Discovery Health Medical Scheme spent over R177 million for breast cancer drugs in 2015

Breast cancer affects the young, old, women and men. Raising awareness of and supporting early detection of this most-common cancer among South African women will help save more lives. When breast cancer is detected early, the survival rate is as high as 95%. Discovery Health and the Discovery Health Medical Scheme support early detection through screening. The Scheme’s Screening and Prevention Benefit will, from 2017 as part of benefit changes, now provide clinically appropriate screening for all members, with enhanced screening benefits for those at a higher risk.

In an effort to raise awareness of the prevalence of breast cancer, Discovery Health shares some of the 2015 claims statistics of Discovery Health Medical Scheme members who received treatment for breast cancer.

Age is not among the most indicative risk factors

In 2015, there were 9 984 Discovery Health Medical Scheme members who received treatment for breast cancer. Of the women receiving treatment, 79% were older than 50. This means that over 20% of cases occurred in women below the age of 50 and in some cases in women in their 20s and 30s. Although age increases the risk for developing breast cancer and the most advanced cases generally occur in women older than 50, there are many risk factors that contribute to breast cancer occurring at any age.

This was evident from the women who received treatment in 2015. The youngest among the 9905 females registered on the Discovery Health Medical Scheme Oncology Programme for breast cancer treatment was only 19 years old. The oldest among them was 97 years old. Family history, genetic predisposition, having babies later, oestrogen exposure over time, dense breast tissue, lifestyle behaviour, and hormone replacement therapy have all been linked to breast cancer.

Men also get breast cancer

The risk factors for breast cancer apply to men too. It is a misconception that breast cancer only occurs amongst women. In 2015, there were 79 men on Discovery Health Medical Scheme who underwent treatment for breast cancer, their ages ranging from 30 to 85 or older. The highest prevalence of breast cancer among men, were between the ages of 45 and 74.

Breast cancer treatment and cost

There are many different ways to assess breast health. Regular self-examination is the first and a crucial ongoing step. Up to 60% of women present with lumps bigger than five centimetres at diagnosis, which could indicate the need to raise the importance of self-examination. Regular screening and awareness of family history are important for both males and females.

Breast cancer is treated in many ways and different types of specialists work together. Surgery, chemotherapy, radiotherapy or a combination is the main treatment for breast cancer. In 2015, Discovery Health Medical Scheme paid over R177.5 million on breast cancer medicines. A total of R71.7 million of that amount went towards one drug, Trastuzumab (Herceptin)

Signs and symptoms to be aware of

The lifetime risk of breast cancer in women in South Africa is one in every 29. It is important to know what to look out for and warning signs of breast cancer include: general pain, irritation or itchiness, a lump, thickening or swollen skin, a change in breast size or how the breast feels, any skin changes. Consult a medical professional if any of these signs are present for an assessment.

Discovery Health Medical Scheme pays for one mammogram each year for men and women. Only consultation costs will come from member funds. Tests to determine the breast cancer susceptibility genes are paid from day-to-day benefits. The oncology benefit provides comprehensive cover for consultations and treatment. In lower plans, all claims are paid in full up to a limit of R200,000 plans and R400,000 on higher plans. Claims above these limits are paid at 80%, with no upper limit.

Even 2.5 hours of brisk walking a week notably reduces risk for cancer

CEO of Discovery Health, Dr Broomberg says, “with regular screening as many as 64% of people are diagnosed at stage 1. Early diagnosis has many patient benefits, and it reduces cost of treatment by up to 9%.” He also adds that a study of 1.4 million people by the American Institute for Cancer Research showed that the risk for certain cancers were reduced by up to 20%, and up to 7% for all cancers, with regular physical activity.