In an opinion piece for STAT, medical journalist Howard Wolinsky describes how life insurers treated his active surveillance for prostate cancer as "untreated cancer," leading to denials and a sharp reduction in coverage. Wolinsky, who has a low-risk Gleason 6 tumor, followed his oncologist's recommendation to monitor the cancer with PSA tests, biopsies, and MRIs rather than undergo surgery or radiation. Yet when his term life insurance policy expired in 2013, eight insurers turned him down, and he could only convert to a $100,000 universal life policy at the same premium he had previously paid for $600,000 in coverage.
To see if the situation has improved, Wolinsky asked two insurance brokers to assess a hypothetical 64-year-old man with a new Gleason 6 diagnosis and a past heart attack. The brokers estimated that some insurers might postpone a decision for three to five years, waiting for stable PSA results and no cancer upgrading. The heart attack would also trigger a "table rating," adding roughly 150% to standard premiums in one estimate, potentially tripling a $1,000 annual premium. The brokers' ballpark figures ran into thousands of dollars a year, suggesting the challenges Wolinsky faced in 2013 have not disappeared.
Wolinsky argues that "untreated cancer" is a misleading label because active surveillance is a recognized management strategy for low-risk disease. He calls on insurers to weigh stable findings and to be more open about their underwriting criteria. He also raises the question of whether surgery or radiation would improve insurability, but says he does not have the answer. The piece is an opinion, so it reflects one patient's experience and a broker-based hypothetical rather than systematic data, but it highlights a potential gap between medical guidelines and insurance practices.