Insurance Update
October  2016
Issue No. 73
In this issue

What is breast cancer?

 

 

About Us 
Insurance logo 
  A not-for-profit ministry of
Church of the Brethren Benefit Trust Inc.

Church of the Brethren Insurance Services provides the following products: dental, vision, basic life and accidental death & dismemberment, supplemental life and AD&D, dependent life and AD&D, retiree life, long-term disability, short-term disability, and Medicare supplement for eligible Church of the Brethren employees .
 
Dental, vision, retiree life, and Medicare supplement coverage may also be available for eligible retired Church of the Brethren employees.
 
For eligibility information, call Connie Sandman at 800-746-1505, ext. 366, or contact your human resources representative.
 
Medical and ancillary plans (named above) may be available to Brethren-affiliated employer groups.
 
Long-Term Care Insurance is available for all members of the Church of the Brethren, their family and friends, and employees of Church of the Brethren-affiliated agencies, organizations, colleges, and retirement communities. 

Contact Us 
1505 Dundee Ave., Elgin, IL 60120
800-746-1505
www.bbtinsurance.org 
  


Dear


The autumn season brings with it many predictable changes, including cooler temperatures, the leaves changing to their vivid fall colors in some climates, and the return to school for countless students and teachers  (what some call the "academic spring"). Though some are not excited about being back in school, there is no denying that in our American culture, fall promises new ideas, new experiences, and often new acquaintances, as classes from kindergarten to graduate school begin a new year. Even in the business world, people have returned from their vacations and are ready to throw themselves into their jobs with renewed energy. The crisp fall air after the heat of summer seems conducive to renewed effort.
 
With the onset of fall's splendor is an annual emphasis we have come to expect called National Breast Cancer Awareness Month. There are fundraising walks and runs, and even the National Football League joins the effort to raise money and awareness. The symbolic pink ribbons begin to appear.
 
Breast cancer is the cause of death for more women than any other cancer except lung cancer. All of us know someone who has had breast cancer, and many of us have family members who have suffered from the disease. It is clearly something we should know more about, and so the purpose of this month's issue is to increase our understanding of this troubling disease.
 
Through uplifting stories of women who have faced breast cancer with courage and grace and a positive outlook, you will read about not only breast cancer's symptoms, stages, and treatments, but also joy and hope, even in the face of this illness.

We would also like to take this opportunity to remind you that Open Enrollment happens during the fall, from Nov. 1-30. This is the perfect time to reflect on how well you are covered and consider insurance you don't currently have, add to existing insurance, or add to your peace of mind with some new products being offered for the first time -- critical illness and accident coverage. You'll find more information on the importance of Open Enrollment in our issue below.
 
Time to consider two NEW insurance products from Brethren Insurance Services
Voluntary Critical Illness Insurance is coverage for many of the costs associated with treating a critical illness (cancer or heart failure, for example). It covers things like lost income, co-pays, deductibles, living expenses, and even transportation to and from treatment.
 
Accident Insurance is coverage for the extra costs that are incurred when you have a car or bicycle accident, a sidewalk slip, or an accident in your home, etc. This insurance gives you an additional level of coverage and security for those things not covered by your primary medical insurance -- like time off work, deductibles, child-care expenses, even minor things like over-the-counter medicines and bandages. And the good news is, coverage (up to a certain amount) is guaranteed for eligible employees, with no underwriting as long as you sign up during the enrollment period.


Open Enrollment Nov. 1 - 30
Planning for proper coverage is so important. Don't miss this opportunity to step up to the plate and get the insurance you need during Open Enrollment.

In addition to Voluntary Critical Illness and Accident, here is a summary of the other insurance products offered to eligible employees through Brethren Insurance Services.
 
Dental:  Choose from one of three dental plan options for you or your family. These plans can cover checkups and other preventive services, as well as fillings, oral surgery, and orthodontia. This coverage is offered in partnership with Delta Dental of Illinois.
 
Vision: Three plan options are available to you and your family through EyeMed Vision Care. These plans offer various levels of coverage for eye exams, lenses, and frames.
  
Basic Life, Dependent, and Retiree: There are different levels of coverage, between $7,500 and $50,000, determined by age and status.

Supplemental Life:  This insurance is available to members who already have Life insurance coverage through Brethren Insurance Services. This age-rated product is available for up to $50,000 of additional insurance for those who have not yet reached their maximum benefit amount.
 
Short-Term Disability:  Cover the gap between the onset of disability and the start of Long-Term Disability coverage with Short-Term Disability insurance. This plan will pay up to 60 percent of your salary - up to $1,250 per week.

Long-Term Disability: This gives you the security of continued income in the event of an accident, illness, or injury, with long-term benefits, including 66⅔ percent of your salary, and up to $5,000 a month.

Medicare Supplement: Medicare Supplement insurance can help you pay for some of the health care costs that Medicare Parts A and B do not cover. Copayments, coinsurance, and deductibles for Medicare-approved services are covered by this supplemental product.

Medical:  Open enrollment will take place in November for employees of eligible Brethren Medical Plan groups. Specific details will be provided by your human resources representative just prior to open enrollment.
 
For eligibility requirements specific to your employer, please contact your employer's human resources representative. For general information, visit  cobbt.org/insurance .

Check with us at cobbt.org/open-enrollment-2017 after Oct. 31 to find rates, options, and enrollment forms for 2017 Open Enrollment. 
I became determined
The fight against breast cancer
"I was devastated. This disease was so dreaded and frightening. I thought it would change my life forever, and I was discouraged. I felt my body had somehow betrayed me. I exercise and eat well; I am healthy. It seemed so unfair. I felt it was beyond my ability to cope." These are the words of a recently widowed woman who contracted breast cancer in 2010.
 
The news that you have cancer is dreadful wherever in the body the cancer may be, but there is something frighteningly intimate for a woman to find cancer in her breast. This is one of the many stories of women shattered, frightened, and overwhelmed when first being told they have breast cancer.
 
One in eight women in the United States will be diagnosed with breast cancer at some point in her lifetime. The first signs are often found by women themselves, as was the case for this woman. She noticed a lump and went to have it checked out. There are many symptoms, according to the National Breast Cancer Foundation , ranging from a lump or thickening near the breast or underarm area to unexplained change in the size or shape of the breast. Click here for further signs and symptoms.
 
It goes without saying that a woman should have a checkup immediately on finding any possible symptoms. However, ideas differ on when women should start regular breast cancer screening. The recommendation used to be to have a mammogram each year after the age of 40. But now some say 45 or even fifty and only every two years. Presently at the Mayo Clinic , doctors offer annual mammograms to women age 40 and older, but they say this is a matter of personal preference. They recommend that women and their doctors "discuss the benefits, risks, and limitations of mammograms and decide together what is best. Balancing the benefits of screening with the limitations and risks is a key part of deciding when to begin mammograms and how often to repeat them."
 
The risk of mammograms is that they are not perfect. Normal breast tissue can hide a tumor and give a false negative. Or a mammogram can show an abnormality that looks like cancer but isn't, thus giving a false positive. This is why self-examination is important. Sometimes another form of breast imaging is called for. Also, it is quite common for a biopsy to be ordered.
 
A breast biopsy removes tissue or fluid from the suspicious area. These cells are then examined and tested to check for the presence of breast cancer. The biopsy is the diagnostic procedure that can definitely determine if the area in question is cancerous.
 
How widespread is breast cancer? The American Cancer Society estimates that nearly 250,000 new cases are expected to be diagnosed among women in the U.S. in 2016, as well as more than 60,000 additional cases of "in situ" breast cancer. "Ductal carcinoma in situ" is the presence of abnormal cells inside a milk duct in the breast. It is considered the earliest form of breast cancer and is non-invasive, meaning it has not spread out of the milk duct to other parts of the breast. It is not life-threatening but it does require treatment.
 
The median age at time of diagnosis is 61, meaning half the women diagnosed with breast cancer are younger than 61 and half are older. Incidence increases with age. There is some evidence to suggest that the incidence of breast cancer varies slightly according to race and ethnicity. The American Cancer Society estimates that over 40,000 women in the U.S. will die from breast cancer in 2016, though death rates have been decreasing since 1989, especially for women under 50. The only other cancer responsible for the deaths of more women in the U.S. is lung cancer. The most recent statistics show that there are more than 2.8 million U.S. women with a history of breast cancer.
 
According to the American Cancer Society, many risk factors can increase your chance of developing breast cancer, but it is not yet known exactly how some of these risk factors cause cells to become cancerous. Hormones seem to play a role in many cases of breast cancer, but just how this happens is not fully understood.
 
Breast cells become cancerous because of mutations in DNA. Five to 10 percent of breast cancers are thought to be inherited, but most DNA changes related to breast cancer are acquired in the breast cells during the woman's lifetime. These may result from various factors; however, the causes of these acquired mutations are still unknown, and most breast cancers have several acquired gene mutations.  
 
Cancer Treatment Centers of America lists the following risk factors that, in addition to genetics, might cause breast cancer: aging, obesity, not having children or having them late, high breast density, a menstrual history that started early and lasted late, a sedentary lifestyle, heavy drinking, using birth control pills, hormonal therapy, cancer-causing chemicals, and radiation exposure. Some of these are only slightly correlated with breast cancer, and none of them has been demonstrated to be a direct cause. They are "risks," which means their presence can increase the possibility of getting breast cancer.
 
The Mayo Clinic suggests the following will help reduce the risk of breast cancer: limit your alcohol consumption, refrain from smoking, keep your weight under control, breast-feed your children, limit the dose and duration of any hormone therapy you receive, avoid exposure to radiation and to environmental pollution, and eat a healthy diet.
 
Once a diagnosis is made, there is a complex system of five stages used to determine the nature and severity of the cancer. The stages are 0, I, II, III, and IV; they are based on the size of the cancer, whether it is invasive, whether it is in the lymph nodes, and whether it has spread beyond the breast to other parts of the body.
 
For instance in stage 0 there is no evidence of cancer cells. This is the "in situ" breast cancer referred to above. In stage IA, there is a small tumor in the breast that is 2 cm or less in size. In stage IB, there are small groups of cancer cells in the lymph nodes, no larger than 2 mm. There may also be a tumor smaller than 2 cm in the breast. At the other end of the spectrum is stage IV, which means there is invasive cancer in the breast and nearby lymph nodes that has spread beyond the breast and the lymph nodes to other organs of the body and has metastasized. The stages in between represent sizes and degrees of invasion between these extremes.
 
There is a wide range of treatments for breast cancer, and they are used depending on the size and location of the tumor or cancer cells. The general categories of treatment are: surgery, radiation therapy, chemotherapy, hormone therapy, and targeted therapy. It is not uncommon for a woman to receive more than one type of treatment.
 
However, in the past 20 years, knowledge of this disease has exploded, resulting in great improvements in treatment. According to Dr. Dennis L. Citrin of Cancer Treatment Centers of America , 20 years ago mastectomies were frequent. Now most women with early stage breast cancer can be treated with breast-conserving surgeries, by removing the tumor and a small surrounding area of healthy tissue.
 
Radiation treatment has also advanced. In a process called intraoperative radiation therapy, a dose of radiation is given at the same time as the surgeon takes out the tumor. That may be all the patient needs. There is also external beam radiation therapy, where a focused dose of radiation conforms to the shape of the tumor, causing less damage to the surrounding tissue and resulting in improved appearance and fewer side effects.
 
In chemotherapy, there are now drugs that specifically attack the protein that is present in 20 percent of breast cancers. These medications are less toxic and less likely to cause side effects. Further testing and diagnosis are more sophisticated. Researchers can determine the mutation of the tumor and design an individual treatment plan.
 
Each treatment plan takes into account the stage of the tumor, the tumor's type, genomic markers, the patient's age, general health, and preferences, the patient's menopausal status, and the presence of inherited mutations.
 
As everyone knows from the stories patients tell, there are sometimes very unpleasant side effects to the various treatments. Common ones are loss of hair, pain or nausea after surgery, fatigue, hot flashes, and joint pain. There can also be headaches, numbness, dental issues, lymphatic fluid accumulating in the tissues, bone loss, and other less fr equent effects. A team of experts working together is important for good and effective treatment.
 
It is important that women newly diagnosed with breast cancer know the many treatment options and the major advances. Treatment today is so different from where it was 20 years ago. The prognosis for many patients is so much better.
 
According to the American Cancer Society , the five-year survival rate for women with stage II breast cancer is about 93 percent. The five-year survival rate for women with stage III breast cancer is about 72 percent. Breast cancers that have spread to other parts of the body are more difficult to treat and often have a bleaker outlook. Metastatic or stage IV breast cancers have a five-year survival rate of about 22 percent, yet there are still many treatment options for women in this stage.
 
The stats on breast cancer are often given in this five-year interval. For instance, the 93 percent survival rate means that of 100 people with that stage of breast cancer, 93 will live at least five years. But these stats are estimates and cannot predict what will happen for any individual. Many people live far longer than five years. Thus these stats cannot tell a woman how long she will live, but they may help her have a sense for how successful her treatment might be. These survival rates are rising and will likely continue to rise as more effective treatments are found.
 
Because breast cancer is so prevalent, it is often in the news and is the focus of some high-profile efforts at awareness and fundraising. The Susan G. Komen organization has raised many millions of dollars for breast cancer research and treatment, as has the American Cancer Society. Across the country there are runs and walks to raise money. The color pink and the iconic pink ribbon have become symbols of breast cancer. Each fall during Breast Cancer Awareness month, the National Football League, in partnership with the American Cancer Society, features pink products for sale, and coaches, players, and referees wear pink game apparel. A portion of the proceeds from the sale of merchandise goes for cancer research, and the NFL emphasis raises awareness in a population that might not otherwise be interested in learning about breast cancer.
Though this NFL sponsorship seems to give a picture of strong powerful men coming to the support of women at a moment of great vulnerability, a little known fact is that men can also contract breast cancer, although the statistics are much lower. The American Cancer Society estimates there will be about 2,600 new cases of invasive breast cancer diagnosed in men in 2016, and about 440 men will die from the disease. A man's lifetime risk of getting the disease is about 1 in 1,000. The symptoms in men are similar to those in women, but men delay much longer in seeking treatment so their cancer has often already spread. According to WebMD , breast cancer rarely occurs in men under age 35 with the highest incidence between 60 and 70. Though men don't have breasts like women, they do have small amounts of breast tissue, and because there is so little breast tissue, cancer can spread more quickly.
 
Now let us return to the woman who was devastated, who felt her body had betrayed her, who was faced with something beyond her ability to cope, but who survived. She writes, "Gradually my thoughts shifted: I realized as unreal and unfair as it seemed, I did have cancer and I wanted to fight. I was ready to fight the fear and fight the invasion of cancer cells in my body. I became determined ... I stopped thinking of chemotherapy and radiation as my enemy and began thinking of them as my weapons in the fight."
 
Her cancer was stage II, but it was aggressive. Treatment included a mastectomy, radiation, and chemotherapy. She was surrounded by a highly competent team of doctors and medical professionals as well as her family. She suffered many side effects, but her care team helped her manage them, and her son gave her constant support. At the end, a breast-reconstruction expert took her through several surgeries. When the last one was complete, she asked if she could do a cartwheel. He gave her permission and there in the corridors of the medical center and to the delight of the medical staff she turned four cartwheels. Since September 2011, she has been cancer free.
Stories of survival
The website for Cancer Treatment Centers of America carries an extensive collection of stories of women who have survived breast cancer. Though these stories are testimonials for the success and effectiveness of that medical organization and its five hospitals, they give a great deal of information about the various forms and stages of breast cancer and the kinds of treatment. Further, the stories show how combining the latest in research with a team approach and the effective involvement of family and friends can greatly improve the chances for recovery and the quality of life of the patients. Finally, the stories show the courage and spirit of women facing this most frightening disease. Here are links to five of these stories, chosen because they exemplify the different stages and therapies. You may find them so compelling that you will want to go on to read more of the stories.
 
Rhonda Spinks, Stage III
 
Kimalea Conrad, Stage II
 
Felicia Mashburn, Stage IV
 
Rhonda Warren, Stage IIIB
 
Shawna Bunch, Stage IA
Brain Puzzles
We hope you are enjoying our new addition to Insurance Update -- monthly BRAIN PUZZLES -- just for fun!

Sherlock Holmes mystery
One snowy night, Sherlock Holmes was in his house sitting by a fire. All of a sudden a snowball came crashing through his window, breaking it.

Holmes got up and looked out the window just in time to see three neighborhood kids who were brothers run around a corner. Their names were John Crimson, Mark Crimson, and Paul Crimson. The next day Holmes got a note on his door that read "? Crimson. He broke your window."

Which of the three Crimson brothers should Sherlock Holmes question about the incident?


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What am I?

I am small as an ant and big as a whale,

I can soar through the air like a bird with a tail.
I can be seen by day and not by night,
I can be seen with a big flash of light.
I follow whoever controls me by the sun,
but I fade away when dark fell like a ton.

What am I?

Click here for the answer.

 LTCILong-Term Care Insurance
Brethren Insurance Services offers Long-Term Care Insurance
 
Eligibility for long-term care insurance benefits is determined by the inability to meet at least two of these six activities of daily living -- bathing, eating, dressing, toileting, continence, or transferring. Cognitive impairment can also trigger benefits.
 
It's difficult to think about the fact that a debilitating condition or a disabling injury might leave you unable to care for yourself, or that when you reach your twilight years, the time will come when you will need some extra care. Long-term care insurance makes sure that you will get the care you need. It assures that the cost of your custodial care will not eat up your savings. Finally, and this is one of the best things about LTCI, it can help protect your children and other relatives from having to use their resources to care for you.
 
Brethren Insurance Services offers Long-Term Care Insurance for all members and employees of the Church of the Brethren and their family and friends; and also for employees of Church of the Brethren-affiliated agencies, organizations, colleges, and retirement communities and their families and friends.
 
If you are interested in obtaining this coverage, contact Brethren Insurance Services at  insurance@cobbt.org or 800-746-1505 for a free, no-obligation proposal or  click here to request more information.