Cancer. The word alone evokes emotional stress and seems to touch all of us in some way.
Recently, cancer claimed two of my close friends. And lung cancer took my mother, a smoker, when I was a teenager 43 years ago. The last years of her life were nothing short of awful and devastating to my family.
The overall survival rate for cancer in the mid ’70s was 50 percent, while today it is around 68 percent. In the ’70s, the five-year survival rates for the five most common cancers were: breast, 75 percent; prostate, 69 percent; lung, 13 percent; colorectal, 51 percent; and bladder, 74 percent. As of 2008, the five-year survival rates for these same cancers were: breast, 90 percent; prostate, 100 percent; lung, 16 percent; colorectal, 64 percent; and bladder, 78 percent.
Diagnosis and treatment are continuing to improve. In 2007, the U.S. incidence rate for all cancers combined was 461 new cases diagnosed for every 100,000 people in the population, compared to 400 cases in 1975. This is because of better and earlier diagnosis, in addition to an aging population.
In 30 to 35 years, the overall cancer survival rate has increased by 18 percent, primarily as the result of research identifying early diagnosis and treatment methods. Chemotherapy was experimental at best when my mother was battling cancer. Yet today, combination chemotherapy is standard in treating many cancers. There now are therapies focused on specific molecular changes and their impacts on continuous cancer cell growth and survival, which are key elements of treatment.
To date, the FDA has approved approximately 30 molecularly targeted agents for cancer therapy. Refined radiation therapy techniques — such as three-dimensional conformal radiation therapy, stereotactic radiosurgery
and brachytherapy (radioactive seeds) — are now widely used resulting in greater tissue, organ and limb preservation.
THE HIGH COSTS OF CANCER
A major issue in cancer treatment is that it is expensive. According to a study published in the Journal of the National Cancer Institute, the estimated total cost of cancer care in the U.S. in 2020 is expected to be $158 billion. This represents a 27 percent increase from 2010 due only to the projected aging and growth of the
U.S. population.
Based on statistics by the National Cancer Institute, the annual treatment costs for cancer, depending on the type, can be as much as $100,000 for the initial year after diagnosis; $10,000 for each year after the first year; and $135,000 for the last year of life. This is in addition to the cost of prescription drugs
which alone can run over $100,000 per year.
HOW WILL THE AFFORDABLE CARE ACT (ACA) AFFECT THE COST TO THE INSURED?
The ACA will require employers to provide minimum essential coverage. For the minimum plan (Bronze plan), the actuarial value is 60 percent. This means that, on average, the plan will pay 60 percent of enrollee health care expenses, while enrollees will pay 40 percent through some combination of deductibles, copays and coinsurance. So, with a potential cost of cancer care at $100,000 per year, the individual would need to pay approximately $40,000 under the Bronze plan. Out of pocket costs could easily exceed the employee’s income.
Cancer is expensive to treat. Insurance will offset those costs if the individual can afford the insurance and the out of pocket costs, or the employer can afford the higher-cost plans. However, don’t expect the ACA to offer much relief from the high costs.
Yes, the word cancer causes much stress.
Jim Barfield is the president, CEO and co-owner of Luke & Associates, Inc. on Merritt Island. His company, founded in 2004, is a major provider of medical and clinical support services for the military. In addition, Luke provides advis-ory and assistance services in the fields of engineering, research, information systems and medical systems.
