with race.
When applying for life insurance over 50 years of age, abnormally high PSA levels may, in some cases, affect your ability to qualify for coverage. This is why it will be important to gather as much information about your prostate condition as possible when applying for life insurance.
This said, keep in mind that abnormal PSA levels do not automatically indicate the presence of prostate cancer. Should your test result reveal PSA levels that raise attention, you and your physician will decide on the next best step. Next steps could include continued monitoring of PSA levels, a biopsy of the prostate gland, or other options as suggested by your physician.
What is your Gleason score?
Should you and your physician decide that a biopsy of your prostate gland is necessary, you will be given a Gleason score along with your results in the event prostate cancer is discovered. This is something your physician will use to help you understand your prostate health.
Here is how Gleason scores are calculated…
First, a pathologist will examine the tumor tissue and grade the two areas where the cancer is most dominant. The pathologist will assign each of these two areas with a grade from 1 to 5.
- Grade 1 – the cancer tissue appears very much like normal prostate cells
- Grades 2 to 4 – the cancer tissue has a range of abnormality
- Grade 5 – the cancer tissue is highly abnormal
For the Gleason score, the pathologist combines the grades of the two most dominant areas of the tumor in your prostate. A Gleason score of 7 might be presented in any number of ways, including:
- Gleason score 7
- Gleason score 7/10
- Gleason score 7 (3+4)
- Gleason score 7 (4+3)
The latter two versions of the Gleason score include the individual grades of the two most dominant areas of the cancer tumor (grade of the largest + grade of the second largest). Your doctor will, of course, explain your Gleason score as well as the grades in much more detail. But here is how Gleason scores are often categorized:
- Gleason score of 2 to 4 – the tumor is considered non-aggressive and will not likely spread beyond the prostate gland.
- Gleason score of 5 to 7 – the tumor is likely mild in its aggressiveness.
- Gleason score of 8 to 10 – the tumor is aggressive.
After having discussed the Gleason score, you and your physician will decide on the next course of action. In some cases, your physician may suggest a special molecular test of the tissue. A test of this kind may help your physician to better understand the nature of the cancer as well as the best options for treatment. These tests will not, however, alter your diagnosis. After all, when a pathologist issues a Gleason score, it is a definitive confirmation of the presence of prostate cancer.
When applying for life insurance, underwriters will take your Gleason score into consideration. But a diagnosis doesn’t necessarily mean that you will be denied coverage. Several variables will be considered during your application, such as your most recent PSA levels, the kind of treatment you are receiving, and how well the cancer is responding to that treatment.
Ultimately, most life insurance providers prefer a Gleason score of 6 or less. However, it is not uncommon for men with a Gleason score of 7 or more to qualify for life insurance. In these more extreme scores, the insurer may require an additional surcharge for the policy. But these fees can often be dropped over time.
How has your prostate cancer been treated?
Your physician will consider many circumstances when deciding which treatment is best for your prostate cancer. A few of those circumstances will include:
- Your age and life expectancy
- The severity of the cancer
- The urgency to treat the cancer
- The overall condition of your health
- Which treatments are most likely to cure or improve the state of your cancer
Your own opinions, of course, will play an important role. More radical treatments may include side effects that you are not willing to risk. Or perhaps your own sense of urgency to treat the cancer is greater than the physician’s. All of this and more will be carefully weighed before deciding upon and following through with a treatment plan.
We will look at 6 of the more common treatment options here…
- Observation or active surveillance
Believe it or not, some cases of prostate cancer require no real treatment. This is because prostate cancer does not grow as rapidly as other forms of cancer. So, if your Gleason score suggests a less aggressive tumor, your physician may opt for observation or active surveillance:
Observation is precisely what it sounds like. Your doctor will keep a close eye on symptoms and may occasionally schedule further tests.
Active surveillance is a little more involved and may require a periodic DRE and PSA test, possibly even additional biopsies every year to better gauge the tumor’s status.
In some cases, patients with prostate cancer may never require anything more than observation or active surveillance.
Should your doctor order these “wait and watch” approaches to managing your prostate cancer, underwriters will take a couple of factors into consideration when evaluating your life insurance application.
For example, your age will be important here. Men in their 40s and 50s have many years ahead of them, and there is always the risk of the tumor becoming more aggressive. Because of this possibility, you may not qualify for the cheapest life insurance over 50, or even 40. But men over 60 may have better chances of qualifying.
- Radical prostatectomy
As the name of this surgical treatment suggests, radical prostatectomy is the complete removal of the prostate gland, as well as some of the surrounding tissue. For more aggressive cancer that has not spread beyond the prostate, the radical prostatectomy is among the more common treatments.
The methods of radical prostatectomy most widely in use today are:
- Radical retropubic prostatectomy – the prostate gland is removed via an incision in the lower abdomen.
- Laparoscopic radical prostatectomy – in this newer approach, longer tools and a camera are inserted into the body to remove the prostate gland via several tiny incisions.
- Robotic prostatectomy – this laparoscopic method grants the surgeon greater precision through the use of robotic instruments.
Possible side effects of radical prostatectomy are erectile dysfunction (ED) and urinary incontinence (inability to control the flow of urine). As with any surgical procedure, of course, there is the potential for complications: blood clots, infection, adverse reactions to anesthesia, etc.
What does a radical prostatectomy mean for life insurance?
For cancer that has not spread beyond the prostate, a radical prostatectomy is often the most successful treatment for completely removing the tumor. If you have undergone this procedure successfully, you could potentially qualify for life insurance right away.
- Radiation therapy
Another common treatment for prostate cancer is radiation therapy. With this therapy, radiation is used to eradicate the cancer. And your doctor may recommend radiation therapy under one of many circumstances.
For example, radiation therapy might be suggested as a first treatment for patients with relatively low Gleason scores, assuming the cancer has not spread beyond the prostate. For patients with cancer that has spread beyond the prostate, radiation therapy is sometimes recommended as a first treatment in conjunction with androgen deprivation therapy (see #5 below).
A doctor might also find radiation therapy appropriate for patients who have undergone radical prostatectomy and yet the cancer has returned to the area where the prostate had been.
Finally, in some aggressive cases of prostate cancer, a doctor could suggest radiation therapy to impede its growth and alleviate symptoms.
Of the types of radiation therapy employed, two are most widely in use: external beam radiation therapy (EBRT) and brachytherapy.
EBRT delivers high doses of radiation from external sources aimed at the prostate. While painless, this treatment will usually extend over a period of several weeks with as many as 5 sessions weekly. Potential side effects are:
- Erectile dysfunction
- Extended fatigue
- Inflamed lymph nodes
- Radiation cystitis (urinary problems)
- Radiation proctitis (bowel problems)
Brachytherapy delivers radiation to the prostate internally. If your doctor has recommended brachytherapy, he may suggest one of the following methods:
- Seed implantation – dozens of tiny, low-dose radiation pellets are inserted permanently into the prostate.
- High-dose rate (HDR) – this temporary method exposes the prostate to higher doses of radiation via catheters that are removed after the treatment. HDR treatment is usually done over 3 sessions, each lasting 5-15 minutes.
Affordable life insurance over age 50 is a real possibility for men who have undergone successful radiation therapy, whether ERBT or Brachytherapy. However, most insurers will often require applicants wait about 1 year after the treatment to ensure the radiation has cured or diminished the cancer.
In the event the cancer was not killed during radiation therapy, your doctor may recommend cryotherapy. With cryotherapy, cold gases are injected directly into the prostate to freeze and destroy the cancer. In some cases, cryotherapy is used as a first treatment for men with low Gleason scores.
The prostate only remains frozen for a few minutes, though side effects may include:
- Blood in the urine
- Soreness or swelling at the site of the injections
- Urge to use the restroom more frequently
- Pain in the bladder or intestines
For men with enlarged prostates, cryotherapy is typically not suggested. Furthermore, little is known about whether or not cryotherapy causes long-term complications.
Qualifying for a life insurance policy will depend on many conditions, especially how the cancer responded to the treatment.
- Androgen deprivation therapy
Testosterone and dihydrotestosterone (DHT) are male hormones, also called androgens, that also happen to encourage prostate growth. For that reason, androgens may create problems for men with prostate cancer.
Androgen deprivation therapy (ADT), also known as androgen suppression therapy or hormone therapy, is not a cure for prostate cancer. What this treatment seeks to accomplish is a reduction in the number of androgens in your body, or, in some forms of the treatment, to prevent them from reaching the prostate cancer altogether. A successful ADT treatment may either slow the growth of your prostate cancer or cause the size of the tumor to shrink.
However, ADT is often reserved for patients with whom either surgery or radiation therapy was not successful. In cases with very aggressive prostate cancer tumors, the doctor may recommend ADT in conjunction with radiation therapy. Or, ADT might be suggested prior to radiation treatment as a means of shrinking the prostate in hopes of a more effective treatment.
A wide range of ADT treatments are available, and your doctor will help in deciding the most appropriate method. These include a variety of possible injections, prescription drugs, and even outpatient surgical castration. The latter being the most cost-efficient is also permanent, yet patients receiving this treatment may opt for artificial testicle implants.
Regardless of the ADT decided upon by you and your doctor, there are many side effects to consider. Depending on the treatment, side effects may be as mild as nausea and fatigue to as severe as osteoporosis, anemia, and more.
The treatment for your prostate cancer that you and your physician have decided upon, as well as its effectiveness, will also be taken into consideration by underwriters when applying for life insurance.
As for ADT and life insurance, the important thing to remember here is that no two prostate cancers are exactly the same. The underwriter takes into consideration the grade of your prostate cancer, the treatment, and information from your most recent doctor’s appointments when assessing risk and determining the life insurance policies for which you may qualify.
While there are a few other treatments your doctor might consider, chemotherapy is the last treatment for prostate cancer we will discuss here. As you may know, chemotherapy involves anti-cancer drugs administered either orally or intravenously.
Chemotherapy is often reserved for patients whose prostate cancer has spread beyond the gland, or as a supplement to ADT.
Contrary to popular belief, however, chemotherapy does not often cure the cancer. Instead, a successful treatment is expected to help prolong men’s lives while reducing their symptoms.
Common side effects include hair loss, nausea, vomiting, and vulnerability to infections.
As with other kinds of prostate cancer treatment, the underwriter will need to account for several variables when reviewing your application.
How to Apply for Life Insurance with Prostate Cancer
This has been a lot of information to absorb, and it is certainly not the most pleasant topic to discuss. Like many men over 50 with prostate cancer, you may be thinking that life insurance is out of the question. But as we have already stated: age and health do not automatically disqualify you from policies.
Yes, to be perfectly honest, prostate cancer is one of the more difficult conditions for underwriters when assessing risk. And yet it happens. There are many men today who have been diagnosed with prostate cancer who were also able to purchase affordable life insurance over age 50.
When applying for life insurance, you can help your situation immensely by gathering all the relevant information the insurance company will require. Be upfront and honest about your diagnosis and the treatments you have received. This will greatly expedite the process.
Even if you are denied traditional life insurance, you may still qualify for burial insurance over age 50 with prostate cancer. With more aggressive cancer, burial insurance can help your family to better manage finances in the event of death.
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