Team Doug Report #9

In today’s report we will explore another “F” word: finance. Some of you -- especially my US and Canadian readers - might be interested in what my industrial-strength treatment costs in Australia. But first, the latest news.

This week I changed my treatment program from 3-weekly to 6-weekly. It’s a major improvement  that gives Dianne & me much more leeway to travel and live our lives.

Oyster tasting with Dianne & Julie

Brief recap: I was diagnosed with Stage 3 cancer in July 2023, with two primary tumours in the right side of my neck, up under my jaw. From there the cancer had spread to some of my vertebra and a couple of small spots in my liver. I started chemo therapy and immunotherapy in August and since then the tumours have all shrunk or stabilised and the cancer activity has stopped. This is called partial remission. Yaaay! Since December I have been taking just immunotherapy, a 30 minute infusion of Pembrolizumab (“Pembro”) every three weeks at a local private clinic.

This week (March 6^th), for the first time, I was given a “double dose” of Pembro to start me on the 6-week cycle. It’s the same volume of liquid – so still only 30 minutes -- but twice the concentration and half of it is slow-release. In mid-April I’ll have another PET-CT scan to check on my progress.

Family cruise on Pittwater

I don’t have the same energy as before, but I’m still carrying on life as normal. Recent activities have included a visit from our Canadian friend Julie, a family cruise on beautiful Pittwater, celebrating Dianne's birthday, and a special lunch for our anniversary (46).

My side-effects are pretty minimal. I have a slight pain in the right side of my neck; taking paracetamol (acetaminophen) as needed does the trick. The only worrying problem is in my mouth. The muscles on the right side of my tongue don’t work very well. This means it’s more difficult to manipulate food in my mouth, which slows down my eating. And my speech is altered. I have trouble with “D”, “L”. TH”, and “S”, leaving me with what I call Sylvester’s Syndrome: I thound like Thylvethter the cat. (Thufferin’ thucotash!)  It’s not painful, just clumsy. I’ve been to an ear, nose and throat specialist who says there’s nothing physically wrong with my mouth or throat; he suspects the tumours in my neck are pressing on some nerves, including the hypoglossal nerve, which drives the muscles of the tongue.

Our anniversary lunch

There’s no guarantee that this will resolve itself in time: nerve problems tend to linger on. I have an appointment with a head & neck specialist in early April, hoping for a more detailed diagnosis and some treatment options, even if it’s just speech therapy.

I know I need to put this issue in perspective: my treatment to date is stopping my cancer and saving my life. This mouth stuff  is small potatoes by comparison. But it’s still potatoes so I want to deal with it. Stay tuned for my next blog post in late April for an update.

 

Funding cancer treatment in Australia

Here’s a short overview of the Australian medical system as it applies to me. There are three main components:

1.   Medicare is the federal government’s tax-funded scheme for public access to health care. It covers:

•  Treatment in a public hospital (see below).

•  All or some of the cost of going to a GP or specialist: depending on the doc, there may be a surcharge which, for specialists, can be a couple of hundred dollars.

•  Some tests and examinations; blood tests are fully covered but there’s usually a surcharge for scans.

2.     Hospitals: There are private and public hospitals.

Public hospitals, funded and run by Medicare, provide care at no cost. This includes doctor and nursing care, medical tests, surgery, and drugs that they administer. You may need to wait a while for non-urgent treatment, you won't be able to choose your doctor (you'll get the on-call), and you may be in a shared room.

Private hospitals are owned and operated by private companies, licensed and regulated by the government. If you’ve subscribed to private health insurance – which we have --  you'll get the same care funded by Medicare plus some -- like choosing your doctor, reduced waiting time for non-urgent surgeries, and the choice of a private room (if available and medically appropriate).

I had my first week of treatment in August in a private room in a private hospital, thanks to our private health insurance coverage. GenesisCare, the clinic where I have had all my later drug infusions, is treated, financially, as a private in-patient hospital.

The standard of care in private and public hospitals is the same. Many doctors work in both settings.

3.     Prescription Drugs: Thanks to the Pharmaceutical Benefits Scheme (PBS), another government program, you only pay some of the cost of approved prescription medicines. You pay even less if you have a government concession card, which we do ‘cause we’re old! Most prescription meds cost us less than $10.

It’s a bit more complicated than this, but that is the basic idea.

The bottom line for me is that the expensive anti-cancer drugs, tests, four nights in hospital, expert, timely care by our GP and oncologist, and regular treatments by our cheerful clinic nurses, all extending over months, have amounted to just a few thousand dollars out of pocket. Plus less than $5000/year for our private health insurance premiums. I also have a cabinet full of just-in-case OTC drugs and ointments that I will probably never finish – I haven’t counted up those costs.

Thanks to you all for your continuing words of caring and encouragement. It’s great to hear from you! Dianne’s love, care, and understanding continue to amaze me.

See you all in my next post. As always, you can read my earlier posts on this page.