In Treatment For Breast Cancer

There is no way to predict the experience of any individual during treatment. We are all unique.

While it is understandable that your main focus is on maximizing the effect of your treatments, there are other matters that are also important to your life.

This article presents an overview of subjects to consider while in treatment. More information about each subject is contained in other documents on this website.

The Basics

• Although it may feel as if breast cancer has taken over your life: Keep in mind that you are a person with breast cancer. Breast cancer does not define you.
• Adopt a positive, "I'm going to get the health care I need," attitude. 
  • People do best who expect the best. 
  • Do not beat yourself up if you have days when you can't do anything. 
  • If fear threatens to take over, use it as a trigger to take a moment and center yourself to the here and now.
  • See: A Positive Attitude and How To Keep It
• Trust your doctor.   
  • That does not mean that you cannot ask questions or even have a difference of opinion. 
  • If you do not trust the doctor, or you cannot easily speak with the doctor, switch to one you can. See: What To Do If You Are Considering Switching Doctors
• Learn how to maximize your limited time with a doctor. For instance:
  • Learn about breast cancer and your treatment - including the words you are likely to hear.
  • Write down your questions before seeing the doctor and prioritize them in order of priority. (We provide a tool that stores your questions and permits you to prioritize them with a push of a button before your appointment. See Prioritizer).
  • See: Doctors 101 (Choosing, Working With Effectively, Switching, Paying  For)
• Share your feelings with the people close to you. 
• Start reaching out for support even if you are used to going it alone. Breast cancer support groups are available in person, online or on the telephone.
  • It will make it easier to go through the decision making process and the seemingly endless waiting.
  • Consider seeking a breast cancer buddy - someone who is going through the same thing you are, or who has recently gone through it. See: How To Find A Person In A Similar Situation (A Buddy)
• Select a person to act as a patient advocate to go with you to important doctor appointments. A patient advocate can help ask questions, help remember what the doctor said, and review the meeting with you afterward. Professional patient advocates are available if needed.
• Break things into doable steps. Then deal with each step one at a time.
• Do not make any major financial or other decisions you do not have to make right now.
• When you have contact with your employer, an insurer, or government agency: 
  • Always get the name and/or i.d. number of the person with whom you speak.
  • Make notes.
    • Include the day and time and what was said.
    • Keep your notes in the file with whatever subject you’re calling about.
  • Keep a photocopy of all forms you complete.
  • If you mail anything that seems important:
    • Include a cover letter with a date. 
    • Keep a copy. Attach a copy of the cover letter to your copy of the form.
    • Send it by a delivery system that provides delivery receipts such as certified mail, return receipt requested or, by overnight.  Note on your copy of the letter the receipt number so there is proof what was included in the particular envelope. Keep the receipt with your copy of the letter or document.
  • When you are told things must be done by a deadline, note the deadline in your diary – and finish on time.
  • After each conversation, make sure you are in sync with the other person by repeating what is to be done, by whom, and by when. 
  • Make an alert to follow up to be sure the other person does what he or she agreed to do. 
  • Follow up on the day of your alert.

Managing Your Medical Care

• See: In Treatment For Breast Cancer: Managing Your Medical Care (Then click the back button on your browser to return here)

Finances

• In general
  • Even with health insurance, your diagnosis can play havoc with your finances. Over 50% of the personal bankruptcies in this country involve health care costs. Over 75% of those people had health insurance. While this may sound scary, think of it as a call to action.
  • It is important to get control of your finances now or as soon after your treatment as you can focus. (Survivorship A to Z Financial Planning information can help.)
  • Do not let general fear about money drain your energy. Push the thought aside with action. 
• Budget
  • If you don't have it already, get a handle on your finances by creating a Budget. You don't have to budget to the dollar. The key is to get a general idea of where you will be financially during the period.Include a guesstimate about medical expenses you have to pay.
  • If there looks like there will be a short fall, see How To Cope With A Financial Crunch Or Crisis.
• Keep up your finance basics.
  • Health insurance
    • If you have health insurance:
      • Pay your health insurance premium on time. Heath insurance is likely one of your most important assets when dealing with breast cancer.
      • Arrange for automatic payment from a bank account or for someone to pay the premium for you in case you forget or become unable to. An insurance company would like nothing better than to cancel you for nonpayment.
      • Learn How To Maximize Use Of Your Health Insurance Policy
      • NOTE: If you have your health insurance through work: If for any reason you leave your job during treatment, you will likely be able to continue it under a law known as COBRA. Before taking COBRA, check to see if you can obtain less expensive and perhaps better insurance in your state. See www.Healthcare.gov
    • If you don't have health insurance, you can still get treatment. See: Uninsured. Also see: How To Qualify For Medicaid.
  • Pay your rent or mortgage and minimums due on your credit card. This is not a time to negatively impact your credit rating if you can avoid it.
  • Medical expenses and bills
    • Start keeping track of all medical services you receive and expenses you pay. You may be able to deduct them from your taxes.
    • Do not pay a medical bill just because you receive one. Check them first - either yourself or ask someone else to do it. Professionals are available if you don't have a friend or family member who can do this for you.  Professionals Who Negotiate Medical Debt
    • See: Medical Bills: How To Save Money
  • Consider asking a trusted loved one to take over your finances while you are in treatment. A helper could: 
    • Check and prioritize bills
    • Read statements
    • Monitor income checks and deposit them
    • Write checks for your signature
• Financial assistance is available for women with breast cancer.
• Postpone as many major non-medical decisions as you can until after treatment. Treatment creates stress as well as brings up emotions which can cloud judgment. If you are undergoing chemotherapy, you may also get what is known as chemo brain - basically a fogginess.
• Cash can be king. Keep as much of it as you can. Put off discretionary purchases for now. Use credit instead of cash when possible.  If you are considering purchasing an expensive item such as a car, see if you can get credit life insurance on the balance. Generally this kind of insurance does not request medical information. It will pay off the debt in the event of your death. See: Credit: Score, Getting, Fixing, Maximizing Use
• If you have a money crunch and are having difficulty paying medical bills, there are uses of assets you may not know about (we call them "New uses of assets" ) as well as other techniques to consider. We provide information about dealing with a crunch and dealing with creditors, as well as financial planning information and tools for a person with cancer. Use them now if you have to. Otherwise postpone planning until after treatment ends - unless planning would help you feel more in control of your life. (We even tell you how to borrow money from family and friends if necessary.)
• Emergency+Fund: Unless you have it already, start working toward a goal of a cash fund equal to 3 to 6 months of monthly expenses. This is the amount of money generally recommended to tide you over periods of no income or unexpected expense. It doesn’t mean you have to put this much money away today. However, now is the time to start. (If you work in a specialized area where there are very few jobs, aim for 12 months of expenses in your fund.)
• If you have extra money:  Put as much money as you can spare into your retirement accounts. Saving tax dollars is the same as earning extra money. You can usually withdraw money or borrow it if necessary. If you become disabled, withdrawals are usually without penalty. Plus, money in a retirement account is protected from creditors. If you have a choice of accounts:
  • First priority is to fund accounts in which your employer matches your contribution. The value of your contribution is increased as soon as you put it into the account.
  • Then consider:
    • Which accounts are easier to withdraw money from or borrow against in case of unexpected expense. Pay particular attention to when you can do these things as well as the costs you’ll pay, such as penalties.
    • Which accounts are earning you the most money.
  • If you need help with this decision, speak with a financial planner, your accountant or attorney.
  •  If you still have money left, open new accounts to the maximum permitted by the tax laws.  
• Investments: Tweak your investments to take account of your health condition.
• For more information, see: Breast Cancer: Finances

Day To Day Living  

• See Day To Day Living

Emotions

• See: In Treatment For Breast Cancer: Emotional Well Being

Work Issues

• Seeking Work
• At Work
• On Disability
• Self Employed
• Small Busineses Owner (1 or more employees)

Insurance  

• Health Insurance (including Medicare and Medicaid (Medi-Cal in California)
  • Health insurance cannot be cancelled because of your treatment.
  • If needed under your plan, make sure you get pre-approval before accessing medical care. If you do not, even though the service is medically necessary, the insurer not pay. See: Health Insurance: How To Maximize Use Of Your
  • If your insurer says "no" to any medical care you believe is necessary, appeal - and keep appealing. Keeping at it pays off. Look for a source of influence that can help. Get professional help if necessary. Keep in mind that there are usually procedures to fast track appeals if required by the medical situation. See:
    • Health Insurance: Claims: Appeals
    • Medicare: Claims: Appeals  326
    • Medicare Advantage: Claims: Appeals
  • See: Health Insurance: How To Maximize Use Of Your
  • Do everything you can to help keep health insurance in force. 
• If You Do Not Have Health Insurance
  • Check to see if you qualify for Medicaid, or could take steps to qualify for Medicaid. In most states, you can take actions to qualify for Medicaid and qualify the same day.
  • There are also techniques for accessing the health care system even if you are not insured. See Uninsured.  Also see: How To Deal With A Financial Crunch Or Crisis.
  • Start doing what you can to get health insurance.  People who have had any type of cancer are at risk of the cancer returning or of another cancer in the future. See: How To Obtain Health Insurance.
• Disability Insurance If there is a possibility your breast cancer will make you unable to work for a short period of time or permanently:
  • Check to see if you have disability income coverage through your employer. If you do, what is the waiting period before you receive money, and then how much?
  • If you have a private disability policy, check to see what is defined as a "disability."
  • See: Disability  Income Insurance 101
• Life Insurance
  • You can still get life insurance.
  • Get as much life insurance as you can. In addition to providing coverage for dependents, life insurance can be a source of money if your life expectancy becomes short. For example:
    • You can get insurance known as "guaranteed" life insurance which is sold with few if any questions.
    • You may be able to get life insurance through your employer during an open enrollment period - or increase the death benefit for any life insurance you already have.   
    • You may be able to get a death benefit on your credit cards. 
    • See: Life Insurance: How To Buy Despite A Health History.
•  Other Insurance  Keep up premium payments on other insurance such as Homeowners (Renters) and Automobile insurance. Aside from any legal obligations you may have to carry such insurance, this is no time for an unaffordable loss.

Government Benefits

• Health coverage If you do not have health insurance, check to see if you qualify for Medicaid (Medi-cal in California). If you do not qualify at the moment, you may be able to take steps to qualify immediately.
• Income 
  • If you become unable to work, you may be entitled to income from Social Security Disability Insurance (SSDI). People on SSDI qualify for Medicare 29 months after the onset of disability.
  • Also explore whether you are entitled to an income from Supplemental Security Income (SSI) or any state income programs.
• If your breast cancer is arguably work related If your breast cancer is somehow work related, you may be entitled to Workers Compensation.
• Food If your income is low, or stops altogether, you may be entitled to food stamps.
• Other benefits  There may be state and local benefits for which qualify, or could qualify. See: www.benefits.gov

Planning Ahead

• You have seen how life can change in an instant. If you haven't already, now is the time to do some planning "just in case." It will help you feel in control during a time when you may feel that things are beyond your control.
• At the least, consider what would happen if you need medical care and are unable to speak for yourself, and what would happen if you die. Even the healthiest person never knows when these situations may occur.
• Thinking about these subjects and executing the suggested documents does not mean that they will be needed. Executing the documents that take care of these situations can help ease the anxiety that accompanies an impending treatment.
• Every treatment has risks. While the risk that you will become unable to speak for yourself is likely minimal, the resulting impact on you and your finances could be huge. Consider what you would to happen medically if you become unable to speak for yourself. Then execute the documents known as "Advance Healthcare Directives." One advance directive to consider is a Living Will - the document that would have kept young Terry Schiavo from wasted years hooked to a machine. Advance directives are free. 
• Once you execute an advance directive, let the people who will take care of you know about our article: How To Enforce A Living Will And Other Advance Directives
• If you have underage children, make plans for their care. To learn how, click here.
• At the least, everyone needs to have a will - no matter how little or much you own. It is the only way to control what happens to your assets if you die. Wills are not expensive - and can sometimes be free. Make sure your will is challenge proof. To learn how, click here.
• Last, but not least,: check all documents, securities accounts and bank accounts with beneficiaries on them to be sure:
  • The beneficiary you want is listed. 
  • If there is more than one beneficiary, the split between them is clear.

NOTE: When treatment ends:

• Read our A to Z information about Breast Cancer: The First Six Months After Treatment.
• Think about celebrating. Include all of your family and friends who have helped you through. It can even be a virtual celebration - such as everyone raising a toast at a specific time no matter where they are. 

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