Dealing with practical aspects of a breast cancer diagnosis

After a diagnosis of cancer, there may be a number of practical things to think about. These may include the cost of treatment and support, travel and accommodation costs, childcare, or the cost of prostheses and wigs.

Concern about practical issues can affect how a woman feels, especially if it interrupts her daily activities. Some women worry about who will look after the children or another family member while they are in hospital, or how they will cope financially if they are unable to work for a while. Sometimes women feel guilty about the impact of their cancer and its treatment on the family.

This section provides information about some of the practical considerations following a breast cancer diagnosis and where to find more information.

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Costs of treatment and prostheses

You should talk to your doctors about the likely cost of medical tests and treatments. The cost of treatments for cancer will depend on whether a person:

is treated in the public or private system
is working and has to take time off
lives in a rural area and needs to travel for treatment
has private health insurance.

Talk to a social worker or welfare worker about what financial and practical support services are available (a member of your healthcare team can tell you how to access a social worker or welfare worker). Talk to your local Medicare office about the ‘safety net’ on costs of medications and medical bills.

Listed below are some questions that might be useful to ask a health fund about treatment costs during treatment for cancer:

Which treatments are covered by my insurance?
Which treatments are not covered by my insurance?
If I claim for a particular treatment now, does that affect what treatments I can claim for later?
What’s the gap between the cost of treatment and the private medical insurance rebate?

Government-assisted travel schemes

Women who need to have treatment in a hospital far away from home, may be able to get help with the cost of accommodation and travel. Each State and Territory has a government-funded scheme to help patients who have to travel long distances to obtain specialist treatment that is not available locally. The names for these schemes vary but may include:

Patient-Assisted Travel Scheme (PATS) – WA
Transport for Health – Isolated Patient Transport and Accommodation Assistance Scheme (IPTAAS) – NSW
Interstate Patients Transport and Accommodation Service (IPTAS) – ACT.

Depending on a woman’s individual situation and where she lives, assistance with childcare, meals and general home help may also be available. Some women may be eligible for a sickness allowance while having treatment.

Where to find more information

Sources of information about financial and practical help include:

the breast care nurse or social worker at your hospital
your community nurse
Cancer Council Helpline on 13 11 20
local councils
Centrelink
Department of Veterans Affairs.

Questions to ask

Listed below are some questions that may be helpful when discussing practical support during treatment for breast cancer.

What will the treatment you are recommending cost?
Will I need to have time off work?
If I take time off work, how do I apply for temporary income support?
Will I need to travel for treatment?
Am I eligible for help with travel and accommodation costs?
How can I find out about help with childcare while I’m being treated?
How can I find out about home help while I am being treated?
How can I find out about counselling or psychological support?
How can I find out about help with the costs of prostheses or wigs?

Listed below are some questions that might be useful to ask a health fund about treatment costs during treatment for breast cancer.

Which treatments are covered by my insurance?
Which treatments are not covered by my insurance?
Does my insurance cover other services, such as the cost of breast prostheses or wigs?
If I claim for a particular treatment now, does that affect what treatments I can claim for later?
What’s the gap between the cost of treatment and the private medical insurance rebate?

Choosing a cancer treatment

Every patient has the right to participate in any decision about their health care or medical treatment. In general, health practitioners are required to inform you of the nature of the proposed treatment and to gain your consent for all treatment, before it starts.

Making a decision about treatment can be complex and frightening, but most people make complex decisions every day. Deciding which car to buy and where to live are also complex decisions, but most people make these decisions successfully many times during their life.

If you are offered a choice of treatments, you will need to weigh the advantages and disadvantages of each treatment. If only one type of treatment is recommended, ask your doctor to explain why other choices have not been offered.

Some people with more advanced cancer will choose treatment, even if it only offers a small chance of cure. Others want to make sure the benefits of treatment outweigh any side effects. Still others will choose the treatment they believe offers them the best quality of life.

Some people may choose not to have treatment to eradicate cancer, but instead will choose to have symptoms managed to optimise their physical and emotional well-being. You may wish to discuss your options with you treatment team, family and friends, or with a counsellor, psychologist or psychiatrist.

Questions you should ask include:

What are my treatment options?
Is this treatment plan meant to help side effects, slow the spread of cancer, or both?
The discussion should include information about any alternative treatment options, including different types of surgery and other treatments. You are also entitled to seek a second opinion.
What are the expected outcomes of each option?
What’s the best we can hope for by trying this treatment? What is the goal?
Successful treatment can never be absolutely assured and different procedures carry different risks. You need to be aware of the expected outcome of the treatment or treatments being recommended, including known complications, so that you can decide which treatment option is best for you.
What is the likelihood that each expected outcome will occur?
What’s the most likely result of trying this treatment?
The likelihood of expected outcomes (success, side effects and/or complications) varies with different treatments and with individual patients’ characteristics. Statistics for success and complication rates are based on studies of large numbers of people with the same stage of cancer. Knowing how likely it is that each outcome will occur will help you and your clinician weigh up the benefits and risks.Some procedures that are new or uncommon may not have sufficient research to support meaningful statistics and your doctor will make recommendations based on other information, such as personal experience, training or expert knowledge. Where your doctor is relying on alternative information they should discuss this with you.
What are the possible side effects and other downsides of the treatment?
How likely are they? Are the possible rewards bigger than the possible drawbacks?
Doctors and other health practitioners know a lot about the treatments they recommend, but only you know about your lifestyle, the demands of your job and family and your personal needs and preferences. You will need to weigh the impact of the treatment against its likely outcome.