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The Cost of Cancer
Side effects are the first thing many people think of when talking about issues survivors face, but they go beyond physical or emotional challenges post treatment. Insurance remains the biggest challenge universally. "At our clinic, the drugs have to be approved by insurance before we can give it to them," said Ganz. So what happens to patients who are uninsurable or dropped from their plans? And even with insurance, cancer is costly. "If you have a $100,000 bill and insurance pays 80 percent, you're still left with a big bill," added Ganz.
Dan Fuson estimates his chemotherapy treatment visits ran up about a $6,000-a-day bill; his ongoing monthly bone strengthening treatment is about $3,000; ten radiation treatments for palliative bone pain cost him about $24,000; periodic scans cost him more than a thousand dollars each time; and hormone treatments run Fuson approximately $50 a month, thanks to his good drug coverage plan. "Thank goodness for my strong program and my wife's secondary family policy," said Fuson.
Debbie Hughes stopped working after surgery and has never been able to go back, due to her feeding tube, voice problems and overall weakness. Her only source of income these days is through Social Security benefits. The plan allows her a set amount each month to live on. "It's hardly doable," Debbie said. "I will never be able to afford to take a vacation, buy a car or save money, because it takes every penny just to live." She is now trying to figure out how she could afford a lawyer, because she filed for disability and has yet to be reimbursed for the time she was going through treatment.
Cancer's Impact on Employment
Other survivors are stuck in an unsatisfying job they feel they can't leave. Most patients are paying into an insurance program through their place of employment; if they were to leave, their insurance coverage would end. Getting hired by a new employer after cancer can be tough, too. Ganz said cancer patients need to be educated on how to present themselves in job interviews when potential employers see a gap in time between jobs on a resume and want to know what the candidate has been up to during that time. Whether you chose to share your health information is a personal decision, and not one most experts advise revealing. "As an employer I cannot ask about those things. It's against the law to ask, and a survivor doesn't have to reveal this information," explained Ganz.
Programs at Vanderbilt-Ingram and across the county can help patients and survivors deal with some of these issues that come with life after cancer. Washburn said Vanderbilt-Ingram, Vanderbilt Corporate Relations and Nashville's Gilda's Club have partnered to address cancer in the workplace. "We're working to educate human resource departments of major corporations in Tennessee to help them understand survivors' needs during and after treatment," said Washburn.
Apolinsky said Gilda's Club offers programs to bring in speakers to discuss job discrimination, insurance issues, how to rebuild relationships, retreats for couples to help them reconnect, and much more. And the best partÉ it's free. "All support groups are facilitated by licensed clinicians, but people volunteer their services for our workshops, classes and social events. It's all manned by volunteers, making it free for everyone living with cancer, including family members and friends of people facing a cancer diagnosis."
Looking to the Future
Every cancer survivor's journey is unique, but there are similar roadblocks along the way, and soon there will hopefully be a universal map to help guide the way here at Vanderbilt and at other cancer centers nationwide. Until then, survivors already navigating what can often feel like a maze are gaining strength in numbers and learning from one another.
Dan Fuson is hoping his prostate cancer never decides to wake up from its nap. "I'm doing okay. You can't go up to the doctor and say 'how long do I have to live,' because they don't know. I am just living day to day," he said.
Felice Apolinsky finds comfort and healing in her role at Gilda's, helping other survivors. "What really grabs my heart is that Gilda's Club provides a community full of people we consider the true experts ñ other people who are living with cancer, or loving people living with cancer. They offer a true and deep level of understanding, wisdom and support," she added.
Caroline Hale has turned her journey into her passion, becoming an advocate for children with cancer. "It is so important for childhood cancer awareness. So many people out there don't know children are affected. It's important for people to know this is a community issue," said Hale.
And Debbie Hughes is sharing her cancer experience with other newly diagnosed patients, volunteering her time two days a week at Vanderbilt-Ingram, meeting and greeting patients in the clinic waiting area. Despite her limitations after cancer, her inspiring spirit is infectious. "You just learn to live with it, make the best of it, accept it, and thank God for every day that you have. Your life is never like it was before, but that's OK," said Hughes. "You learn to adjust and accept it. You cry. You have sad days, but you know the worst is behind you and you've got your life." 
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