Kathryn (00:03):
Hi everyone. We’re on season five, episode 10, and I have Matt Rann with me. Hi Matt.

Matt (00:09):
Hi, Kathryn. How are you keeping

Kathryn (00:11):
I’m very good. Thank you. How are you?

Matt (00:14):
Yeah, yeah, I I’m very I’m well, and I’m very pleased that, um, I’ve recovered from, uh, my, uh, out of COVID, uh, as indeed the rest of the family. So, um, we’re up, up and raring to go. In fact, a little bit of a story there. I, um, tele interviewed a client, um, the other day. And as you do, um, you need to ask them what’s common to ask them whether they’ve had COVID and they were hospitalised, wait for recovery and things like that. And the chap turned around and said on the phone turned around and said, well, actually, yes, I have had COVID and do you know what? I can now lift twice my normal amount at the gym and run twice as fast? What he said it was like kryptonite.

Kathryn (00:59):
I was going to say, I’ve not heard it that way around. I’ve heard it, definitely it the other way around, but not that way.

Matt (01:03):
Absolutely. Absolutely. So, um, this part, this particular cha has had a kind of a renaissance almost. I, I can’t say that’s a very good, um, uh, endorsements of COVID.

Kathryn (01:16):
Absolutely not.

Matt (01:17):
No. Well, as we both know, we certainly wouldn’t recommend it, but there you go. I thought, um, that that was a little bit different. So I thought I threw it in.

Kathryn (01:24):
Absolutely, absolutely. I was going to say, well, just in case we shouldn’t get any noise in the background at all at my four year old is home. Because he tested positive for COVID for the second time, since January, uh, last week, he’s fine. We’re all the rest of us are all negative. So we’re kind of also wondering now if it was a bit of a false positive, because I mean, he’s obviously completely in my face all the time as our four year olds are and I’ve not got it again. And he’s, he’s very close to his, especially his seven year old brother, again, very close to each other’s faces, no matter what we do to keep them apart, you’ll suddenly find them together like nurse to nurse and you think, well, yeah, so, well he’s enjoyed having some time off school. Luckily it was partly over a weekend, so it wasn’t too intense, but, uh, but yes, very, very interesting. And uh, as always very thankful for grandmas on hand. So today we’re going to be talking through testicular cancer and insurance. This is the Practical Protection Podcast.

Kathryn (02:21):
So if we jump straight into things matter as always, we have a little bit of a chat beforehand just to make sure that we are both sure about what we’re going to be. Kind of like what we’re going to be saying, what kind of like route we’re going to be taking the conversation. And, um, I know you’ve picked up some quite interesting thoughts on one of the, kind of, one of the statistics or guidance things that I’ve found. So I always do a bit of research beforehand on the topic because whilst I know about testicular cancer, I don’t know all the statistics off the top of my head. And, um, and I certainly don’t know anything and everything about the condition. So I also want to make sure that I bring a nice rounded kind of bit of background information when we start the podcast. So in the research, um, I came across the fact that, um, in the UK, there were more than six cases of testicular cancer diagnosed every day and testicular cancer itself accounts for 1% of cancers diagnosed in men in the UK.

Kathryn (03:16):
And I’d say, just looking at those statistics really surprised me actually, because I was thinking it’s only 1% and I was thinking, surely, you know, what about all the others? You know, we’ve done podcasts before about prostate cancer and it’s obviously such a higher percentage of the amount of cancers that are diagnosed for men. But 1% to me, not that it’s not something the gating how important it is and it how difficult it can be to have cancer, but it sounds on like such a small, small amount of people. But then when you actually, I think this probably comes back to the whole thing about statistics, isn’t it? When you look at the math, it’s 1%. So you think, oh, well that’s not many people, but then when you humanise it and you say, well actually that’s six men every day in the UK that it, that feels a lot more like it’s a lot more people.

Kathryn (04:00):
And I know it’s not in the grand statistics of, you know, how many people are diagnosed with a heart attack every day in the UK, but still that, you know, it’s six men. And that really, that really surprised me actually, especially seeing that difference of how the numbers can just change so much, depending upon the context in which you present them. The prim age diagnosis is actually between the age use of 30 and 34 years. And maybe you’ll be able to correct me at some point, Matt, if I get this one, but I’m sure I saw something that said that really. I think it’s like over the age of 75, that doesn’t tend to really be many people in that age group that, um, are diagnosed with testicular cancer. So it is more sort of around sort of like middle, I don’t want to say middle ages at you because I’ll probably get told off, um, for saying that, and I’m 37 and I don’t necessarily want to think of myself as middle age. Um, but um, hang on am I 37?  I’m going to get myself confused now. No, I’m not. I’m 36. I was thinking to myself, I don’t remember turning the

Matt (04:55):
Was the right way. Exactly.

Kathryn (04:56):
Yes, exactly the right way, but then even better when it comes to, when we’re looking at things 91% chance of survival from a testicular cancer diagnosis, which is just absolutely incredible. And I think there is probably quite a few reasons why it’s that high? My, my thought is because again, Matthew may correct me on this, but my thought is probably that the testicles aren’t something that people, well generally don’t see and avoid in a sense of, you know, if it’s something that’s much more of an internal organ, then it’s going to be much harder to notice or any kind of differences. And um, and obviously in terms of sensitivity in that location, I’m trying to be so careful with my wording here. Um, sensitivity in that location. I imagine a lot of men would probably notice quite quickly if there was any kind of particular changes. And I know you’re definitely going to have some thoughts on this next one.

Kathryn (05:54):
I’ve just, haven’t had a quick chat about it, but when you look at, um, the websites and different things like that about it, they do say that there’s no specific way to prevent testicular cancer. So with a lot of, um, cancers, when we’re talking about things, there will be certain things like lifestyle factors. That’ll say things like try and keep it a healthy BMI don’t smoke, uh, try and avoid alcohol as much possible regularly exercise. And what the evidence suggests is that those things don’t necessarily have a direct, um, correlation to testicular cancer being diagnosed. So that’s quite a lot of things there that I’ve just gone through Matt. So do you want to kind of take, uh, sort of like a bit with all of them and have a, a good thing in generally as well? Just tell us about testicular cancer, please.

Matt (06:40):
Okay. Absolutely. No problems just to go back on something that you said about the over 75, you, you you’re absolutely correct that, that statistically certainly out there that is extremely rare as a because of death in, in men over the ages of 75, which brings it back. This is a, um, a cancer of, of younger people and I understand it to be the most, uh, productive isn’t the right word. It, it is the highest rank cancer, highest ranked cancer in for young males. Yeah. Um, of all the cancers. So again, it kind of, it, it’s an interesting, isn’t it, it puts a spin on, um, uh, you know, your 1% figure that you, that you mentioned. Um, but, and also of course the, um, six, uh, diagnoses every day in the UK. Um, but for young men, it is, is the biggest killer. Right. Which is an interesting one, I think.

Matt (07:43):
Okay. I mean, I’m sure, uh, all, if not everybody knows, um, the biological, um, state of the testee, if you like on an old level, uh, but just in case there’s one out there who doesn’t, um, repeat, uh, that the testicles are too oval shaped male sex organs, and they sit inside there and nearer side of the penis. Now the testicles are an important part of the male productive system because they produce sperm and I’ll go onto that later on the germ cells are very important and also it produces a hormone testosterone, which obviously plays a, a major role in, in male sexual development. So apologies for that very basic biology lesson, but, um, nice,

Kathryn (08:31):
Useful.

Matt (08:31):
Thank you. I think it’s, it’s just worthy of repeating, um, refresh people’s memories if indeed they do. Okay. Um, as you’ve already said, Kathryn, I think testicular cancer is no doubt. One of the less common cancers. And if you look at all the cancers, um, that occur, um, it is actually ranked the, the 17th most common, um, in between years of 2016 and 2000, uh, and 18, I think the, the challenge that we do have is that the incidence rate has actually doubled since the mid 1970s and like testicular again, cut that you’ve mentioned. Um, there’s a lot of lack of you about the reasons why, uh, on some of these things and, and particularly the reason is unclear on why that has that there has been that doubling, um, as you’ve already said, estimated lifetime risk is, is one in 215 to go statistical on the, on our audience.

Matt (09:31):
So that’s less than 1% for males born after 1960. Okay. Uh, you’ve already talked about them, was the people, um, being diagnosed on a daily basis and also, uh, 10 year survival rates. Okay. Now I thought some perspective might be useful in the context of, uh, the, the 17th ranking and all the other numbers that we put together, but this is, um, 70 type lifetime risk of one or less than one, sorry, one in 215 or less than 1%. Now we’ll look at the, if you compare that with the statistic that we see on critical plans, um, all the time, just as a reminder, that one and 250, less than 1% compares with a lifetime risk of 50%, uh, IE one and every two will be diagnosed with some form of cancer in their lifetime. Yeah. So those are statistic. I think that we all know because of critical illness.

Matt (10:32):
Uh, but that I think is also another perspective of where testicular cancer sits in with the overall, um, cancer diagnosis area. Um, we’ve again, again, Kathryn, you, you, you talked about it most common cancers very, very quickly not talking about them today, but prostate followed by breast followed by lung, followed by bowel, that accounts for about 53% of all new cases. It’s quite interesting looking back at, um, some of the statistics that are, that are around in fact that in terms of this is directly testicular, so you’d have to excuse me. Yeah. But in terms of the last 10 years, thyroid and liver cancer have been the, have shown the fastest increases in both sexes in ladies, kidney, melanoma, skin cancer, head and neck cancers have shown marked increases and kidney melanoma, Hodgkins, lymph infirmary males. Okay. ULAR cancer. Despite me saying there’s been enormous increase back from, um, since the seventies doesn’t get into those league tables. So again, I think we at, um, the way that statistics can be interpreted mm the, as you’ve already said, the key ages of diagnosis are age between 30 and 34 to expand that a little, um, uh, cancer is mostly, mostly affects, um, men between ages of 15 and 49. So obviously your 30 to 34 fits in very neatly into the middle there.

Kathryn (12:05):
Yeah.

Matt (12:06):
In terms of the early signs then, um, and in large testicle or small number or area of hardness in the testicles is often the first sign. Um, but I, from memory, the NHS, uh, do have, uh, five warning signs for testicular cancer. It’s worth just running over these. If you feel some swelling or pain of discomfort in the scrotum or swelling. You either testicle often painless. So I think that’s something just for men to bear in mind. Okay. Or mothers or sisters or whatever, when they’re talking to men, uh, we’ve already touched on painless discomfort and testicles changing how the testicle actually feels. That’s a little bit vague, I think, but I’ll have to leave that once your imagination, I think. Yeah. Um, a dull ache or heaviness in the lower abdomen or groin. So just don’t think about testicles per se. If you’re getting aches down, down in that area, let put it that one down the lower abdomen of the groin, just, um, pay a little bit more attention than you normally would to, uh, sort areas. Yeah.

Kathryn (13:17):
I was going to say, I think generally it’s, it’s just good advice for anything isn’t, it matters it in many ways, it’s sort of like, you know, as a woman, if, you know, if your breast starts to feel uncomfortable, go get it checked out. If you’re a man and your testicles starts to feel uncomfortable, go get it checked out. And I think, I don’t know if there’s still this kind of thing of where sometimes, you know, men tend to not want to go and hassle a doctor and, and, and things like that. And they’re just rather, they just say, yeah, well, you know, see how it goes, but you know, it is really something that’s, if there is, if there’s probably persistence, maybe discomfort or persistent change or persistent lump, and really it’s, it’s something that someone should really be getting checked.

Matt (14:01):
Absolutely. And I think it’s the persistency is the, is the difficult quantifies, isn’t it. And in any situation testicular or any other scenario, um, I personally, it’s a personal abuse. Isn’t an underwriting comment per se. I think if you have a lump or a painful, painful, they talk testicles as that’s the subject we’re on, but more than say seven days, I think you need to see your doctor. Yeah. Um, or, or get a medical view. Let me, let, let me put it that way. Um, but yes, you’re absolutely right. It’s, it’s, it’s good advice for, for all types of, uh, ailments as there’s no two ways about it and good us men. Aren’t great about seeing doctors as, as search is well known. I think it’s certainly, um, present in the media. Um, so, so don’t be shy. Um, doctors are there to help and they, and you know, as, as you see all the time they’ve been there done it, seen it a hundred times. So don’t, don’t feel embarrassed.

Kathryn (14:58):
Yeah, absolutely.

Matt (14:59):
There, there are two main types of testicular cancer and they really classified by the type of the cells where the, the cancer actually begins. And, um, in generic terms, um, the most common are germ cell testicular cancer. And that accounts from 95% of all cases now germ cell alluded to something or, sorry, goes back to something I mentioned earlier, a germ cell is a type of cell, the body uses to create sperm.

Kathryn (15:27):
Okay.

Matt (15:28):
Okay. So there is a kind of a generic terminology there, but those, um, are broken down. The gym cell counts are broken down to Sue subtypes, and these ones will be, um, more common to the underwriters and the claims folk out there. And also of course, anybody who has, um, suffered from testicular cancer themselves or, or heard had a friend suffer from the same

Kathryn (15:52):
When you say germ cell. Yeah. Is it literally, is it germ like G E R M?

Matt (15:57):
Absolutely.

Kathryn (15:58):
All right. Okay.

Matt (16:00):
Yeah. Um, I think, I think germ sells you, you can get germ cell, um, kind of a predetermined for wheat growing and all types of things.

Kathryn (16:09):
Okay.

Matt (16:10):
So, um, yeah, it, I think ger as in the bug kind of comes as a secondary to, to J being the producer of something that grows.

Kathryn (16:20):
Okay.

Matt (16:20):
I think I’m sure of anybody out, out there who is, um, knows Latin or Greek would probably put me right on that one.

Kathryn (16:28):
I was just thinking to myself, I’m sure you’re saying germ, and I’m think I’m surprised somebody to said like German relation to some kind of, a sell, you know, it just seems like such a specific, I, I don’t know. It just seems to have a different connotation depending if on we’re talking about it.

Matt (16:42):
Absolutely. I, I can certainly come up with a comment about some something to do with germs. Um, and, and, but I won’t because we’re, this is a, this will go out to the public. So either which way you’ve got two, two German, sorry, two main subtypes of, of, uh, ger cell. And these are, I say, um, be probably more common to underwriter or, or IAS who, who tend to deal with preexisting medical conditions. One, uh, is called seminoma or seminomas. Um, and they tend to grow and tend to spread more slowly than the alternative group, which, um, nobody has really well at the time. Nobody really used their imagination to, uh, to classify it as non seminars. So you, you have, so to repeat that two, two sub sorry, two main subtypes ones called seminars and the other non seminomas, the non seminomas, uh, are more common than seminars and they account for 60% of all testicular cancers. Now, in terms of the nons, that really doesn’t help me particularly, although it has to be said that they are treated the same as seminars. Um, initially at least I’ll go on the different types of treatment later on, but your underwriters and, and, and, um, people talking to people with, uh, clients who have a history of, we also maybe hear the client mention it or a doctor for that matter mention teratoma and the is a form of nonno. I that’s, does that make sense? Okay.

Kathryn (18:23):
Yeah, it does. I think sometimes, you know, when I talk about different things, not saying sometimes when we talk, I specifically, we in you, I just think, you know, sometimes we talk about medical things, sometimes it can start to feel a little bit. Okay. So we’ve got things like carcinoma now we’ve got seminar and te trauma and it’s, it can be quite sort of okay. But I suppose that’s the thing, you know, it’s really useful for, for advisers, you know, who are potentially speaking to people, if you hear seminar and then it’s, it’s, you know, obviously thinking straight away, right. That’s possible a cancer then. Yeah. Yeah. And then to think of where that is. So the, so, so non-melanoma, does that just mean it’s a cancer that’s different or does that mean like, it was non-cancerous

Matt (19:04):
Oh, no, no, no, certainly malignant or it’s, it’s just a, a, a subtype of a germ cell.

Kathryn (19:12):
Okay.

Matt (19:12):
Cancer. Okay. So two types, two different types effectively, so you can put non seminomas. Um, you’ll see. Particularly these days they often known or called OMES as well. Okay. Okay. There are other types of, um, of, of, uh, testicular cancer, but I won’t go into those now, now even more slightly confusing thing, uh, to, to, um, listeners might be that you can actually have a mixed Sula tumour.

Kathryn (19:40):
Right.

Matt (19:41):
And therefore, when I say mixed, it is literally mixed. So you can actually have a tumour, which is part Semino and part non Semino.

Kathryn (19:50):
Oh, how unusual?

Matt (19:52):
Uh, in indeed. Um, I couldn’t absolutely give you the physiology of all of that, but they, they certainly do occur. So would

Kathryn (20:00):
That treated as, like one tumour?

Matt (20:03):
Yes.

Kathryn (20:05):
Okay. Because that’s really, that’s really interesting to know. Because I think if I instinctively, if someone had said to me that they’d had something and something, I would also to be thinking, oh, they’ve had two. And even if they told me they’d had one, I think my, even though I would research and obviously, and I would obviously speak to underwriters for clarification. I, I do think that my instinct would be to think, well, that must mean too. Um, so really, really good to know that. Thank you.

Matt (20:28):
Absolutely no problem to remembering that they they’re both germ cells types of germ cells and, and they are located in the testes. So that kind of takes you back to the one, but you obviously have to try and remember that. And I, and I completely agree with you what you, what you’re saying. Um, as I say, there are other types of, um, tumour specific names, but, uh, let’s, let’s not go into the, for the moment and the purposes of this chat. Okay. Well, we looked at, um, the, the, the term that you mentioned, Kathryn was no specific ways to prevent testicular cancer. And yeah, it’s interesting when I, when, um, all about the term prevent, I suppose it could mean different things to me and to other people. Um, but I think it’s certainly very important to mention that one of the because of, uh, testicular cancer is, is, uh, an understand test or in send testicles. And that’s has this wonderful name of crypto organism. Oh. And is the, uh, most significant risk for testicular cancer. Okay. So the, you then get into this word prevention and the reality is, um, that, uh, young infant boys, um, as far as I’m aware, would always have their testicles checked at almost their first meeting with a medic. Um, certainly I remember it with my son.

Kathryn (22:01):
Definitely happened with mine. I can’t remember if it was the first meeting or not, but it definitely happened with mine. And I didn’t even think for second it was anything cancer. I just thought all the checking everything’s there.

Matt (22:12):
No, absolutely. It’s not that, of course it’s not in any way of diagnosis of cancer, but in, is that on the basis of prevention is better than cure. Yeah. Then let’s make sure the, the testicles have descended because they’re, they they’re actually hidden in the abdomen. They hidden, they are in the AB and then they descend, um, at birth or, or within a few months afterwards. Um, so the doc really is just saying, well, look, if they’re there, great big tick. And if they’re not, we just need to keep an eye on things here. Yeah. And the testicles can descend, um, to be perfectly honest with you over a good number of years, but usually, um, within the first couple. Okay. So three, three to 5% of boys have this condition of birth. I understand the testicles. Um, and they usually descend within the first year, first, first year, first couple of years, maybe, but some do not.

Matt (23:10):
Um, and it’s important that they are moved down in early childhood and that can be done by relatively simple operation, um, again, to talk statistics men. So we are talking adult men here with unended testicles. How are about three times or three times more likely to develop testicular cancer than men with descended testicles? So it is important. And I can, for me, this is around prevention. So I would kind of take, I would disagree maybe with the word prevent. Um, however, I can, I can see that there is a, you know, a, a play, not a particularly good one, but a play on the words here and how those words are interpreted. Okay. Um, the risk factors here and underwriters, this, we are talking here Andal generally get sort out. Okay. Because they are things that are checked, either doctors at birth, um, but may have been missed. Maybe the parents didn’t want surgery to take place. Um, but risk factors, um, are present from an underwriting particular cancer perspective where the condition isn’t corrected at all and also where the surgery hasn’t taken place by their use of 11 to 13. Okay. So those, the risk factors as an underwriter would look at

Kathryn (24:36):
Okay.

Matt (24:37):
For both, well, for all of the risk products, namely life only critical illness and income protection, um, prevention. Yeah. Otherwise the only thing I can really, um, harp on and talk about there is the, is let’s use the, um, the medical term crypto or, um, and looking after yourself there or looking after your, your son there. Um, but otherwise prevent any other preventions and why and where falls. Aren’t really no at this stage. And that’s despite substantial research on the subject. It’s, um, it’s, it’s amazing really given these days of, um, fantastic research and science, as we all know from COVID as an example. Um, but there we go. Not, not for this particular one.

Kathryn (25:26):
No, absolutely. I was going to say as well, I do really apologise. because now my, my five year old is definitely back and he is nearby and, um, and I’ve managed to, uh, keep the, the, the, the noise on my side, quiet for a while. So you were just explaining everything brilliantly there, Matt, and, um, and hopefully, um, I’m not going to catch it too much when my microphone is on. Um, so I suppose the next thing, when we’re looking at things, um, in terms of like advice and in terms of getting insurance policies, one thing we always talk about with cancers are usually chat with cancers is things like the staging and the grading. Are we looking still at staging and grading with testicular cancer? Are there any other kind of readings that we should be aware of,

Matt (26:05):
Um, in terms of the, the staging itself? No, you, you, I think you find that, um, every cancer, I stick my neck out rather on the, every the word every, but every cancer is going to have a staging of some sort or another. So you’re absolutely right. That, that, um, particular cancer does have staging. And, um, again, we have a type of cancer that has different staging’s dependent on which parts of the worlds that you were like in the, the way that the doctors, which, which kind of staging they adhere to. So for instance, Americans have different one to, to most Europeans, but here we’ve got actually for, for UK Europe, we’ve got two types, sorry, two different ways of staging. Let me put it that way. And the first one very, very quickly runs through, um, because they were all, I think whatever it comes through is they’ll, they’ll have a familiar ring, but the first one’s a number staging.

Matt (27:02):
Um, and stage one is where the cancer is, um, contained within the testicle. And you’ll get, um, a description of a stage one a, or a one B depending on the size of the tumour now, importantly, and if I may have got time, I just knit back to some of the treatments. because I think they may have maybe have some interest to, to people, but one of the reasons why they think that, um, in fact it is, I, I believe it is the only type of cancer where blood markers, tumour markers, in other words, play such, I said, the only is the one it’s the type of cancer that blood tumour markers play such an, an important role. They play an enormous role in the diagnosis and prognosis of this particular type of cancer.

Kathryn (27:52):
So that’s quite interesting because I’m just going back to like in my head, like the prostate cancer, um, when we’re looking at that, and obviously there things like the PSA readings with prostate cancer and, and there does seem to be quite to a lot. I wouldn’t want to upset anybody here depending upon which way they feel about it, but there’s quite a lot of debate about whether or not they actually accurately represent how much in a sense, you know, in a sense the cancer’s affecting a certain area and infecting the prostate. Um, but obviously in a different range then obviously for the testicular cancer, the, the specific blood for that is actually pretty accurate. It would sound then

Matt (28:26):
Absolutely. There, there are two, but yes, very much so, you know, so much so that the, the medical profession, um, puts a lot of weight on the readings more than any other form of cancer is my understanding. So I’ll, I’ll nip onto those a little bit later, um, stage. So I got stage one when I, and one B and you also find, um, levels relating to the, the, the tumour marker as well, often presented on, um, hospital reports or, or reports from the GP. And that is it’s numerically one S okay, I’ll just go into that at the very end of this, this particular part of the, of the, um, presentation. But so stage that stage one, I talked about one a and one B and one S stage two spreads. It, it shows that the tumour is spread into the, to the nearby lymph nodes in the pelvis or the abdomen.

Matt (29:21):
Um, and stage three, God blesses split into three, three sub stages three, where the spread is into distant lymph nodes and importantly, the marker levels, the tumour marker levels are normal or only slightly raised three B, which is spread to the local lymph nodes, but there’s higher marker levels and three C, whereas the same with stage stage three B, but you have very high marker levels. Um, and those would be, I’ve talked about, um, S one, the very high marker levels could be demonstrated by S three. Uh, okay. So I’m sorry, this, that probably sounds very complicated. Or, and as I say, I’m not aware of any of the cancer. You you’re going to have stage one stage Tuesday, stage three stage four cancers that, um, have appeared or, or been mentioned on these podcasts. But to the best of my knowledge, the staging of the blood markers is a, is a, is something that is unique to, uh, testicular cancer. I’ll just whip through those very quickly. Yeah. S zero means the mark, the tumour markers are normal S one slightly raised S two moderately raised S three very raised. Okay. So you’ll have, as I say, stage one, a B stage two, stage three, a B, uh, C. Um, but you’ll also see this, this staging around the tumour markers as well. And those are incre, those are very, very important.

Kathryn (30:57):
So with that SOS, if somebody were to Sage is why I’ve had stage two, a testicular cancer. Um, so it would be, that would, so there’s that, but then there’d also be additional staging around the blood marker.

Matt (31:10):
Correct.

Kathryn (31:11):
Okay, great. Yeah. So from an device point of view, so say like, if I was speaking to somebody who had, um, who’d had testicular cancer, and I’m trying
to get as much information as possible beforehand to come to you, Matt, to help me on understand if we can potentially underwrite it. So for the key thing, absolute key thing is known as staging and the grading, which would be, I kind of want to say almost the genetic version now in, but I know it’s not genetic, but, you know, suspect the,

Matt (31:33):
I know exactly what you

Kathryn (31:34):
Mean. Yeah. The, the overall staging and grading, if I could then also have the staging and grading of the blood marker that I’m assuming make it even, it’d be even more useful to you,

Matt (31:45):
It would provide an awful but more information and more useful to determine the type of risk of an underwriter was assessing. Yeah, absolutely.

Kathryn (31:53):
Okay. Then that’s really good to know. Because I think that’s, again, I imagine a lot of people wouldn’t necessarily think to ask that about, you know, thinking that there’d maybe be two versions of it or two readings of it. And, and I don’t know how many people would necessarily know themselves as well. So I imagine for, for an adviser, you know, in terms of like, I, I know I’ve, I do sales to people generally when I’m training as well, is that if you’re going to do research for somebody and they have had a cancer, then then pretty much in almost all cases, make sure you have the staging and the grading, because, you know, the, the difference between me coming to you met with someone who was stage one, a and committee with someone who was stage three B is phenomenally different in terms of what the outcome would be, um, in Sherman wise.

Matt (32:32):
Very much so.

Kathryn (32:33):
Yeah. So I generally, you know, I, I will look into things for people, but when I’m really looking into an option for somebody, if they’re wanting a, quite an accurate expectation, then I will be saying to them, right, I need to know this. And usually it’s the case of, or we’ve mentioned before about the TNM score. So that’s 10 going to vendor Mike score. Yep. And that can be either on a specialist letter or people can just swing up their GP and ask them. And I think the only time that I’ve not had the majority of people, when I’ve said to them, look, I need this because basically if you explain it right to them from the start, you can say, well, look, if I don’t have this information, then basically I can give you a best case scenario. But the worst case scenario could be that all of this is, is not possible with this.

Kathryn (33:20):
Um, and I’d need to pick a different insurer for you all, you know, go to a specialist policy, potentially it might be that it is absolutely best case and everything’s fine. And we could go to any insurer, but we wouldn’t know without that information, the only time for me that I’ve not been able to get that information. And I think it’s something for again, advisers to be quite a aware of is, um, I’ve spoken to, I think it’s, there’s one person really sticks out my mind. It might have been a couple of people where in a sense, they’ve, they’ve kind of compartmentalised the fact that they had cancer and they wanting insurance, they know they need to tell me about cancer they’ve had, but they all also want it to be something that’s kind of over there. They want it to not be something that they have to relive and go back through that information.

Kathryn (34:08):
Some of them have completely destroyed all of the records that they had in terms of specialist letters, um, because they just could not face having that information in the house. And that kind of reminder, even if it’s in a box in the loft, you know, or hidden somewhere, it’s too much for them to face. And also then even speaking to the GP to find out can be too much. So at that point for people, I would then maybe do a situation of speaking to an underwriter and saying, right, if it was stage one, what are we, you know, and it was this longer ago, what do we generally expect? And again, I know that the grading, obviously it comes into it, but I think at that point, everybody then just has to be very, very conscious of the, almost the sensitive vulnerability of the person that you’re supporting and how we need to try and be as open as possible about what we think might happen and just give them those facts to, in front of them.

Kathryn (34:57):
So that, you know, instead of saying, well, well, I can’t do anything to support you because I don’t have all this inform. It’s a case of right. Okay. Based upon your situation and how you’re feeling and the information we have in a sense, the best that I can do is prepare you for what it might be. And if this was a situation, this is what it might be if it was this, you know, and it, it kind of becomes a bit of a bit of a long, um, explanation that you have to give to somebody and you have to try and set to out nicely so they can, it’s easily kind of read through it. And there’s a, if it’s be as kind of as transparent as possible. Um, but it’s really important to just make sure that you, you try and do the best as possible, but also wherever you can possible, make sure you get that staging and grading.

Kathryn (35:39):
Um, when you are providing somebody there, there’s lots of other things which will probably come across, which is I’ll discuss today, which is obviously time of diagnosis, time of any chemotherapy radiotherapy surgery. And it’s not just that, it’s how many people tend to either remember, well, I had chemotherapy from March to September, or they may turn around and say, well, I had six rounds. And so it’s just remembering all that information and getting all that information so that when you do speak to somebody like Matt, um, he can then really give you a, a very clear idea as to what he would be in a sense allowed to do given the insurer’s rules and everything in, in terms of supporting that person.

Matt (36:16):
Yeah. I would, I completely agree with all of that. I think the two points I would make, um, I know that a previous life, when I was a chief underwriter of a, of an insurer, we did, um, some analytics of the telephone, um, inquiries that we had from IASS. And by far, the larger portion of, we couldn’t really give an answer was on cancer because IASS were phoning in without the information that you just relayed. We can give you a starter for 10 and an end game, but of course, most cases will fit in, in the middle. And that was the biggest, um, um, challenge yes. From a resourcing perspective that, um, that particular insurer had. So absolutely the, the more precise information you can get, um, it, it really helps speed the process. So I have a friend who is exactly the, the type of individual that you mentioned, this won’t talk about her cancer ever.

Matt (37:18):
So upsetting for her, even though she’s, you know, touch wood and certainly a long time afterwards, can’t even talk about it now. And those are, as you quite rightly pointed out, those are incredibly sensitive. Uh, uh, times I also had in terms of the, um, the, um, emotions I, um, and, and cancer in particular, I saw, I read an article recently, um, on LinkedIn whereby it was around, um, mental illness and asking questions about mental illness. And, uh, it occurred to me, um, during the time, well, rather like my friend, um, would I, would I really like to be questioned heavily about when I personally, he was diagnosed with cancer, um, because that was an incredibly stressy time. Um, I know, I know that suicide and, and suicidal ideations ideations are incredibly difficult thing to talk about, but also I would throw in that when you’re sudden in front of the doctor with your wife and say, you’ve got one in two chance of living five years has occurred to me, that is incredibly distressing as well.

Matt (38:26):
So I think we need to, you know, it is something Kathryn that you, you bang the drum on enormously about being, uh, receptive to people’s emotions when they talk about are also, you know, I talk about counsellors, we talked about mental health suicide, but we’re also, you know, heart attacks stroke. These are incredibly emotional events for the majority of people and, um, you know, more power elbow to, to raise the point that advisers need to be simp pathetic in total to, um, these, these conditions that arise. Anyway, I’ll get off my I’ll get off my hobby hall, but they’re really just reemphasizing what you were saying.

Kathryn (39:04):
Absolutely. I think it comes down to as well, the difference between, and, you know, it’s, it’s a bit of a difficult one, but you know, when it comes down to that whole idea of, are you an adviser or your salesperson, and I know D different, um, companies work in different ways in terms of like different targets and things like that. But when you are speaking to people with health conditions, and if by the very nature of working in the protection assurance space, you will, the majority of the time be talking through people’s medical history, you might be someone who speaks to bar anybody with anything on their medical history or a family, a medical history. Um, I would say it’s probably quite rare actually to be in a situation where it’s somebody that has absolutely nothing. I was going to say, I, I do get that.

Kathryn (39:44):
I sometimes, um, I tend to get it if somebody goes obviously for the own nature of us as a business is cur if I don’t speak to somebody with any health conditions or family health conditions, it’s usually that they’re doing some incredibly scary and high risk sports of some sort. Um, that’s quite interesting to hear about. Yeah. Um, but you know, in terms of it, you know, it’s, it’s how you view your clients as well. So, you know, if you are, you know, and sometimes it might be, it might not be the adviser’s fault. They might be in a very high pressure environment. There may be incredible, um, uh, requirements upon them about how many people they speak to in a sense, how many what’s clustering, our technical side of these are client fact finds how many client fact finds they do a day, um, or a week, and how much, you know, profit they’re bringing into the company. And from the way of the business culture, it could well be that somebody, us to lose the ability and the time to actually take the time to speak to someone and really help them through the conversations. And, you know, there with some advisers who just aren’t don’t have the personality yeah.

Kathryn (40:54):
Do that. You know, I mean, we, we’ve got to be honest as well. You know, we can’t say everyone and everyone can do these things. Some people aren’t necessarily, they don’t necessarily have the mindset or, or the empathy to be able to. I don’t think, you know, when I’m saying empathy, there is a, a, a very significant amount of empathy that’s needed for certain medical conditions, but that’s not to say that you have to be a thousand percent empathetic to be able to be in adviser. It’s just that you must be able to change and move between your personality, the client’s personality, what they’re going through and become kind of the person that they need to be able to support them during the conversation. And, um, and I think there are some, say some advisers who naturally just because of the people that they are, it just doesn’t necessarily work for them.

Kathryn (41:39):
So they’re maybe going to be more suited to, to maybe a route that doesn’t need that, you know, maybe sort of like the group insurance world, where you don’t need to be really going into medical size of things. It’s very procedural, um, is very, you know, so like Dockey implementation and compliance and, and that suits them. Um, and then you’ll have us say some firms where somebody is absolutely in the right kind of person in the right kind of mindset, but just because of circumstance of the role that it doesn’t happen. So when we talk about this, and obviously I know we do the podcast in terms of helping advisers and underwriters and charities and publics Seren. So what’s going on when we do say advice is what for me, when I say that I’m also talking about, you know, intermediary companies as well, because it is a specific culture that really helps to like stand out and help clients that are in this, uh, kind of, um, situation. So I just started to quickly have a little side, I don’t know, ran, think about that.

Matt (42:34):
I think it’s important. And what I would say is that, that, I think certainly I think where we both come from in the last five, 10 minutes is, you know, it, it’s not necessarily a particular type of pre-existing medical condition. It can be, it can scraps, um, scan an awful lot, uh, of, of different medical conditions. Um, and, um, yeah, I, I just can’t, I have to say, um, I, I completely agree with everything that you say I’m wary. I agree with you too.

Kathryn (43:05):
Yes. I’m wary of time too.

Matt (43:08):
So very quickly then if I, can I just say two things, sorry,

Kathryn (43:10):
Go for it, please.

Matt (43:11):
Um, I just thought there of interest to people. Um, certainly the second one, the first one was just to, on this whole, um, debate about family history, whether it’s important or not. Um, I would just add with testicular cancer, if you have a, uh, history of testicular cancer with your, your father or to five times more likely to develop particular cancer and in your brother eight to nine times more likely, right? So statistically, that, that, that is pretty significant. I thought finally, what may be of interest to the listeners? Um, not necessarily purely from advising test particular cancer cases, but for background that’s one of the areas that’s really changed the, um, the face of, uh, particular cancer treatment is chemotherapy. And rather, like we talked about blood tumours earlier on which I think you, you, you mentioned something that you found very interesting. Yeah. You ask yourself, why is, why is chemotherapy so effective with, um, people who have chemotherapy of 90%, 96% cure rate? Oh. And the key to key to I’ve written this down. Okay. But the key to success appears to lie in the cancer’s stem cells.

Kathryn (44:39):
Okay.

Matt (44:40):
Which are more sensitive to chemotherapy than the stem cells found in any other type of cancer. Oh,

Matt (44:46):
Any other type of cancer? The chemo can attack the, the cancers stem cell, which I thought was fascinating, to be honest with you. And just to remind people of stem cell probably, well, maybe a couple of years ago now, but it would’ve been in the media and awful lot about embryo embryonic, um, stem cells versus adult stem cells. But really the stem cell is, um, uh, the bodies raw materials from the stem cell. Um, other cells are created with specialised functions. So it’s very specialised functions. Uh, cells come from where they originate from and specialists, um, uh, cells, um, that generated can include, uh, cells, brain cells, heart, muscle cells, bone cells would be another example. But I thought that would be interesting just as a, as a, as a sign off, because that’s something I haven’t really, um, come across, not really anything to do per se, with underwriting, but I thought of general medical knowledge, that might be interesting to the viewers, sorry to the listeners.

Kathryn (45:52):
Yeah, absolutely. So, so from that,

Matt (45:54):
No, I’ll be quiet.

Kathryn (45:56):
No, I was going to say from that kind of thing. So to me, that kind of makes me think, so we saying specifically targets, you know, especially the, um, the stem cells for whether cystic cancer, um, has happened. So to me, that’s kind of like, so I, again, yeah, with stem cells, I kind of think straight around thinking of like regrowing organs, you know, just get stem cell, you’ve been able to do something. Um, so it’s almost as if it’s, it’s going into that area. And it’s almost as if it’s, I kind of imagining like a bit of like an razor, you know, like a rubber and it’s going in, it’s going to the stem cells. It’s just going along going, you know what? I’m going to erase all this cancer stuff off, you let’s start AF fresh, let’s get blank slate kind of thing.

Matt (46:33):
Lovely way of putting it as you always do on my time.

Kathryn (46:38):
Imagine some people be like, what is she on about? Um, so I think then to just end off again, because of thinking time wise, I’ll give a case study. Um, so at Gio we had a couple that came to us and we identified that they needed some joint level life insurance and they were both smokers. So for anybody who’s new to the podcast or on you to the insurance world, if somebody’s class is a smoker, then that effectively means that the premiums that they’re going to pay for the insurance in when it’s protection insurance are going to be doubled, because there is seem to be a much higher risk of a claim happening for people that are smokers. And, um, with this couple, the male life he had had test cancer. And, um, his had been stage two. And when we did the research and we put the application forward, the only thing that we knew was that it was either a or B grading.

Kathryn (47:24):
And so what we did is when we did the research we’d approach the underwriter, we said, look, we know it’s stage two. What is it going to be if it, if its grade a what’s it going to be if it’s grade B. And then obviously we then decided, which was the best insurer, talked it through with the clients and they wanted to go ahead. And for this person about, um, five and a half years before the policy started, he had had the last of his treatment of an initially it had a testicle removed he’d then had two rounds of chemotherapy. And, uh, obviously very luckily as well, the cancer hadn’t spread at all. So it hadn’t known what what’s done is metastasised. It hadn’t gone into any lymph nodes or any other nearby organs. And what we were able to arrange was 90,000 pounds of joint level life insurance over 21 years for a premium that was just under 15 pounds per month.

Kathryn (48:14):
And, um, something I want to clarify with that as well, just a little bit further is that pricing is the standard rates. So that means that this person’s gentleman was accepted for the insurance, even though he’d had stage two, a testicular cancer, um, he was given that insurance without any, you know, if someone else had gone for it in the exact same situation, as a meaning in terms of age, smoker, status, everything else, and hadn’t had the cancer, they would’ve been given the exact same price too. And I think, um, what’s really important as well to say is 15 pounds per month. Now that is for two people and to bear in mind as well. That’s also on the smoker rates, which means it’s already been increased. So if they weren’t smokers the pricing from that, would’ve been under 10 pounds per month. Uh, so what I’d like to say is thank you again to everybody for listening.

Kathryn (49:00):
It’s always lovely to have you here listening in with us. And thank you again, Matt, for all of your insights. It’s always a pleasure to have you on. If you’d like a reminder of the next episode, please drop me a message on social media or visit the website practical-protection.co.uk. And don’t, don’t forget that if you’ve listened to this as part of your work, you can claim a CPD certificate on the website too. Thanks to our sponsors, Octomembers. So thank you again, Matt, and I’ll speak to you soon.

Matt (49:26):
Take care. Bye.