Business Brief

According to the World Health Organisation, in 2020, prostate cancer was one of the leading cancers diagnosed globally[1]. As per the 2019 National Cancer Registry in South Africa, the lifetime risk for prostate cancer in men is one in 15[2]. Risk factors for developing prostate cancer include a family history of the disease, advancing age and black ethnicity. Some studies suggest hormones and certain dietary factors may also increase the risk of prostate cancer[3].

Prostate cancer may be picked up during screening (screening usually entails performing a clinical examination along with a digital rectal examination and having a blood test to determine Prostate Specific Antigen (PSA) levels) or after symptoms (e.g., difficulty in starting or stopping urination, frequent urination, poor urine flow) may have developed.

Once prostate cancer has been diagnosed, treatment depends on the cancer stage.

A cancer diagnosis is often untimely, disruptive and met with disbelief and uncertainty. Cancer workups and treatment regimens may be rigorous and require many consultations with various healthcare professionals and different treatment modalities ranging from surgery to targeted therapy and hospitalisations, all of which come with added expenses that must be catered for.

An additional consideration is the time needed to treat and manage cancer and cancer-related side effects, which usually means time away from work and loved ones creating further strain on the individual, primary breadwinner or caregiver of a family.

Purchasing PPS Insurance cover offers members an opportunity to protect themselves and their families against known and unforeseen costs and burdens associated with a life-changing event such as prostate cancer.

Given the all-encompassing impact of cancer on members and their families, PPS offer various benefits to address the critical needs of our members in their time of need to alleviate financial concerns pertaining to the ability to work and cover additional financial costs.

PPS’s Sickness benefit covers the potential income loss due to an inability of a member to work full or part-time while undergoing treatment or during recovery.

Critical Illness Cover (CIC) and the associated EXPANDER Rider and EXACT Rider benefits aim to meet the additional financial needs or shortfalls which may accompany a cancer diagnosis.

With Critical Illness Cover, a lump-sum amount pays out on cancer diagnosis. The amount paid out varies by the stage of cancer diagnosed. Members can boost the payout to 100% for certain cancers by purchasing either the Core 100% or CI 100% options.

The EXPANDER Rider benefit pays out a lump-sum amount on the diagnosis of early cancer. The presence of early cancer means that abnormal cells have been identified in the body, but these cells are confined to the organ or site involved and may advance to stage 1 cancer if not treated.

Given the high cost of targeted cancer therapies, PPS offers members an opportunity to purchase additional cover via the EXACT Rider benefit. This benefit pays out a lump-sum amount should a member have an existing, valid CIC cancer claim and provides evidence (as set out in the Provider Policy) that the cancer is amenable to targeted cancer therapy (which must be approved by the US Food and Drug Administration and the South African Health Products Regulatory Authority) as per the treating oncologist.

PPS also acknowledges that, sadly, cancer is not always a once-off event. Sometimes, cancer can progress despite the best and optimal treatment. Therefore, PPS’s CIC includes reinstatement as part of the cancer category to allow for an additional payout should the cancer progress to a worse stage.

Lastly, should a member develop permanent and significant impairment as a result of cancer which impacts their ability to work (partially or fully), PPS offers members Permanent Incapacity (part of the Sickness and Permanent Incapacity benefit) and disability (Professional Disability Provider) cover which will pay out if a member is occupationally disabled or functionally impaired. For example, the Occupational Disability Provider would pay out 100% if a member is diagnosed with brain cancer that affects their cognitive function, making them unable to perform their usual professional duties. Our Functional Disability Provider includes claim definitions from stage 2 cancer.

Meet Dr Thompson*, a 58-year-old surgeon diagnosed with prostate cancer (stage 2). Dr Thompson has R1 500 000 Critical Illness Cover with CI 100% to boost his payout in the event of cancer.

Because he has CI 100%, his valid CIC claim, which would have been a 25% payout (R375 000), is upgraded to a 100% (R1 500 000) payout. Dr Thompson can now use the lump sum to offset any unforeseen medical costs due to his illness.

Meet Mr Jacobs*, a 49-year-old advocate diagnosed with an aggressive type of prostate cancer (stage 3). He could not work when he underwent treatment and thus could not perform his occupational and professional duties.

Fortunately, Mr Jacobs has the PPS Sickness and Permanent Incapacity benefit and could claim from his Sickness benefit when he was unable to work. He was able to meet his monthly financial obligations to support his family and their ongoing needs.

CLICK HERE to read the PPS prostate cancer information sheet.

By Dr Lauren Acton, Senior Medical Officer

* The names used are fictitious; however, they reflect real-life claims received by PPS. All valid claims are assessed individually and paid in line with the product rules.

PPS is a licensed insurer conducting life insurance business, a licensed controlling company and an authorised FSP.

[1] https://www.who.int/news-room/fact-sheets/detail/cancer

[2] www.nicd.ac.za/centres/national-cancer-registry/cancer-statistics/ (Cancer in South Africa, 2019 Full Report, National Cancer registry)

[3] https://www.cancer.gov/types/prostate/patient/prostate-prevention-pdq