Another trip to the urologist: More on PSA guidelines

By Jeff Reed

Kestler Financial Group


We have previously discussed the impact of the recent news on the effectiveness of PSA testing. The primary take away from that discussion was that despite the talking heads trumpeting the news for all to hear, it really was not going to have an impact on our business any time soon, if ever.

That, of course, was bad news for those of us looking to move on cases that involve a history of PSA elevations or even prostate cancers. So, rather than wait for the medical community to make up their minds about PSA testing and hope that it benefits underwriting someday, how about we talk about what we can do? Sounds good, but is there really anything we can do once the cancer is diagnosed?

The answer, like so many things in our business, is, "It depends."

What does it depend on? Four things:

Age of the client. The older, the better. The idea is to identify the risks that they are likely to die with the cancer, rather than from it.

The nature of the cancer. Specifically, a recent diagnosis with a Gleason Score of six or less and a PSA of less than 10.The balance of the pathology details need to be favorable, as well.

Well followed. Regular visits to the doctor, with a recommended treatment protocol that is followed to the letter. Even watchful waiting is in play here in the right circumstances.

Manual shopping.  As in "underwriting manual." Some carriers use one, others two, and a very few use three. That gives the underwriter who truly knows his or her craft the option to use the one that will give the client the most favorable result.

How much more favorable? How about a risk similar to the one described above receiving offers of decline, postpone one year, or a Table B, depending on the manual used? In the case described above, they did, in fact, offer Table B. On a 61 year old. Here's the kicker: Only one carrier in the industry uses that third manual.