Triage Life: Part 2 – Managing Stress & Improving Mood

Triage Cancer Blog - Managing MoodWe all try to live a stress-free, positive life, but the expression “don’t worry, be happy” is easier said than done, right? Sometimes, your road to happiness can be quite simple with some small steps:

  1. Sleep angry

Not only is sleep restorative, contrary to popular belief, it’s ok (and maybe even better) to go to bed annoyed or frustrated. Expressing anger towards petty nuisances only intensifies aggravation. Instead, let those feelings rest because oftentimes a good night’s sleep allows the anger to boil down.

  1. Go outside

Science has proven that the outdoors boosts your mood. So, get some fresh air to take a break from the indoors and because science said so.

  1. Exercise

In addition to improving your physical health, staying active releases endorphins in the brain, relieves stress, and boosts your self-esteem.

  1. Make your bed

As simple as this may sound, making your bed can actually improve your confidence. Integrating this into your daily routine will give you a sense of accomplishment every morning. Not to mention, your room will look significantly neater.

  1. Engage in a hobby or find a new one

A hobby that you enjoy and that demands your full attention provides an outlet that can improve patience, focus, relaxation, well-being and, of course, happiness.

  1. Spend more time with family and friends

With the support, love, and company of others, those positive relationships can significantly improve your well-being.

  1. Fake it ‘til you make it

If you’re feeling down, make a conscious effort to act more cheerful than you feel. It may trick you into actually feeling happier.

  1. Don’t dwell

Dwelling on things will not make bad feelings go away. Instead, try and accept and acknowledge the fact that you feel a certain way. If there’s nothing you can do to fix the situation, move on. If there is, take action!

  1. Do a good deed

Giving back allows you to make a positive difference in the lives of others, which can be very rewarding for you, in many ways.

For more extensive information on managing stress, register for our upcoming webinar, Don’t Stress the Stress!

For more information on being resilient, watch the Triage Cancer webinar on Resilience: Thriving not just Surviving.

Cancer & Employment: International Series – Japan

Triage Cancer Blog - Employment JapanThere are endless questions to think about when it comes to employment after a cancer diagnosis. But perhaps the most important question is one that is out of one’s control: will my country protect and support me in the workplace? In the US, the Americans with Disabilities Act (ADA) is a civil rights law that not only provides protection against employment discrimination, but also gives access to reasonable accommodations, such as part-time positions and health and disability insurance. Unfortunately, not all countries provide that same security.

In Japan, cancer survivors are heavily victimized in the workplace. Some Japanese firms will explicitly reject cancer survivors solely based on their medical history while many will immediately dismiss the survivors after they are diagnosed. 30 percent of cancer patients said their salary was cut by 70 percent, ultimately forcing them to either reduce treatment or end treatment altogether. The reasons for these injustices are because 1) there is no disability discrimination law in Japan and 2) many believe cancer to be a death sentence, both in terms of health and in terms of maintaining dignity and contributing to society.  The unfortunate truth about cancer in Japan is that the illness carries a severe social stigma that cancer patients have to face both in the workplace and out in society.

All Japanese do not believe this stigma, though. Naomi Sakurai, a cancer survivor, former victim of employment discrimination, and now the head of a job consulting firm, stated that “We, the cancer patients and our families, are a part of society.” Her advocacy for equal rights initiated a revisal of the Cancer Control Law. The revised law requires that employers continue hiring cancer patients, demands that the government promote general education about cancer, and calls for a society that will better provide for and accept cancer patients.

There’s no doubt that the improved law has already taken effect, as Chugai Pharmaceutical Co. recently received the “Excellence Award 2015” from Tokyo Metropolitan Government Cancer Project as an acknowledgement for their support for employees with cancer. This award is given to promote the importance of “keeping a good balance between treatment and work.” With an award like this, Japan is effectively developing into a society in which everyone, disabled or not, is treated fairly.

Sakurai and the government’s actions are leading a movement toward a social environment that includes and accommodates for cancer patients. According to the National Cancer Center’s data, half of Japan’s population can expect to contract cancer in their lifetime. However, 60 percent of sufferers now have at least a five-year survival rate. With serious statistics like these, there’s no doubt that cancer patients will need a place in society, for it will become “an increasingly big issue for companies to secure manpower” without them, says senior researcher Doteuchi.

From having no established disability discrimination law to revising legislation to then nationally awarding a firm for their support for employees with cancer, Japan is slowly but surely transforming into a country where the needs of cancer patients are valid, understood, and heard. And that’s exactly the direction Japan should be heading toward. Soon, Japan will have a culture where cancer doesn’t carry a stigma, a work environment where all employees are treated fairly, and a society in which cancer patients will have complete control over their employment.

Triage Life Series: Part 1 – Where to Start

Cancer comes with a never-ending influx of health records, medical bills, lengthy emails, and important documents that over time can get difficult to keep track of, especially on top of daily clutter. So, here are some organizing tips for a little peace of mind:

  1. Keep it together

If you leave things scattered, there’s a high chance you’re going to lose something important. Create a work space – a desk, computer, or basket – dedicated to keeping paperwork tidy and safe. Maybe start with an inbox, where you can put your mail or papers that are waiting to be filed or organized. You could even have one for things related to your health care and one for everything else.

  1. Be colorful

Adding different color-coded files or tabs can make your space not only, more aesthetically pleasing, but also make it easier to find what you need.

  1. Try a storage rack, file box, or tray organizers.

Clear off a cluttered pile by mounting a storage rack. With this, you can separate the bills from the medical records from everything else in neat, separate stacks.

  1. Organization takes time

Just like it took some time for the clutter to appear, it’s going to take some time to declutter. Set aside time (maybe 20 minutes, depending on your clutter) each week to go through everything.

  1. Streamline your wallet

Do you collect store rewards cards?  If yes, you can go digital. Download the CardStar app (free, cardstar.com), then take a photo of the barcode on each card, or type in the number, then toss the hard copy. The store can scan the bar code on your phone at checkout.

  1. Get rid of junk mail

Nobody likes junk mail because it is, well, junk. So, cancel it by downloading the PaperKarma app ($2/mo, paperkarma.com). Then, take a picture of each unwanted piece of mail with your address showing, click send, and just like that, you will be unsubscribed from each of those mailing lists.

For a more extensive guide on how to stay organized, you can watch the recording of our webinar, Drowning in Documents!

Sign Up for a “my Social Security” Account

The Social Security Administration (SSA) is responsible for administering retirement and disability benefits.  Disability insurance or even early retirement benefits can be critical to an individual who is no longer able to work due to a cancer diagnosis.  However, many individuals don’t even know if they are eligible for these benefits, and if they are, how much they might receive.

Triage Cancer Blog my Social Security AccountThat is why it is important to sign up for a “my Social Security” account.  These online accounts provide secure and convenient access to earnings records, estimates for retirement, disability, and survivor’s benefits.

In the past, the SSA would automatically mail this information to ever person with a social security number annually.  However, the easiest way to ensure regular access to updated information is to sign up for a “my Social Security” account at https://secure.ssa.gov/RIL/SiView.do.

To sign up you must:

  • Have a valid E-mail address,
  • Have a Social Security number,
  • Have a U.S. mailing address, and
  • Be at least 18 years of age.

For more information, visit https://www.ssa.gov/myaccount/materials.html#&a0=8.

Don’t Miss these Changes to the 2017 Health Insurance Marketplaces!

In March 2016, the U.S. Department of Health and Human Services released new rules for Triage Cancer Blog Health Insurance Marketplace Changesthe health insurance marketplaces. These marketplaces are available to people who want to purchase their own health insurance in any of the 38 states that use the online federal marketplace (www.HealthCare.gov) or to any of the 13 states and District of Columbia that host their own health insurance marketplaces.

In a recent article published by Kaiser Health News, they provide a summary of three specific changes that may affect consumers using the 2017 federal marketplace (www.HealthCare.gov):

  1. Increased consumer access to information about the size of an insurers’ network of doctors and hospital.

New rules require insurers to give consumers 30-days’ notice if a provider is being removed from the health insurance plan’s network. Insurers must also provide continued coverage for up to 90 days for patients in active treatments (e.g., chemotherapy, or for women in later stages of pregnancy) – unless the provider is being dropped for cause.

  1. Increased warning for “surprise” medical bills from out-of-network providers.

A patient’s ancillary care, such as radiology or anesthesiology, will count towards an insurance plan’s annual out-of-pocket maximum, if the insurer does not notify the patient (within 48 hours) that they may receive care and bills from out-of-network providers.

  1. More standardized out-of-pocket costs for consumers.

This new rule was designed to make comparison shopping between plan choices easier for consumers. Federal regulators have created six standard plans that they are asking insurance companies to voluntarily offer in 2017.  These plans include specific costs for copayments, prescription drugs, primary care, mental health, and substance abuse treatments. This standardized plan design has been implemented in several states, including California, Oregon, and DC; and allows consumers to plan for possible expenses.  But these plans have been opposed by insurance companies. Because of this opposition, consumers will likely see both standardized plans and the current varied policies available in the marketplaces. In addition to these plans, HHS has decided that the maximum amount that consumers can be charged for annual out-of-pocket costs is $7,150 for an individual and $14,300 for family coverage.

For more information about the Affordable Care Act and health insurance options, read our Quick Guide on the ACA and Health Insurance.  Or read past blogs on health insurance topics, here.

Resources:

Kaiser Health News

Kaiser Family Foundation

The Latest on Colon Cancer Screening: What You Need to Know

Even though no one likes to talk about having a colonoscopy, a colonoscopy can you’re your life!  Colon cancer is the second leading cause of cancer deaths in the United States, but colon cancer can actually be prevented through screening tests.  When a colonoscopy is performed, and a polyp is found, it can be removed, before it becomes cancer.  That’s why it is imperative that people learn about the different types of screening tests offered.

Last week, the U.S. Preventative Service Task Force (USPSTF) – an independent panel of medical experts – said the benefits of being screened between the ages of 50-75 (the Triage Cancer Blog USPSTFyears of average risk of colon cancer) are “substantial.” Previously, the colon cancer screening tests that were available included the colonoscopy, the sigmoidoscopy, and two types of home stool tests, the gFOBT and the FIT.

Recently, the USPSTF added two new, less-invasive, ways of testing to the list of colon cancer screenings that may qualify for free preventative screening:

  • A virtual colonoscopy that uses unique X-ray machines to examine the colon.
  • An at home test called the Cologuard, which checks stool samples for elevated levels of altered DNA that could be a sign of cancer. This test typically costs $650.

The USPSTF does not have a favorite test; each one has been found to be equally beneficial to the patient. Because of the USPSTF’s “A” rating of these tests, they must be offered to most privately insured patients without a copayment, cost-share, or applying it to their deductible under the rules of the Affordable Care Act.

Unfortunately, insurance coverage of these tests isn’t always straightforward.  Medicare already covers Cologuard as a preventive screening tool; however, many private insurers have not been covering it for free. There is some ambiguity with the wording of the new rules and advocates in the healthcare community are seeking guidance from the Obama Administration.

Although preventative screening is covered at 100%, without copayments or deductibles, some patients may still end up with a bill. For example, while most private insurers cannot charge patients for polyp removal under the ACA, Medicare will impose a 20% copayment if a polyp is found during a screening colonoscopy and removed. Another way patients can be hit with unexpected bills is if a stool test, sigmoidoscopy, or other exam indicates cancer might exist and then a colonoscopy is performed.  Many insurers would then consider the colonoscopy a diagnostic exam, rather than a preventive screening, and charge the patient.

Stay tuned for more developments on insurance coverage for these news tests and other ACA updates!

For more information about colorectal cancer, visit:

http://www.cancer.gov/types/colorectal
http://nccrt.org/

LGBT Protections under the Affordable Care Act

The Patient Protection and Affordable Care Act (ACA), more commonly known as Triage Cancer Blog LGBT CancerObamacare, passed in 2010, but continues to evolve through rules issued by agencies such as the U.S. Department of Health and Human Services (HHS).

On May 13, 2016, the HHS Office for Civil Rights released a final rule that provides nationwide, nondiscrimination protections for members of the lesbian, gay, bisexual, and transgender community (LGBT), throughout federally-funded health care facilities, programs, and activities. Under the final rule, Section 1557 of the ACA extends protection against discrimination against LGBT people throughout the healthcare system. Previously, Section 1557 of ACA did not explicitly prohibit discrimination based on gender identity and sexual orientation.

Two key provisions clarified the protections for the LGBT community:

  1. Explicit protections for transgender individuals on the basis of gender identity.
    2. Explicit protections for lesbian, gay, and bisexual (LGB) individuals on the basis of sex stereotypes.

Provision One: Protections on the Basis of Gender Identity

Transgender people encompass approximately 0.3 percent of the United States population, or slightly under one million Americans in 2016. Transgender individuals’ gender identity, or their internal knowledge of their own gender, is different from the sex assigned to them at birth. Within the healthcare system, discrimination of transgender individuals on the basis of gender identity is massive, nearly 6,400 transgender and gender-nonconforming individuals reported discrimination, including being denied care, according to a 2011 study.

A health care provider now must provide medically necessary health care services to transgender individuals, as long as they are within the scope of the provider’s practice. Sex-specific services must be provided through Medicaid and private plans nationwide. Specifically, this applies to transgender men receiving cervical Pap tests and transgender women receiving prostate exams.

Provision Two: Protections on the Basis of Sex Stereotypes

The final rule does not define “sex” in Section 1557 to include sexual orientation; however, the rule expands the protections to LGB individuals to address the higher rates of discrimination in the health care setting. Health care providers are prohibited from discriminating against patients because of their sexual identity.

The rule also notes that protections against discrimination will continue to expand through the legal system. Currently, Equal Employment Opportunity Commission v. Scott Medical Health Center and Equal Employment Opportunity Commission v. Pallet Companies d/b/a IFCO Systems NA, Inc. are two of the federal circuit court cases fighting to expand the sex discrimination provision under Title VII of the Civil Rights Act to include sexual orientation discrimination.

In order to enforce the rule, HHS will take collect adequate demographic data on individuals filling complaints, to identify patterns in complaints of discrimination. HHS OCR will also need to work with other operating departments throughout HHS to maintain the enforcement of these protections. The goal of this final rule regarding Section 1557, is to continue the expansion of protections and provide healthcare services to more and more Americas under the Affordable Care Act.

For more information regarding LGBT+ healthcare, visit www.cdc.gov/lgbthealth.

Addressing Mesothelioma from a Medical Perspective

Today’s guest blog comes from our new partners at the Mesothelioma Applied Research Foundation.The Mesothelioma Applied Research Foundation

The word, Mesothelioma (pronounced mez-uh-thee-lee-oh-muh), is often much better known than the illness it represents.

The legal issues surrounding this cancer make mesothelioma, the most expensive keyword on Google (while most keywords cost pennies, the keyword mesothelioma can cost over $300 per click). Mesothelioma, in most cases, can be traced back to exposure to asbestos. Therefore, there are legal avenues for patients to seek compensation.

Mesothelioma is a cancer that most often affects the lining of the lung or abdomen; it has no cure and treatment options for patients are few. Prognosis is generally considered poor, at less than 10% survival at five years post diagnosis. The vast majority of mesotheliomas are associated with exposure to asbestos, with the latency between exposure and disease development ranging between 20-50 years.

Diagnosis of mesothelioma has always been difficult, mostly because initially its symptoms are quite general (shortness of breath, general malaise, pleural effusion, gastro-intestinal problems). In addition, because of the long latency between exposure to asbestos and disease development, patients and their doctors aren’t led to a diagnosis quickly, thereby wasting valuable time that could have been used to begin treatment.

When the Mesothelioma Applied Research Foundation (Meso Foundation) began its operations in 1999, mesothelioma was a cancer largely ignored by the scientific community. At that time, virtually no research funding was available for it, and consequently, patients found themselves with little hope and sadly, very little time to live. What’s more, patients, as well as physicians, lacked updated and comprehensive treatment information about mesothelioma.

This is where the Meso Foundation comes into play. The Meso Foundation is a nonprofit organization dedicated to eradicating mesothelioma and ending the suffering caused by this aggressive and incurable cancer. It does so by funding peer-reviewed research, by providing education and support to patients and their family members, and by advocating Congress for an increased federal investment into mesothelioma research. To date, the organization has allocated more than $9.4 million of its own funds and has directed more than $13 million of Department of Defense (DoD) funding toward important mesothelioma research.

For years, mesothelioma has been known as a cancer that strikes predominantly older males because of their past occupational exposures. Most recently, however, the Meso Foundation has found that more than ever before men and women in their 20s, 30s, and 40s are contacting the Foundation for help.

To better define this patient population and to spur advances in mesothelioma clinical research and treatment a registry bill has been introduced in congress. HR 3284 enjoys bipartisan support and, if passed, we anticipate it will lead to unprecedented advances in mesothelioma science.

Despite the poor prognosis, patients today who are able to obtain a quick and accurate diagnosis and expert guidance to treatment options (like state-of-the-art clinical trials) can live long and fulfilling lives, with good quality of life. The Meso Foundation can help patients navigate the best path through most effective mesothelioma treatment options.

For more information about the Meso Foundation or to obtain help, patients and their families are encouraged to visit www.curemeso.org. Please note: the Meso Foundation does not provide legal referrals.

Triage Life Insurance

Many people ask us if they are able to buy life insurance after being diagnosed with cancer.

And the answer is . . . it depends.

The reason we buy insurance, is to protect us in the event that something happens.

Car insurance protects our cars; home owners insurance protects our homes; life insurance provides for the people we care about when we pass away.Triage Cancer Life Insurance

The insurance industry argues that if we wait to buy life insurance until we have a serious medical condition, then that’s like buying car insurance after we have been in a car accident.

Life insurance companies are still allowed to refuse to sell policies to people with a pre-existing medical condition. Because the life insurance industry does not have the same protections that are now available in the health insurance arena, it is left up to each insurance company to decide the parameters for if or when they would be willing to insure someone after a cancer diagnosis.

For example, some companies have a policy that they will insure someone 10 years out from a diagnosis of cancer, some companies have a policy that they will insure someone 1-5 years out from the completion of active treatment depending on the type and stage of diagnosis, and some have a policy to not provide coverage at all. Each company is different.

So, that means the only way to know which companies sell policies to people who have been diagnosed with cancer, is to contact the insurance companies that offer policies in your state and ask them.

To find out which companies sell policies in your state, you can contact the insurance agency in your state, and look for the section on life insurance. You can find your state’s agency here: http://triagecancer.org/resources/stateresources. For example, the Texas Department of Insurance lists these companies as selling life insurance policies in Texas.

It can be valuable to shop around, because policy costs can vary a great deal among companies.

Sometimes, there are other options available for getting a life insurance policy, such as getting a group policy through an employer or a professional association, where they may not ask medical questions and do not impose pre-existing condition exclusions.

Here is an article on some other tips for buying life insurance after a cancer diagnosis.

Cancer in the News

What does the Affordable Care Act (ACA), race/ethnicity, and the 2008 economic recession have in common? They have all had an impact on the cancer community.

ACA Saves California Families $2,500 on Health Care

Ever since the ACA’s premium tax credits and cost-sharing subsidies took effect in 2014, Triage Cancer Blog Cancer in the Newsthe health care reform law has received severe criticism in the news media. Yet a recent study from the California Health Care Foundation shines a different, more positive light on the impact of the health care law. New data shows that median annual out-of-pocket spending for families with individual health insurance coverage has dropped nearly $2,500. This drop in spending is attributed to increases in consumer protections and coverage in the policies sold through the state health insurance marketplaces under the ACA. Although this study was specific to California, national health care spending has declined as well. For more information about the Affordable Care Act and how it impacts the cancer community, read our Quick Guide on Health Insurance.

The Deadly 2008 Recession

The 2008 economic collapse was a dark time for the world, as it caused many companies to lay off workers, who in turn were left unemployed and in debt. A new study has found that the 2008 recession also caused an additional 260,000 cancer deaths worldwide. The increased deaths are largely attributed to the US and Russia, both countries in which employers or individuals have to pay for their healthcare. On the other hand, countries with universal health coverage, like Britain, saw no additional cancer deaths between 2008 and 2010. This is because people in Britain, employed or not, had health insurance whereas many unemployed Americans and Russians either faced poor or delayed treatment, were diagnosed late, or couldn’t afford medical attention altogether. But it’s important to note that although the UK and other countries with universal health coverage did not experience an increase in deaths, they still underwent a significant rise in unemployment. This forced many countries into cutting their spending on health care. Ultimately, the impact a financial downturn has on the economy trickles down to cancer patients, for a reduction in government spending can impact access to care and impact cancer survivorship.

Intersectionality in the Cancer Community: Hispanic and Black Young Adults More Likely to Die of Their Disease Than White Counterparts

According to a study conducted by the University of Colorado Cancer Center, black and Hispanic cancer patients, between the ages of 15 and 29, have an increasingly higher risk of mortality than same-aged white cancer patients. This disparity is largely explained by one’s socioeconomic status and access to financial resources. However, even after holding insurance status constant, the scientists found the same discrepancies among the race/ethnic groups. The study therefore suggests that race/ethnicity is not only independent of socioeconomic status, but also that race/ethnicity plays an independent role in mortality. Additionally, this demonstrates that intersectionality among patients is in fact a lived reality in the cancer community. Meryl Colton, a medical student at the University of Colorado School of Medicine, says that “Knowing that a disparity exists allows us to ask questions that can help ensure everyone receives the best possible care.” Now the focus can turn to identifying those questions and finding the right answers to them.