Kathryn (00:03):

Hi everyone. I have Matt Rann back with me for episode six of season five. He’s here with me for the first time in 2022. Hi Matt.

Matt (00:13):

Good morning, Kathryn. How are things going? It’s lovely to be back. It has

Kathryn (00:17):

To be said, it’s lovely to have you back. Things are going very well. Thank you. I only have one person in the house with COVID now. Everyone else is recovered. So that’s always a good thing. How are you?

Matt (00:27):

Yes, absolutely fine. I’m glad that the days are getting very slowly, but they’re getting lighter, which is always a good thing for me. I’m not a, I’m not a great lover of the, the winter gloom and so yeah, yeah, every day is, is it gets better, so, yeah. Good. Very good. Thank you. And the whole family touch wood and we are very, very lucky. You’ve avoided COVID to date. Brilliant. So yeah, we’re all very, very good. Thank you. Fingers

Kathryn (00:58):

Cross. This stays that way. Absolutely. So today, if the we’re going to be talking through cervical cancer and insurance, so this is the practical protection podcast.

Kathryn (01:13):

So as going back to my usual format with these things, I’m going to provide a little bit of stats, a little bit of info, and then Matt I’ll come to you for the, the really in-depth side of things that I know the you can do in far more detail than me. So in terms of cervical cancer, remember talking about the cervix, that is what’s no, what what’s known as is it is the where the opening between the vagina and the womb is. So for women, you’ve probably very aware of where that is. And especially if you’ve maybe had children and you be quite aware because it’s something that we, as somebody who’s had three kids, it’s something that we’re kind of constantly being told to have checked and different things like that. And with cervical cancer itself, it’s often linked to, what’s known as the I’m going to try and pronounce this right human papilloma virus or HPV, which is the main cause of called cancer ways that we know that could potentially help reduce the risk of getting what’s known as a HPV virus is practicing safe sex.

Kathryn (02:14):

And for a lot of the, I’m going to say younger generations now, which makes me feel incredibly old. They will have had vaccines. But a lot of its girls will have had vaccines to prevent HPV whilst doing secondary school. If I remember right now, they’re also now starting to roll that out to boys as well, which I’m very happy about because I, I have all boys lots of types of HIV are about, and about 12 of them are the ones that high risk for causing cervical cancer is, and this surprised me a little bit actually, cause I, I didn’t realize it was this way around, but it’s more common in women who are under the age of 45. And for some reason, I don’t know why, but I felt it was something that was, you know, as, as, as with a lot of things, as you get older, the, the risks of different things start to increase.

Kathryn (03:01):

So it really, it surprised me to, to see that an interesting thing for me is that obviously you’ve said that the HPV virus is the main cause, but again, I didn’t know this one, one in 10 cases of cervical cancer are linked to taking the contraceptive pain. I and I found that quite surprising obviously in terms of the UK, what we have here is a really good cervical screening program that is offered to people who are between the ages of 25 and 64. And then another stat that kind of probably hit me in the face a little bit. When I was we set is that there is approximately nine cases of cervical cancer diagnosed each day in the UK. So I think a good place to start Matt is to talk through what cervical cancer is.

Matt (03:55):

Okay, well, thanks very much. I mean, cervical cancer. And again, we within the clinicians, the doctors and the nurses and so on and so forth do sometimes use the term cancer particularly where we have something called carcinoma in situ, carcinoma in situ by the way, it is not malignant. The condition is not malignant. The cells is not malignant and it’s certainly not cancer, but here we, and I think in, in common terminology it is pre-cancerous, I think that’s probably a term that we’ve, we’ve used a lot in, in underwriting and, and doctors and so on, so forth. However, you know, I just go, when I was looking into the subject again and refreshing my memory, carcinoma in situ, which I’ve gone to explain until later, by the way, what that is, mm-hmm <affirmative> it’s also known as stage zero cancer.

Matt (04:59):

Known for basic cancer pre-invasive cancer, but immediately you’ve got stage naught cancer. And in fact it is not cancer in the, in the, in the traditional way of thinking. I E it, it is not spread anywhere and it is unlikely to spread anywhere in the very short term, okay. When, when is it is actually diagnosed. So there is this confusion, I think when certainly clinicians use the word cancer, but in fact, carcinoma in situ is a pre-cancerous situation, a bit like ductal invasive carcinoma of the breast. What I would do is I think, I think I just work through the premalignant areas and then briefly touch on cancer which I think cancer, generically. Most of our viewers, sorry, listeners will know is where the cells become abnormal and they, and they have the tendency to float around in the, in the, in the blood and limbs grams to distance sites. Okay. That’s really, when you get cancer you define it as cancer in terms of the cell changes. Again, you’ve got pre through areas and the most common ones, I think that our listeners will come across are what are used top commonly abbreviated to sin. And that’s not S I N this is C I N. And that stands for cervical intraepithelial neoplasia.

Kathryn (06:35):

I’m glad you that instead of me.

Matt (06:37):

No, no, no, absolutely. Don’t worry.

Kathryn (06:40):

Good set of words, isn’t it?

Matt (06:43):

Yeah. It’s, it’s, it’s one as an underwriter, I think you get used to, so it, you can’t trip off the tongue, to use that expression. Okay. So this is really where the squamous cells, which is particular type of cell show abnormalities, if you like, which are on the outer surface of the cervix. And they’re graded one to three C I N one, C I N two, C I N three. C I N one technically, and this is where you will get a histopathologist somebody who looks down a microscope at a slide. In other words, C I N one is low grade. It is one third penetration into the outer surface of the cervix. And with C I N one, these are usually monitored and no treatment is actually given, but monitoring is very, very important, once you have a C I N lesion. C I N two known as high grade, and that’s two thirds of the depth monitored, or treated, C I N three is high grade.

Matt (07:50):

It’s the full depth of the outer surface, the cervix, and is usually treated or treatment is offered. I’ve got some statistics here in that, C I N one is generally a monitored condition, and that is because the action of those cells on the surface of the cervix can return to normal. Okay. And therefore treatment would be somewhat over the top for a very low grade lesion. I’ve got a statistic here that, that shows that 60% of C I N lesions actually regress to normal. 30% stay the same and 10% progress to a C I N two or a C I N three.

Kathryn (08:43):

In terms of C I N two and C I N three. Is that kind of the same as like, when we have staging and like you’ve got stage one, stage two, stage three, do those numbers kind of correlate in the same way? No, they don’t.

Matt (08:55):

They don’t correlate. No. With you’re thinking of full blown cancer. I’m assuming typical stage 1, 2, 3, 4. No, not really. It’s just a, it is a, a method by which a lot of these staging’s you’ll find, you’ll find it certainly in cancer. You’ll see it here is a way that doctors identify how to treat or to, or not to treat the, the particular cervical inter epithelial neoplasia. Okay. So if it’s a C, so they’ll classify as a C I N one. Okay. That means we don’t have to treat it. We’ll just monitor it. C I N two may monitor it may offer treatments, CIM three best to have treatment. If the person who has the cervix, of course, which can be in some trans people are willing to take the treatment. So really it it’s, it just determines what type of treatment is required that may, that may simply be follow up.

Matt (09:56):

Yeah. So, and again, it’s the same with cancer full cancer stage 1, 2, 3, 4 will actually define what type of treatment is required. And that’s the same with all the, the majority and not all cancers. Okay. Stage one, I’ll go back to myself. And I’m being a here, but the stage one cancer of the colon really is, is a, is a resection only surgery. Take, take the lesion out of the part of the colon around stage three is when chemotherapy is indicated. Stage four is when chemotherapy is indicated. So as soon as you hit stage three, you know, that you’re going to have chemotherapy or that can be offer to you. Okay. So it’s, it’s really something that the doctors use for trip for, for deciding what treatment. So I said C I N two regression, 60% on C I N two regression, 50, 60% stay the same 32% and 8% go on C I N three. When you have C I N three, which is the highest grade within that particular numeric system, then 32 to 40% will likely to progress, okay. To carcinoma in a CTU stroke and then cervical cancer itself.

Kathryn (11:20):

Suppose the main thing with any of these as with any cancer is, is it’s getting it as quick as possible hundred percent. And definitely trying to see it. I think what’s quite good in some ways. And I don’t know, cause up to, we talk about staging and grading. So when I think of staging, if I were to sorry, think of, I don’t know, an organ or some thing, you know, as the staging progresses for me, I, I kind of like if there’s no cancer there, the organ is just its organ as an ex. You know, I’m trying to think of an example to try and cause I say, I I’m quite visual with these things, you know? Yeah. And then with, as the staging progresses, it’s, you know, there’s maybe a bundle like a circle or a lump of the, these abnormal cells in that organ. And as the staging progresses, in a sense, probably the more of the organ that’s filled with that.

Kathryn (12:01):

And then obviously then it’ll maybe start to go outside of the organ into other areas with the grading. I kind of like when I’ve seen the visual side of things just to, to maybe help other people understand it and make it firm in their minds to what that is, is I sometimes kind of think of a little bit like a brick wall where everything’s really a uniform. The bricks are the bricks and it all looks pretty uniform <laugh> uniform. Absolutely. And then as the grading develops, well, a certain amount of those bricks start to maybe, I don’t know, instead of being rectangular, they start to become a little bit more wobbly around the edges or something. And, you know, then the structure starts to, to not be as, as strong in a sense. And then the, the further the grading is the more wobbly or even, I don’t know, completely different shape of hexagon suddenly comes along as something as well. And I think that’s kind of how I, I frame that in my mind. So what you’re saying as well is that sort like the cervical cancer, it’s not necessarily it it’s, it’s not necessarily that the Dustin two in three thing, we’re not necessarily doing exactly going into the staging and grading aspect, possibly the grading, but I, I don’t know, I’m getting myself a little bit. It

Matt (13:14):

Confuses no, no, that’s right. I think, I think in the way that I look at it and I have to say there are probably underwriter out there who may look at it or, or, or explain it to themselves, put it that way in a different way. CI CN two C, N three are really just numeric numbers. They are not as staging. Okay. okay. In terms of the the way that you’ve just described cancerous cells, which I think is a really good way of thinking about it by the way. Okay. But you know what you do have here, those C I N lesions 1, 2, 3 are still, they diff they’re differentiate is by the depth of the penetration into the, onto the outer surface of the cervix. So they are still abnormal cells. Mm-Hmm <affirmative> okay. But they are not determined to be cancerous.

Kathryn (14:11):

Okay. So as you said, precancerous,

Matt (14:14):

Precancerous. Yeah. That, that’s the word that, that certainly I would, I have tried to understand it, myself, put it that way. I hope that helps a little <laugh>

Kathryn (14:23):

No, absolutely. That really helps. Cause

Matt (14:26):

The big headline is, is pre-cancerous that’s the headline.

Kathryn (14:30):

Absolutely. I think that is really important because you know, it, it is something that, you know, when I I’m doing stuff and I’m helping people that it comes back and I’m sorry, obviously I always double check, make sure I’ve really got my understanding with things. And I’ll, I’ll be thinking like pre-cancerous, but I think at the same point, because it is that thing of cancer St. In grading, as soon as I start to see a number. Yes. So like my instinct is to possibly think, oh right, we’ve gone to a two, or we’ve gone to a three. And obviously, you know, we are saying that in terms of the pre-cancer side of things, yes. One is more favorable than a three. But it’s still not at the, at this, at the cancer level. Absolutely. What kind of treatments would you be ex for somebody to be getting in, in, in any kind of, sorry, the range of things that we’re talking about?

Matt (15:20):

Treatments probably in, in the most generic terminology, I suppose here would be for C I N normally you’d have a, if there is a 1, 2, 3, particularly two and three, if not them all to be perfectly honest with you, you’d like to have a colposcopy. Okay. Something called a colposcopy and this, it, it really decides the test itself decides what is really going on with your cervix. Okay. I mean the, the cervical screenings these days will take a still terminology smears, will take a, the test will give the person looking down the microscope, a view of what’s going on on the service, surface, why do I keep on saying service?

Kathryn (16:13):

There’s lots of cervix, surface, service.

Matt (16:16):

Absolutely, so, colposcopy is really where they take a bit of tissue. And therefore, they’ll look beyond the surface into the skin itself underneath the skin. This, the outer surface is a better way of putting it. Biopsies will, will also some point that was an interesting one for me actually looking into this recently was that sometimes it probably explained a little bit better. Why you have a colposcopy and not just go on the smear, but the, the, sometimes the cervical screenings and the colposcopy results can be different. Okay. I can only think that’s really, because one is on the surface and one is going in. Okay. So it is important to have that colposcopy, but again, it’s a test. Okay. To look what’s going on, it’s not defining whether you have cancer or not. It’s just a test. See what’s going on – C I N 1, 2, 3, and therefore the doctors can then put an advice on further treatment. Yeah. Okay. Biopsies, punch biopsies, where again, they just take a little bit of tissue. The something called a Lletz and it’s actually spelled L L E T Z another wonderful medical acronym for us. And actually it stands for the large loop excision of the transformation zone. And that’s when I did have to look up

Kathryn (17:57):

More like an airport terminal, rather than something that’s happening in the cervix.

Matt (18:04):

That’s something that didn’t trip off the tongue, or simply put it as a loop biopsy and that’s, that’s where they snare a piece of skin from the cervix and, and you take that away and, and do a, a biopsy on it. And also, I,

Kathryn (18:21):

It always sounds incredibly cringeworthy as a woman. So start like, here’s some of these things, but I think that’s, isn’t that the one that’s kind of like, is that the one that’s kind of like a bit of like a loop, maybe like wire loop that is used in one of those things, sorry. Think really don’t want to have that done, but

Matt (18:38):

Oh, no, it sounds absolutely scary. Isn’t it? I mean, obviously terrify it’s when you

Kathryn (18:42):

Mean that chainsaws were originally developed to help with childbirth it’s chainsaws. Yeah, they, yeah. It’s let’s

Matt (18:49):

Logo.

Kathryn (18:50):

Yeah. I was going to say it’s it’s something that I think every woman would rather never ever think about that that may have happened at some point.

Matt (18:58):

Good. God. Well, as, as a father who from being born, I can absolutely equally mind you what <laugh> anyway, let’s move on. <Laugh>

Kathryn (19:07):

Absolutely.

Matt (19:08):

Oh dear. And then you go onto the scanning really. And again, people will, will know of that either themselves or from friends and family who have had MRI scans and cat scans. Those, those will go on if there is a suspicion of something more sinister going on around the SURS MRIs, magnetic, resonance imaging. And that really is I, I would call it the, the gold chip of of scanning.

Kathryn (19:42):

I’m one of those people that I’d be quite happy to have an MRI done every single year. Just all of, I just like just double check. I’m sure there’s some kind of negativity to having an I’ve done every single year, but I just feel like if I could have a scan of everywhere done, I’d be quite happy. I think

Matt (19:58):

<Laugh>, I do know what you mean. And of course those services are, are available in the marketplace, not through the NHS for obvious reasons, but they’re certainly around privately, I think the challenges an underwriter, and I I’m sure the same with with certainly with chief medical officers of insurers, as well as the clinicians of this world is that those scans show things that people never knew really existed.

Kathryn (20:22):

Yeah. It’s

Matt (20:23):

And more importantly, what do you do with those things that are completely new or very, very new? You want to do something about it? Do you intervene, you conduct surgery and that is the absolute classic of those scans.

Kathryn (20:37):

It is difficult. And it’s just reminded me, and I’m going a bit off topic here, but there is somebody that I’ve been chatting to recently that I’ve, I’ve been supporting and in her thirties there was a random test on which showed that she was born with one kidney. Yeah. And it was a case of sort of, there is that thing of right. Well, actually, if that test wasn’t done, yes. Obviously it’s good to know because obviously long term health wise, you know, but in terms of insurance, if the test wasn’t done, the insurance could have been applied for, without having to say, I’ve only got kidney, which then in itself brings a whole of the host of, of questions. And obviously you then kind of think, well, how many other people are living with one kidney, have no idea whatsoever. And applying for the insurance quite rightly in saying that no, there’s no problems with their kidneys because they just don’t know. Yep. And it’s, it is that kind of like balance. So do I want to know about it so I can dress it straight away, but actually then that’s a knock on effect elsewhere potentially very complicated.

Matt (21:32):

It, it is. And you know, I, again, I’m going to draw another story here that as underwriters, now we get, we get fantastic scans of the heart as well as ever other organs as well. <Affirmative> but they, they find absolutely MI micro abnormalities in the heart valves. Yeah. Which they wouldn’t have known about 10 years ago. Yes. But those people, 10 years ago, would’ve had standard rates. What do you do about the people who’ve got these abnormalities, minor abnormalities? Is that a standard rate case or is that a premium loading? It’s quite a debate, quite a debate’s

Kathryn (22:11):

Definit a debate. So it really comes in as well, you know, for people who are living with type two diabetes or high blood pressure, high cholesterol, so many people, no idea that they’re living with these conditions. And as you say, you know, it’s, it’s kind of like, well, what do you do? You know, I, I, I really don’t or the answer, you know, not

Matt (22:30):

Realistic to, it’s not easy. Well, I mean, if you, if you don’t know you have something, then you contract your, you obviously when you sign a proposal form, the answer is no to the yes, absolutely. And if there’s something comes up later on, then that’s, that’s fine from an insurance company perspective. But yeah, it’s the I of some of these new scans and how fantastically sensitive that they are is, is proving a great challenge. But then again, for me as an underwriter, that’s what the world is all about. And that’s, what’s so great about underwriting cause it changes absolutely so much different challenges.

Kathryn (23:07):

So when it comes to things like the cervical cancer and, you know, I think it comes down to obviously as with insurance, it’s all about risk and insurers and underwriters. When they’re assessing things, they’re looking at what is the risk of this person claiming on this policy? So for life insurance is the case of based upon this person’s medical history. What’s the likelihood that what they’ve had previously in the past is going to potentially affect how long that they might live for, with critical illness cover it’s how much is there a risk of this person’s past for them potentially to develop, you know, a critical condition and in turn, make a claim. And then with the income protection again, it’s like, what is the likelihood that this will potentially affect this person to a point where they’re unable to work? So I suppose when it comes to things like the things like cervical cancer and obviously as well, I know we’ve, we’ve spoken quite a bit about sin the sin side of things.

Kathryn (23:57):

And you know, in terms of like, if it had been full cancer of the cervix, then people were, would be expecting possibly potentially chemotherapy radiotherapy possibly removal of at least some of the reproductive organ to, to try and obviously stop the cancer spreading. But what, in terms of, as an underwriter, when you see, you know, cervical cancer or potentially those sin readings coming in, what’s standing out in your mind in terms of like, right, well, this is something that, you know, I’m, I’m, I’m not worried, but this is the risk that I see.

Matt (24:38):

Absolutely. Well, the, the classic with the, we talk about the pre-cancerous first, because that’s the, that those are the main, main, the most common areas that we see from an underwriting perspective. Really, it, it would be that, that the person, once the person knows they have a lesion, is that they are followed up and treated as necessary. They, they follow medical advice as such with all those three C ones, sin two CIN, three you’d want to have, at least you’d want to know the di initial diagnosis. So you want to know what Sy lesion it was or whether it was carcinoma in city for that matter. Or the other types of, of sin, which I Haven about really, I very, very quickly mentioned C G I N, which is the cervical intraepithelial neoplasia. And that’s where the cells of the canal within the cervix that leads the uterus, the wound are impacted. And also something called smile. I’m not sure if that wonder a acronym again, smile.

Kathryn (25:50):

Okay. Begin with a CS. Let’s just try and establish.

Matt (25:54):

So sorry. Thinking

Kathryn (25:56):

Sy starts with, since starts with a C yes. Instead an S so I’m thinking smile, what does that start with a P or something?

Matt (26:05):

I don’t know where the E comes from. It has to be said, I’ve looked at, I can’t find it, but smile sounds, sounds for stratified mirror in producing intra epithelial lesion. Okay. Now I would suggest that that particularly is one where the doctors of this world, and of course I’m using that in a very generic sense. Mm-Hmm, <affirmative> have come up with something which they can’t fit into the general CIO, CI N 1, 2, 3 lesions, and feel it should be treated in a different way or monitored in a different way. Yeah. But all of these things really come from, well, let’s some abnormal cells here. What are me as a clinician, me as a doctor, what am I going to do about it? Okay. Yeah. So those, you, you, you may come across those. I must admit, I’ve never heard of smile before I did a little bit of prep for this for this chat.

Matt (27:04):

As I say, they could, both of those rather, like the CN can be, could be monitored or actually, or actually treated in terms of the, you talked about risk. Okay. So you’re looking at sins or, or those do, it’s the, it’s the, the chances of those developing Interfor blown cancer. Okay. And we’ve talked, gave some stats doors about regression. Yes. And whether they stay the same, other words, they don’t progress than the cases that do progress. C I N one doesn’t progress. Very rare. Rarely does it progress to cm two, as long as it’s Mon monitoring to make sure it doesn’t, it’s obviously very, very important. And then you go higher than the chances. Are it progresses quicker? What are neuro of concerned about with the the sin CN lesions are the progression to cancer. And as we’ve already, I’ve already mentioned some, the statistics given earlier this morning the lower, the C grading, do I use the word grading C I N one is, yeah.

Matt (28:12):

The, the, there are slim chances 10%, isn’t it? To progress to C I N two C I N three. And then you’ve got C I N two, which we’ve discussed C I N three. You discussed; you’ve got carcinoma in situ after that. So you have an individual would need to go through all of those levels of, of sin. So if they, they need to go to two, three in CTU before they got to cancer. So, and from an underwriting perspective, C I N one, as long as it it’s being monitored, then it is, it is not a concern. Once you get up to cm, three in carcinoma sorry, Caroma and CTU importantly then there is more of a concern that matters may get may progress and cancer could be in the future in the short term. Okay.

Matt (29:12):

So underwriter, obviously we were more worried about those, again, as in terms of the I’ve, I’ve mentioned the treatments or not monitoring or not of those sin lesions then treatment will be, if treatment is required, then that will be, that needs to be carried out for <inaudible> really to be able to provide terms once those, once those of the treatment has been given if needed then and it is successful. Success looks like a repeat test to show that the, the sin lesion has gone disappeared. Then again, standard rates for life insurance, isn’t a proper same with carcinoma in I as well, standard rates for life insurance. Not a problem, again, must be treated and there must, and there must be a follow up test, which show that those abnormal cells have been removed or have disappeared.

Kathryn (30:18):

Yeah. I think that’s something that’s really important that as well, because obviously we have obviously a lot of people who come to different situations and we do have quite a few women who will come to us. Who’ve had maybe some abnormal cells in a smear test. Yeah. And what you will generally find is that most insurers want to see a smear test that has been in a sense shown a normal results before they able to offer the insurance. And I think, you know, for, for, as, as a woman, you know, having that kind of a test where, you know, potentially you are told, oh, it’s just a wait and see kind of thing, approach disappear on its own. Or maybe just, oh right. Yeah. We’ll just pop up to the I know some of my friends, you know, maybe popped up to the hospital and had I think it’s possibly like a, a certain very, very small procedure done. That is literally just a case of you maybe just feel uncomfortable for a day or two. I think for a majority of people you wouldn’t necessarily think, I think that that would maybe put the stoppers on getting the insurances. So it’s really important that people know that that that could be what they, they face. So interrupting now I just make sure I got

Matt (31:23):

At all. No, no, no, no, no clarification is, is, is very, very important. No, I would agree with, with, with everything you’ve just said there a again, I would just reiterate something that I, I said before casts also known as may here, somebody in with the medical qualifications say <affirmative> stage north cancer. Yeah. As you heard the word cancer, you think, oh my goodness. And, and, but you have to remember that stage north cancer car city of the cervix is not cancer. Yeah. Not malignant cancer. Yeah. I think if I remember rightly when you and I spoke or had a session on malignant melanoma yes. The same type of problem. Sometimes people have skin cancer. Yeah. Locally knows skin cancer, but it is not malignant. Yeah. So it is important for people not to panic. When they, when they hear certainly C 1, 2, 3, and also cost number to two. Yes. And if Indi talk to your medical professional. Yep.

Kathryn (32:30):

I was also going to say it as well. The NHS site is really good. And, and a lot of the time when I’m looking at things I’ll often look at charities, but I’ll, I’ll specifically look at UK based charities just so that I can, cause I often have so much information on them and incredibly good. And, and they’re always really, really useful in terms of really explaining these things to, to quite in depth detail.

Matt (32:54):

Absolutely. No, to is very good ID like to throw in another medical term, which the older, certainly that includes me listeners will have heard of, and that’s theosis.

Kathryn (33:09):

I’ve never

Matt (33:09):

Heard of that. Yeah, absolutely. Well, just shows you my age, Kathryn. <Laugh> thank you for reminding me, sorry. However, certainly underwriters, I will no doubt have seen it cause it’s if they are looking at detailed medical records of someone who is of a certain age and what I mean by that is over 50 I’m well over that, so thank you. I’ll just get that in. But really it’s it’s means that there are changes to the cells. Okay. It is not the same as CI. Okay. It’s it’s just extremely general term and OSIS. Therefore, if you sit on a medical report underwriters out there you need to know more information. Yeah. Theosis it’s like you to be followed up because there are changes to the cells. It needs following up needs Mo monitoring, but really it, it is not the same as CI and you can see where, where CNS more modern and ality gives it levels when two, three.

Matt (34:18):

Okay. Okay. So I just thought I throw that in for, for, for, oh, really good to know. Thank you. A medical bent out there. Okay. In terms of cancer itself, if we, if we go that far, I think cancer, you’ve kind of you’ve, you’ve, you’ve covered really the main points because generic the majority of cancers have staging, which you’ve already mentioned invasive carcinoma of, of the cervix will come up with stage one, a and one B two, a two B three, a four, a and four B. So again, you’ve got those classic four stages. Yeah. Which those who who underwrite or, or in the broker distribution community will maybe have been disclosed and really the, the stage ones have the best prognosis stage fours, again, like all lot of cancers, if all the stage four have the worst prognosis stage one, just to, just to underline that really a, a kind of microinvasion so up to three millimeters.

Matt (35:36):

Okay. Four B is the worst where you’ve got metastases to distance sites and effectively as I sure lot listeners will know, metastases is where the cancer is spread away from the unit, the original site, original organ, and has ended up in other parts of the body <affirmative> typically liver lungs and very occasionally brain. Yeah. Okay. So again, you will have different treatments for those surgery radiotherapy chemotherapy for, for those later stages in terms of an underwriting context, then I believe that quote, that that any case of stage one and two will be postponed a decision will be postponed for three years from when the treatment stopped. Okay. So if it’s simply surgery, date of surgery, three years, stage four stage three and stage four, generally you are looking at at least five years of of, with no recurrence.

Matt (36:57):

Okay. Then you are still both, I want to say three years, you’re still going to get a rating after that with loaded premium. And in five years, you are more than likely to get a loaded premium after five years as well. Yeah. so again, those probably those, I probably, I don’t think shout if I’m wrong, need to say too much more about cancer because it follows the I don’t mean clinically here. I mean, from, from a risk perspective. Cause we’ve we the way that we try and group yeah. Outcomes and prognosis, then it, it’s not too dissonant to a lot of other cancers out there.

Kathryn (37:36):

Okay. Thank you. I think that’s something that’s really important as well. Cause it is something I have to discuss with clients at times, is that what the medical professional professionals will say in terms of prognosis and stages of not necessarily the stages of cancer, but in terms of the person’s recovery and, and where they’re at is very different to how potentially the insurance world will view somebody. So, you know, you could have somebody who’s, as you say, five years down the line, and obviously it absolutely rightly the consultants are incredibly positive. They’re saying how good everything is looking and that they are very, very happy. And, you know, for them, they’re expecting this person to, to live a lot long life. And that can be quite hard. I think sometimes then to actually then reach out to the insurance world sometimes and go, and to then be told, well, actually your medical professional is saying that, but actually we still see from the statistics that you’re not, you know, it’s, it’s, it’s very hard, I think for people to kind of not to accept that, but it’s, it’s hard to hear. I think

Matt (38:43):

I, I completely completely understand. And again I’ve mentioned it before in my own case had stage three colon cancer, as you know. Yeah. And after five years from the, the cessation of the chemotherapy you know, my consultant who obviously over, over a, a five year period, you get to know very, very well. And you know, he said, well, you know, you you’re okay, you’re you go and live your normal life now. Yeah. 12 years on my life, my life insurance, some insurers still rate me. Yes. So some will do standard rates, just some, still some still apply a loading. So there’s, there is a classic example of the difference between a clinician’s view and an insurer’s view. I think, again, one of the things around the five year, oh, you are absolutely fine is because ultimately cool. Tell me maybe, maybe I’m a little bit of a cynic, but ultimately your NHS can’t actually support the follow ups in those small proportion people that will get recurrence of their cancer. And they just simply, can’t now a small number to a clinician is not necessarily a small number to an insurer. Yeah. And I think that’s the absolute classic there. No,

Kathryn (40:14):

I think that’s a really clear example, Matt. Thank you. No worries. I have a case study for us to sort of end on just to sort of explain, obviously I know we’ve got your case study there, which is a really good one. So thank you for bring that to

Matt (40:26):

Us. <Laugh> not cervical cancer though. No, not cervical cancer.

Kathryn (40:29):

But in terms of cervical cancer a case study that we have, and we do have a blog coming out on the care website soon that has a couple of extra case release that people might find interesting. But the one I’m going to be talking about today is a woman that came to us in her late twenties and she needed life insurance for her children. She’d had cervical cancer two years before we arranged her policy and it was classed as a stage one a and that had been a procedure to remove it. And ever since then, all the tests have been clear. And it was, it was one where it, it being caught at the, in a sense, the most favorable time in, in terms of treatments and, and prognosis. And what we were able to do is arrange for her a level life insurance policy of 230,000 pounds, over 34 years for just under 19 pounds per month.

Kathryn (41:19):

So as with anything, with these kinds of policies and the pricing and everything, everybody is completely individual, you know, obviously age really comes into it at the staging, the grading of the cancer, whether or not it was cancer or pre-cancer cells have a huge impact upon things. But I’m hoping that by hearing that it’s obviously that, that nice amount of money to potentially leave to her children without being under 19 pounds per month. I hope that a lot of people can, can hear that. That’s, there’s always that worry that the prices are going to be silly and, and see this one is, is a nice example where the price isn’t, it hasn’t been silly if I can just put it that. And it’s the best context that I think I can, but at this moment when the words are failing me

Matt (42:04):

You know what you mean, Kathryn?

Kathryn (42:05):

Yeah. Good. I’m glad, you know, I mean that I

Matt (42:07):

Do. No, no, no. I know exactly what you mean.

Kathryn (42:09):

<Laugh>, I’m glad I’ve got one person who understands me. I like that. <Laugh> well thank you everybody for listening and thank you for all of your insights as always that it’s been great to have you on board again.

Matt (42:22):

Well, thank you, Kathy. Thank you for inviting me. It’s it, it, it’s, it’s good to talk. We, we <laugh> as you and I always say. Yeah. And you know, for those people out there who have issues with, with cancers in the, the, the cervical region or, or, or SIM lesions, please talk to your financial advisor before for thinking nobody will cover me because as Kathryn has already pointed out you know, there is generally a very good chance of being covered or at least you’ll know you can’t be covered now when you’ll be able to be covered. Absolutely. Thank

Kathryn (43:03):

You. No, of course. Thank you. I have to say, in terms of the talking thing, I have to say to everybody, we do have to try and behave ourselves. Cause we usually natter for at least 30 minutes before we actually start the podcast. And I think the longest weed far was an hour. We put the world to write, and, but for today we did it for 30 minutes. So we did well. Next time I’m going to be back with why McLoughlin for even more industry insights. If you’d like reminder the next episode, just feel free to drop us a message on social media, I’ll visit the website, practical-protection.co.uk. And also don’t forget that if you’ve listened to this as part of your work, you can claim a CPD certificate on the website to thanks to our sponsors, the Octomembers. And what’s even better is that I sat down with my tech guy the other day and we figured out the book that was meaning that the certificates weren’t auto coming out. So that all done. We now don’t need to be carry on manually sending them out anymore. So very, very happy and relieved people within my team at the moment for that. So so thank you so much again, Matt, and I will speak to you soon.

Matt (44:08):

My pleasure. Yeah. Look forward to it.