Testicular cancer and financial stress

There’s one topic that triggers stress like no other: money. Especially if you’re navigating financial worries in the wake of a testicular cancer diagnosis.

It’s normal to wonder: Do I have enough money? Can I keep up with my basic needs? Will my medical care be covered? Finances are naturally one of the biggest concerns (after your physical health) when diagnosed with any illness.

Fortunately, testicular cancer is highly treatable. Often, it’s an operation followed by a few weeks of recovery. Some people need a few months of chemotherapy or radiation after surgery. Depending on your side effects, you may be able to keep working during treatment.

As a result, the financial impact of testicular cancer is usually less than other cancers. Still, money may be a concern for some people, so it’s important to get all the costs on the table to help minimize potential financial stress.

Testicular cancer and money: getting the costs on the table

The cost of testicular cancer treatment can vary based on several factors:

• What type of testicular cancer you have

• How advanced the cancer is

• What treatment your doctor recommends

• What country you live in

In countries with government-funded healthcare (like Canada, Australia and the UK), most medical costs should be covered, assuming you get your care through the public health system. In the United States, where most people rely on private, employer-provided health insurance, the average cost of treating early stage testicular cancer can run as high as $25,000. For advanced cancer, it’s more like $50,000.

How much you’ll end up paying out of pocket also depends on the type and stage of your cancer, where you live, where you receive treatment (that is, public versus private healthcare), what kind of insurance you have and how high your insurance excess/deductible is. In countries that rely mainly on private health insurance, the cost can also depend on whether you’re able to stay in-network for most of your care. (In-network treatment is almost always less expensive than out-of-network care.)

Typical costs for testicular cancer treatment—some or all of which may be covered by insurance, depending on where you live—may include:

• Doctor’s appointments

• Surgery (orchiectomy)

• Additional surgery to implant a testicular prosthesis (if you choose to get one)

• Hospital stay (if needed)

• Medicines

• Specialist fees

In addition, you may need to plan for certain costs not covered by insurance:

• Travel and accommodation during treatment

• Childcare

• Sperm storage (if both testicles need to be removed and you’re thinking about having children later)

Tips for managing financial stress during testicular cancer

While it’s unlikely you’ll need more than a few months’ leave from work (and quite possibly less), it’s normal to worry about the potential for lost income. However, there are steps you can take to help manage the stress.

• Learn as much as you can about your diagnosis and treatment. Doing so will give you some idea what to prepare for.

• Seek advice from professionals. A financial advisor can guide you on steps you can take to reduce the risk of money problems, so you can focus your time and energy on what matters most: getting well.

• Talk to your employer and financial institutions. This includes your bank, mortgage provider, and credit card companies. Your best bet is to reach out before there’s a problem.

• Access income protection insurance. If you have income-protection insurance this may be a good time to make use of it. How long you have to wait before receiving payment, how much you’ll be paid, and for how long may vary depending on your policy.

• Don’t suffer in silence. Look, it can be hard talking about money issues or asking for financial help. This is not the time to be proud. If you need help, reach out to people you trust.

Caveat: when it comes to financial advice, seek an independent source if you can—someone who doesn’t have a vested interest in your personal situation.

How to prepare financially for the road ahead

In addition to managing stress, there are a few things you can do to get your finances in the best possible shape.

Organize your finances.

• Build up your savings, if you have a chance to do so before treatment begins. (For many people, treatment starts almost immediately after their testicular cancer diagnosis, so don’t beat yourself up if this isn’t an option.)

• Look for places to trim your budget. Cut down on nonessential costs wherever you can.

• Track your medical expenses. If you’re paying for your healthcare or relying on private insurance to cover most of the cost, get a system in place to track every medical bill. Detailed records are your friend, especially if you ever need to dispute a charge.

Get the most out of your health insurance.

• Get a case manager. If you have private or employer-provided insurance, ask your provider to assign you a case manager, so you can deal with the same person every time.

• Check your medical bills. Double check every bill (or ask someone you trust to do this) to make sure they’re accurate. Errors and overcharges are more common than you might think.

Testicular cancer and your job

For many people dealing with testicular cancer, job uncertainty is one of the biggest causes of financial stress. You might wonder if you’ll be able to keep working. Or what kind of leave you’ll be able to take. Or how it will impact your take-home pay.

Job-related benefits vary from one country to the next. But here’s a broad overview of sick leave requirements and employee protections by country.

Sick leave by country

• United States: There is no nationwide policy mandating paid sick leave, though several states (and a handful of cities) have policies in place. You are, however, entitled to 12 weeks of unpaid leave if your employer has 50 or more people on its payroll.

• Canada: Like the US, sick leave provisions vary from one province to the next. In most cases, employers are required to provide 3 to 5 days of paid leave. (Which is great if you have the flu. Cancer? Not so much.) You’re also eligible to take up to 17 weeks of unpaid leave for medical care.

• Australia: Full-time employees are guaranteed 10 days of paid sick leave per year, plus up to 3 months of unpaid leave.

• Other countries: Many countries offer more robust sick leave benefits. Sweden, for example, gives workers a full year of paid leave at 80% their normal salary. The UK guarantees a little over 6 months of paid leave, but at a fixed rate that’s about a fifth of what the average person earns.

Depending on where you live, you may be able to apply for government support, such as disability pensions, carer allowances or compassionate/bereavement leave. It’s also important to remember that your employer may offer more generous sick leave benefits than the minimum required by law. Talk to your manager or HR department to learn what your options are.

Workplace discrimination protections by country

Many countries require employers to make “reasonable accommodations” for those with cancer or other medical conditions. There are limits—and these protections vary by country. It’s important to know the law where you live and talk to your employer about your situation.

• Australia: It’s against the law to fire someone for taking sick leave, though you may have to provide evidence of your medical condition. Employers can dismiss people who take more than 3 months of unpaid (or paid + unpaid) sick leave, though employees can challenge their dismissal.

• United States and Canada: Both countries require employers to make “reasonable accommodations” so you can keep working. There is an exception, however, if an employer can prove doing so would cause “undue hardship”—for example, if you’ll miss months of work that can’t be covered by a temporary replacement. The National Coalition for Cancer Survivorship recommends you ask for a specific accommodation. Examples of reasonable accommodation include:
  - Adjustments to your day-to-day responsibilities
  - Remote/work from home options
  - Flexible hours

• United Kingdom: Employers can dismiss those with “persistent or long-term illness” if it keeps them from doing their job. But they are expected to provide reasonable accommodation and recovery time first. Under UK law, a cancer diagnosis is considered a disability, which may entitle you to other protections.

Whatever the law is where you live, employers tend to be more supportive of people with cancer today than they were a few decades ago. Relatively few people report that their diagnosis, treatment, or recovery had a negative impact on their job.

The best thing you can do? Talk to your manager or HR team to find out what options are available to you.

Getting financial help during cancer treatment

If you run into financial troubles during treatment, don’t panic. There are some places you can turn for help:

• Healthcare providers: Many hospitals have financial assistance programs you can access. Talk to your care team to find out what options are available.

• Cancer charities: Many cancer support organisations offer help covering the cost of treatment, medicine or travel.
  - US: CancerCare allows you to search for help by cancer type, need and location.
  - UK: Cancer Research UK has a list of organizations offering financial support.
  - Australia: CancerCouncil offers financial counseling and emergency financial assistance in some cases, as well as low-cost accommodation during treatment.

• Crowdfunding: There’s no shame in asking loved ones for help with cancer expenses or lost income. A crowdfunding platform can save you the time (and potential awkwardness) of having to ask people in person. GoFundMe has resources and tips specifically for those looking to crowdfund their cancer care.

• Retirement savings: Another option is to request early access to your retirement plan, pension, or superannuation—but there are limitations on what, when and how much you’re allowed to withdraw. A few things to keep in mind:
  - You may be able to access your retirement funds on compassionate grounds, or due to severe financial hardship or medical incapacity.
  - In some cases there is a tax penalty for dipping into your retirement savings early.
  - The rules also vary by country, so be sure to seek professional, unbiased financial advice before doing anything.

If you’re nearing retirement age and debating whether to take a lump sum or regular payments from your pension or superannuation, the right choice may depend in part on your treatment. In cases of testicular cancer that have a good prognosis (that is, a high chance of recovery), it’s usually wise to opt for pension payments instead of a lump sum. As each person’s situation is unique, be sure to seek professional advice before making any decisions about accessing your pension or superannuation.

Returning to work after testicular cancer

Depending on your experience, you may be ready to dive headfirst into work after treatment, or you may need to pace your re-entry. Either way, talk to your employer about your return and what to expect. Look into flexible work arrangements to accommodate your recovery. This could include working a reduced number of hours to start and gradually increasing, changing to work tasks and responsibilities, or working from home.

Returning to work can help if you’re worried about finances, but it can also positively affect your self-esteem and emotional well being. However, each person’s situation may be different, so pay attention to how the return to work is affecting you—for better or worse.

Most importantly…

Look after yourself. Financial stress can magnify the worry and anxiety you experience when dealing with testicular cancer, but it doesn’t have to. The best way to prepare for what’s ahead is to know your options—and know when, where and who to ask for help.