• Nathira Salim

Breast Cancer Awareness

Updated: Nov 19

Welcome back to my blog peeps!


October is the month of awareness for two particular cancers - breast and liver cancer, but somehow the breast cancer awareness is more popular. In US, there are pink ribbon events such as marathons and charity events to raise money for cancer research or for breast cancer foundations such as Susan G.Komens and etc.



In Singapore, from my basic google search, there are certain companies and foundations that are making use of this month to raise awareness about breast cancer. I will list them at the end of the blog below. It is from such awareness events that I have learnt about breast cancer earlier on which drove me to try to lose weight - though I didn't do much of a good job losing the weight.


Anyways - as much as eating the right food, moving the body more and sleeping on time are the most basic things that can help prevent major illnesses, there is another tenet that is important - peace of mind. Having a peace of mind - is not only basic, it's important and without it - I don't think the former three pillars of good health will stand. More than ever - having a peace of mind is important especially during times of illnesses because without mental stability and positivity - going through extensive treatments that debilitates you will drain you mentally as well as physically.


You may think I am crazy - but one of the first thing I was worried about when I was told I have cancer was if my hubby could afford my treatment. In fact - my employer and manager were both worried about it - for thats the first thing they asked - if I needed any financial help - because health care is already expensive in Singapore even with the Medishield and Medisave subsidies we get as Singaporeans. If you add major illness to the list - the amount can really shoot up. How far and high can it shoot up you ask? Well let me present to you my case. After all - I am not presenting estimates - only what I was charged.


Before I go on - let me put out a disclaimer here.

My type and treatment of cancer, plus the charges I incurred can be different from another cancer patient's. This is what I was charged and my billing can be different from another person's as well for I think the medical fees are really not that transparent in Singapore. I am just providing the exact charges I was billed without going through the exact medical details cos first of all I am too lazy to type it all out, and secondly, its TMI.


Also another detail to take note - I did not go to polyclinics or a private clinic to get a referral letter. If I had done that - my charges would fall under subsidised rates. But as you know, getting appointment through clinics would take time and this wasn't a matter I felt that could wait, so I went ahead and booked an appointment with a doctor at the hospital directly. It was only after getting hospitalised I was able to use the insurance.


So just go through the example and then maybe estimate it according to the type of treatments - maybe for liver or other forms of cancer and stages.


I had Stage 2 Breast Cancer. My treatment plans were to have surgery to remove the tumors, go for 12 sessions of chemo and 8 sessions of radiation and by the way I had two surgeries done within a month and I also had two biopsies (small mini surgery).


I have also list out in point form for easier viewing and understanding:


Before the surgery:


Mammograms and Ultrasound

2nd Ultrasound

MRI scan

ECGS scan

CT chest, abdomen and pelvis scan

Initial consultations

Follow up reviews and consultations


Total incl GST = SGD 4244.10

Medisave = SGD 424.10

Remaining cash = Insurance



Biopsies


Biopsy 1

Day Surgery - Facility

Lab investigations

X ray investigations.

implants

Consumables

Surgical operation


Total incl GST = SGD 5498.79

Medisave =SGD 1000

Remaining cash = Insurance



Biopsy 2

Day Surgery - Facility

Lab investigations

Consumables

Surgical operation


Total incl GST = SGD 4436.28

Medisave =SGD 443.63

Remaining cash = Insurance

Surgeries


Surgery 1 (2 night stay)

Surgical procedures

Daily Ward &Treatment


Total = SGD 6646.43

Medisave = SGD664.64

Remaining = Insurance


Surgery 2 ( 1 day)

Surgical procedures

Daily Ward &Treatment

Total = SGD 4244.10

Medisave = SGD 424.41

Remaining = Insurance


Genes Testing

Total = SGD 5000


Note: Claimed back the money once the recurrence score was above 25. Mine was 28. Click here for more details about this test.


Radiation

8 sessions and the breakdown as follows:


Mega & Ortho ( Hypofaction)

Simulation

Computer Planning - Complex

Computer Planning - Special

Treatment Imaging

Consumables - radiation bra


Total Cost = SGD 12046.93

After govt subsidy = SGD 6023.47

Medisave = SGD 638.85

Remaining = Insurance


Chemo

I had three different drugs used in differing periods. Hence the charges were not the same all the time. So I shall provide the charges I got billed for the month of March - weekly chemo. The breakdown as follows:


Consultation

Procedure Fee

Additional injections - home visits

Full blood count - Lab investigations

Chemo infusions

Consumables - such as needles and valves

Facility Fee

Drug and injections


Total cost = SGD 9209.19

Medisave = SGD 920.92

Remaining = Insurance


Chemo from Oct to Jan ( Doxorubicin and Cyclophosphamide)

Total charges = SGD 4250.54


Chemo from Feb to May ( Taxol and later Paclitaxel)

Total charges = SGD 39,981.15


All in all - if there was no insurance - the total amount I would have had to fork out is: SGD 86,348.32. Kindly note, this does not include all the expensive multivitamins I purchased from US such as lypo-spheric vitamin c and nano curcumin supplements to help me with increasing immunity before and after surgery.



Now thats me. I am from a middle class family and I worked and yet - this amount is beyond me. And to be honest - I am not the frugal, money saving type of woman so for a person who was living pay check after pay check - this was way too much. Yeah of course my hubby is also there. But don't you think its cruel to let your other half or your family member handle such a mammoth task of sourcing funds all by himself or herself?


My friend's dad, who has an advanced form of cancer ( stage 4a small cell lung cancer) - was advised to take a particular chemo drug orally, was flabbergasted when he saw that the chemo drug - 30 pills in all costed a whopping SGD 8055.60 ( without subsidy)! Now this is just for one month! So his argument reflected mine - what about those who have no insurance? Are they just supposed to roll and die? He says it better than me though.


I feel that people don't take insurance seriously enough. I don't exactly know why they don't take insurance, maybe they believe they will be hale and healthy till they are old, they believe they will never have any terminal diseases in their life, they believe that nothing unbecoming will happen to them. I don't know.


So lets for example say - you live pay check after pay check with no savings ( just like me) with no insurance and one day you get hit by a drunk driver and land in a hospital. You get multiple surgeries, you live in ICU for a while and then you die. Who is going to pay for the hospital charges, the funeral fees, and the credit card debts you may have left behind? And what about loans or mortgages left behind in your name? What about your dependents such as old parents and young kids? After your death - you leave your family penniless and let them move on in a life without you with a huge financial burden on their small shoulders. What an arse! Just because you couldn't part with a small amount of money to be paid monthly to an insurance company? Crap.


And there are a bunch of loonies who in the name of some religions say that insurance is prohibited. I am pretty sure no matter which religion it is - every human has a right to live with dignity and die with dignity. So let's say - if a person who finds himself or herself with cancer and can't afford to pay for the treatment, they have to walk up and down multiple state sponsored charity organisations because that person's religion says insurance is forbidden? From what I gather, the time taken by the charity organisations to get your documents and medical reports, review your file and approve the funds, it will be more than 3 months - and thats precious time meant for treatment. The longer we stay without treatment, the faster it proliferates (depending on the type of cancer). You may read this for more details about fast growing cancers. So begging for money and getting charity is ok then? I am sorry but talks of afterlife when my family suffers in financial mess doesn't just make the cut for me. Thats just me. Hey - you do you - I do me.


I would understand if the older generations like my parents who have no insurance earlier on in their life. My mum had other issues to deal with so I get it. But later on - my dad did take out insurance for him and for my mum which had helped a great deal for the past couple of years. It's not much, but it has helped lessen the financial burden. So what's stopping the current working class to get themselves insured? I don't know. I guess they learn when some shit falls on them I guess.


Ever since my cancer, I have advised my friends to take up insurance. Do take up a life insurance policy at least, because I am pretty sure if nothing else, death is a confirmed event that happens to every one. Also take up something that covers everything from accidents to hospital stays, fertility treatments to cancer treatments, organ transplants and etc. Go through the clauses and take up anything that covers for specific illnesses such as cancer and total permanent disability. This could be a stretch on your monthly expenses and I get it - but you know how much a sense of relief you get when you don't have to pay for hospital stays or treatments because you have it covered?


My hubby has multiple insurance policies for himself as well as for me and our son, but after my cancer, he has now paid extra money for riders as well and for complete and broad coverage. He has no intention of making me curse him for leaving me and my son in a financial mess.


My final take - illness sucks. Treatment sucks. What I went through as a healthy person in the cancer journey - is somewhat the same for every cancer patient - some even worse. Some patients don't get to see the end of their treatment because the cancer is still inside of them, and my heart goes out to them.

You can read such stories here.


I can still remember the depth of darkness in me after every infusion, how fatigued and weak I become, and how painful it is to walk and put on my clothes. Do I also need to worry with guilt that my hubby has to bear the finances of the treatment all on his own? No. Thankfully - and thats where God comes in - I didn't have to pay a single money for the treatment. Whatever I paid before surgery, I got it claimed from insurance. I am so grateful that I took the insurance when the policy was presented to me many years ago.


Death is certain. We are all dying. But our family will still live on for sometime without us. So while we are dying,I believe we should live with some peace of mind that no matter what illnesses or tragedy befalls us the finance portion of the life is taken care of, and we can focus on things that matter. Like ice cream. And maybe love.


Kindly please do think about my suggestion and advise and do talk to that insurance fellow who had been calling on you for some time to buy that particular policy.

I will like to also add - that sometimes you cannot take standard insurance because of some pre existing conditions or heart related issues. There are many technical step backs that can hinder a person from getting a standard proper insurance. I am aware of that and am sorry to hear that.


Since this is breast cancer awareness month - along with the info about prevention and treatment of cancer, I hope people get themselves informed and aware of the hidden cost of conventional treatments of terminal diseases.


And also - please support any cancer foundations if you can. Heart disease or brain disease, children related illnesses or anything that requires more R&D and more funds, kindly donate if you can. Many decades ago - the standard form of breast cancer treatment was to have a mastectomy (removal of breasts). And then later on, chemo and radiation was the norm, and recently immunotherapy and I recently read somewhere that researchers are looking for ways to treat cancer tumors overriding chemo totally. All this breakthrough is happening because of donations from all over the world as well as the brave women and men who enrolled in trials to help future patients like me to live.


It is because of your charity and support - the people who have no insurance can have some glimmer of hope in their treatment, and for some - maybe a breakthrough in treatment strategies in years to come.



http://pinkribbonsingapore.org/

https://www.singaporecancersociety.org.sg/events/campaigns/breast-cancer-campaign.html

https://www.ncis.com.sg/events/BCAM/Pages/2021.aspx

https://www.bcf.org.sg/

https://www.choosehope.com/cancer-awareness-months-calendar/

https://www.islamicfinanceguru.com/personal-finance/insurance-haram-halal/

https://www.income.com.sg/blog/critical-illness-survivor-stories?utm_source=sfmc&utm_term=edm_21514_readarticlecta3&utm_content=7977&utm_id=a4ef588e-1332-41cf-bb68-575c68decc64&sfmc_id=4903370&sfmc_activityid=2603bbfb-f189-4d9c-bc59-6f7ae8be37ee&utm_medium=edm&utm_campaign=female















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