Reflections on a cancer fundraising ride, and what employers can do to help those with cancer

August 9. 2023

Last weekend I rode the Pan Mass Challenge, a two day 194-mile ride to raise funds for cancer research. I wanted to say a few heartening words about how cancer outcomes have improved and reflect on implications for employers. 

The Pan Mass Challenge (PMC) had 6300 cyclists this year (and well over 3000 volunteers - who worked hard and got none of the pleasure of cycling through the Cape Cod dunes).  About 1300 riders and volunteers were “living proof,” people who are currently living with cancer or cured.  

My seat partner on the bus out to central Massachusetts was a man who started riding when his daughter, then 32, was diagnosed with colon cancer metastatic to her lungs and liver. He and his wife were figuring out how they could help her husband and two young children. She is now almost five years with no evidence of disease and has run a marathon. I talked to a rider on Saturday afternoon whose coworkers started a team in honor of a colleague diagnosed with metastatic breast cancer at 28. This colleague was riding this year, too. The youngest PMC rider was thirteen years old - a survivor of pediatric cancer. The five year survival rate for pediatric cancers is now 85% (up from 58% in the mid-1970s). Some of those children go on to develop different cancers years or decades later, though, from their initial treatment. 

Many with cancer don’t do so well. I ate lunch with a man whose mom is being treated for pancreatic cancer. He knows there is worse to come. I’m haunted each year by bike jerseys featuring the vibrant photo of a young woman who died of a glioblastoma (brain cancer). I’m hopeful that continued progress in genomic research can identify more cancer patients whose tumors have genetic characteristics that make them treatable with highly personalized drugs.

Implications for employers: 

1. For the entire population

• Employers can encourage evidence-based screening for colorectal cancer, cervical cancer and breast cancer. Screening tests should be covered without cost sharing, and some employers have instructed their carriers not to charge cost sharing for screening examinations done on those who had past positive tests (like those who had previous colonic polyps but are getting subsequent routine screening). 

• Clean indoor air can lower cancer risk, especially with much of the US having high p2.5 particulate matter in the air due to wildfires this summer. Employers can be sure their ventilation systems are providing adequate air exchange and filtration, which protects from these particles.

• Obesity is associated with higher risks for colon, breast and endometrial cancer, so employer programs to address obesity can lower cancer risk.

• Tobacco remains the number one cause of preventable premature death, and employers can offer full coverage for effective tobacco cessation

2.              For those newly diagnosed with cancer

• Employees or family members newly diagnosed with cancer often don’t have all of the information they need, which might limit future treatment options. Employers can offer centers of excellence through their carriers, and many offer an expert medical opinion service.  Walmart found that expert medical opinions changed diagnosis or treatment in a substantial portion of cases.

• Paid time off and short-term disability are critical to support those newly diagnosed with cancer and their families. 

• Care management and navigation can help members with cancer fully access their benefits.

• Communicate effectively about relevant benefits, such as expert opinion, centers of excellence, or navigation. When patients are given a new diagnosis of cancer, they will need support quickly. The first center they turn to for treatment may be their best shot at a cure. Employers can publicize cancer-related supports to help employees and their dependents turn toward trusted resources.
  
  

3.              For those currently being treated for cancer

• Most new oncology drugs cost over $10,000 a month, so offering a medical insurance plan that has affordable cost sharing helps keep members from financial insecurity. A 2012 study found that one in three with cancer went into debt and over half of those incurred more than $10,000 of debt, and costs have gone up since then. 

• Again, paid time off and short-term disability can help as patients and family members navigate doctor’s appointments and chemotherapy, radiation therapy, or surgery. Cancer therapy is exhausting for patients and their families. 

• Care management and navigation can help members with cancer fully access their benefits.

• Employers can create a travel benefit that will allow employees and their dependents to access appropriate, high-quality care.

• Employers can provide access to short-term care for dependents during the treatment phase.
  Allow colleagues to “donate” paid time off to colleagues with severe illnesses  

• Colleagues can set up a volunteer list to bring meals, offer rides, or provide company.
  
  
  

4.              For cancer survivors

With increasing success of cancer therapy, there are now 18.1 million cancer survivors in the US.  Those who have survived cancer and cancer treatment have special medical and non-medical needs.  

• Survivors often need periodic tests to monitor their status.  These are not considered preventive, and cost-sharing can lead to lower adherence. Employers can offer a plan with lower cost sharing, although this plan is most attractive to older and sicker members, so will almost certainly be more expensive based on population risk.

• Survivors and their families might suffer from depression and anxiety, and benefit from adequate mental health benefits and access to mental health care.

• Workplace accommodations can help return survivors to the workforce.

• Consider offering an Employee Resource Group for cancer survivors and family members/loved ones of cancer survivors. This group can offer support and information for individuals newly grappling with a diagnosis.

Thanks for reading! More on supporting the Pan Mass Challenge here.

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Tomorrow: Oral oncology drugs often go to waste