Lack of Insurance Reduces Cancer Survival

Lack of Insurance Reduces Cancer Survival
These medical bills show that health care can be expensive, even with insurance. Photo courtesy

A cancer diagnosis is not the death sentence it once was, with early diagnosis and treatment increasing survival in many cancer types, including testicular cancer. However, researchers have discovered one non-medical factor that can reduce cancer survival: lack of health insurance.

The study comes from Christopher Sweeney, medical oncologist at Dana-Farber/Brigham and Women’s Cancer Center (DF/BWCC), along with other researchers. The authors published their results in the American Cancer Society (ACS) journal, Cancer. Although testicular cancer is normally curable, the researchers wanted to see if insurance status affected survival.

To see if insurance played a role in the outcome of a cancer diagnosis, the researchers studied 10,211 men who were diagnosed with testicular cancer between 2007 and 2011. The scientists looked at how these men fared after their diagnosis, such as their survival, along with their insurance status, that is, if they had health insurance and, if so, what type.

When the researchers analyzed their data, they discovered the study participants with private or other health coverage had the highest chance of survival after a testicular cancer diagnosis. The risk of death was 51 percent higher for the men on Medicaid, and 88 percent higher for men with no health insurance at all. It seemed that having better health insurance played a huge role in helping men beat their testicular cancer.

This is not the only study to suggest a higher risk of death when the cancer patient is uninsured. In another report in the same journal, patients with glioblastoma brain tumors also had a lower chance of survival when they had no insurance coverage. Sadly, beating cancer seems to not only be a matter of medical advances but also the ability to afford proper treatment.

Normally chemotherapy can help cure testicular cancer, however, the earlier the diagnosis, the better the survival odds. The researchers suggest that without insurance, men may not be visiting a doctor with their concerns as early as they should, and may not be getting a cancer diagnosis in time for effective treatment. They found that when the study participants were uninsured or on Medicaid, they tended to have larger testicular tumors or metastatic disease when they were diagnosed, giving them a poorer chance of survival. Without the early intervention, their disease was able to spread until these men were less likely to survive than their privately-insured counterparts.

Not only were the men without good health insurance diagnosed later, their treatment also seemed to differ. In the early stages of the disease, men with Medicaid or no insurance were less likely to have their lymph nodes removed. This procedure can cure some patients, so doctors often take this preventative measure. In advanced stages of the disease, the uninsured men were also less likely to undergo radiation therapy, a treatment option many of the men with private insurance or Medicaid received.

The United States (U.S.) government has been expanding health insurance coverage, although these study results suggest that getting more patients on Medicaid may not be enough to improve their health. Unfortunately, testicular cancer survival seems to be vastly different between the haves and the have-nots in the U.S. Although cancer care, and cancer survival, has advanced through the years, if patients are not able to afford this treatment, survival will not be as high as it could be. As scientists continue to improve their knowledge and treatment options, too many patients may be left behind for lack of money.

The American Cancer Society predicts that in 2016, 8,270 men will be diagnosed with testicular cancer, with 380 succumbing to the disease. With men aged 26 to 34 having the highest rate of testicular cancer, as well as being the least likely to have health insurance, it means many of these deaths could be prevented medically, although maybe not financially.

Symptoms of testicular cancer include a lump, a heavy feeling in the scrotum, fluid in the scrotum, pain or discomfort in the testicle or scrotum, an achy groin or abdomen, back pain, and enlargement or tenderness in the breast area. When these symptoms are present, especially if they last more than two weeks, men should visit their doctor for a diagnosis. The doctor may use an ultrasound or blood tests to look for lumps or tumors, and they may perform surgery to remove the lump and examine it for signs of cancer. Doctors may then perform surgery to remove the testicle or lymph nodes nearby, they may perform radiation therapy to kill the cancer cells with energy beams, and they may use chemotherapy to kill the cancer cells with drugs. These treatments may be expensive, but catching and treating the cancer early means a good chance of survival.

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