Written For Seniors Without An Insurance Plan or A Critical Illness Insurance Plan
This article comes at the request of many seniors and their families seeking to better understand the financial pathways for breast cancer treatment – especially when they are uninsured or underinsured when diagnose with breast cancer. We’re also writing this for the adult children who may be stepping in to help fund their parent’s battle with cancer. In times like these, every ringgit matters, and our goal is to guide you through available financial resources while introducing KALSIS, an innovative solution for seniors who need financial relief for their cost of treatment during their cancer journey.
At KALSIS, we believe in empowering elderly cancer patients to stretch every available resource in their fight. This article, updated in November 2024, has been compiled with insights from public and private healthcare sources to offer you a comprehensive guide in getting treatment for cancer.
Cancer is a battle, and no warrior fights alone. Let us show you how to enlist the support you need for yourself or your loved one to overcome cancer.
Explaining Financial Pathways for Breast Cancer Treatment in Malaysia and potential sources of financial aids to tap on
Meet our fictitious senior, Madam Halimah, a 66-year-old retiree who used to work at a MNC and stays in Selangor. She owns a fully-paid freehold landed home but does not wish to tap into her retirement savings or burden her children with her medical expenses. Like many seniors, she is uninsured and is looking for ways to ensure she can pay for her cancer treatment.
Having been provided a diagnosis of breast cancer – Stage 3 HER2-positive breast cancer – Madam Halimah needs to start treatment quickly as her cancer growth is considered more aggressive than other types of breast cancer. The HER2 protein, which stands for human epidermal growth factor receptor 2, promotes the growth of cancer cells. In HER2-positive breast cancers, there is an overexpression of the HER2 protein, leading to faster growth and a higher likelihood of the cancer spreading compared to HER2-negative breast cancers.
A timely response could mean the difference between life and a rapidly declining prognosis – where if Madam Halimah’s conditions progresses to become metastatic breast cancer (Stage 4 breast cancer), her 5-year relative cancer survival rate goes from the 50-70% range towards 15-25% range. (Ref. Ministry of Health MyScan data from Malaysian National Cancer Registry)
Madam Halimah’s doctors have told her that she needs immediate surgery followed by a year’s worth of cancer drugs like trastuzumab and pertuzumab in tandem with docetaxel (a chemotherapy drug). The road ahead sounds daunting and that’s why we’ve structured Madam Halimah’s response into 4 parts of the path ahead in beating what is a worrying form of advanced breast cancer.
Note: We did not cover radiotherapy, other forms of radiation therapy, or hormone therapy (commonly used to treat cancer in Malaysia) in the cost of cancer treatment as we’re using Madam Halimah’s story as a case study
PART A: Exploring Financial Aids in Malaysia for Medical Needs
Here are some of the key financial aid options for seniors battling cancer in Malaysia can go to, specifically in Selangor and the Klang Valley.
1. State Government Assistance – Treatment for Breast Cancer (Up to RM5,000)
Cancer patients in Selangor can access up to RM5,000 through the Bantuan Sihat Selangor (BSS) program, intended to provide fast, quality medical treatment for the less fortunate.
Key requirements include:
· Selangor residency for at least 10 years
· Household income not exceeding RM3,000
· Treatment must be in government hospitals
Though helpful, the BSS funding alone may not cover comprehensive cancer treatment, especially for advanced stages like Madam Halimah’s. BSS should not be confused with
Iltizam Selangor Sihat (‘ISS’), has a new hospitalization benefit for inpatient treatment with an RM10,000 annual coverage limit in 48-panel hospitals nationwide – but it does not cover cancer as of this article’s publication date.
3. Zakat Selangor
For Muslim patients like Madam Halimah, Zakat Selangor could potentially provide significant support for medication costs. Once patients submit the relevant application forms together with their personal medical record, they could expect to hear back within 14 working days. From our conversations with patients that applied and Zakat Selangor officers, not all applicants will get financial support and disbursements are now taking longer than before.
4. MAKNA for cancer cases
The Majlis Kanser Nasional (MAKNA) offers financial and non-financial assistance to underprivileged cancer patients (particularly from the B40 group who are less likely to have an insurance policy), receiving treatment in government hospitals. MAKNA distributed RM25.7 million to over 8,000 patients in 2022, averaging RM3,200 per patient, though actual disbursements vary based on their officer’s assessment in co-ordination with various Medical Social Welfare departments in public hospitals.
5. Medical Social Welfare Departments in Public Hospitals
Public and university hospitals have Medical Social Welfare Departments offering non-financial support for cancer treatment in Malaysia including essential equipment, non-formulary drugs and emergency transportation. This is especially useful when patients are likely to require special formulary drugs or support as in Madam Halimah’s case following a breast cancer diagnosis.
6. SOCSO And MySalam (For Younger Patients)
Although Madam Halimah is not eligible, SOCSO can be a vital resource for younger patients regardless of cancer type. Contributions must meet the qualifying period requirements, and patients must be medically certified as unable to engage in gainful activities.
Younger patients, particularly from the B40 group, may wish to consider checking for their eligibility for the MySalam scheme on their website – where they can receive a one-off RM8,000 critical illness benefit and RM50 / day hospitalisation benefit for 14 days.
Note: Clinical trails are excluded but could be a potential alternative for patients with certain types of cancer and require particular treatment. We advise such patients to speak with Cancer Research Malaysia on latest trials available for those diagnosed with cancer.
PART B: How Soon Can You Get Treated, and How Much Will Cancer Care Treatment Cost?
Timely treatment is crucial in the battle against cancer. Here, we explore treatment services and timelines in public and private hospitals for Madam Halimah. While we won’t name specific hospitals, the estimates reflect realistic costs and access to treatment, one can expect across various cancer centres in Klang Valley.
Breast Cancer Surgery Followed By Targeted Therapy and Chemotherapy
For Madam Halimah, her treatment will involve significant out-of-pocket costs, even with financial aid. Combining treatments between private and public hospitals may help reduce wait times and costs, especially in combination with pharmaceutical patient access programs.
This overview is intended for general informational purposes and may not cover all individual variations. Patients should consult their healthcare providers for advice tailored to their specific medical condition.
Before a breast cancer patient undergoes surgery, several crucial steps are taken to ensure the best possible outcome. These steps involve a combination of diagnostic evaluations, consultations, and preparations that help tailor the treatment to the patient’s specific needs.
Here’s an overview of the typical process, estimated cost to treat cancer and waiting times which Madam Halimah can expect as of November 2024.
| Procedure | Public Healthcare | Private Healthcare |
| 1. Initial Consultation | 2-4 weeks | 1-2 weeks |
| Minimal to no charge for Malaysian citizens. | RM 150 – RM 300 | |
| 2. Diagnostic imaging | 2-4 weeks | 1-2 days |
| Mammography: X-ray imaging of the breast to detect abnormalities | RM12 – RM100 | RM300 – RM500 |
| Ultrasound: Used alongside mammography, especially for patients with dense breast tissue | RM12- RM100 | RM200 – RM300 |
| MRI ( if necessary) : Provides detailed images for complex cases | RM37 – 250 | RM1,000 – RM2,500 |
| 3. Biopsy procedures | 2-3 weeks | 1-2 days |
| Fine Needle Aspiration (FNA): Uses a thin needle to extract cells. | RM 10 – RM 50 | RM 300 – RM 600 |
| Core Needle Biopsy: Removes a small cylinder of tissue. | RM 15 – RM 150 | RM 800 – RM 1,500 |
| Surgical Biopsy: Involves removing a larger tissue sample or entire lump. | RM 100 – RM 150. | RM 3,000 – RM 6,000 |
| 4. Laboratory analysis and pathology | 2-4 weeks | 1-2 weeks |
| Histopathology: Examination of tissue to confirm cancer diagnosis. | RM 10 – RM 60 | RM 500 – RM 1,000 |
| Receptor Status Tests: Determine hormone receptor (ER/PR) and HER2 status. | ||
| 5. Staging and additional tests | 2-4 weeks | 1-2 weeks |
| Blood tests to assess overall health | In practice, most out-patients do not need to pay for investigations | RM 100 – RM 300 |
| CT scans to check for metastasis | RM 1,000 – RM 2,500 | |
| PET scans to check for metastasis | RM 2,000 – RM 4,000 | |
| 6. Treatment planning and consultation | 30 days | < 1 week |
| Treatment Planning: Specialists collaborate to create a personalised plan and surgical options – lumpectomy, mastectomy, and reconstruction options. | Minimal charges | RM 150 – RM 500 per specialist |
| 7. Pre-operative evaluation | 2-4 weeks | 1-2 days |
| Medical Clearance: Health assessment to ensure fitness for surgery. | RM 50 – RM 150 | RM 200 – RM 600 |
| Anaesthesia Assessment: Evaluation by an anaesthesiologist. | ||
| 8. Surgery (excludes hospital charges) | 2-4 weeks | 1-2 weeks |
| Breast – Conserving Surgery (Lumpectomy) | RM100 – RM1,500 | RM 8,000 – RM15,000 |
| Mastectomy | RM200 – RM3,000 | RM12,000 – RM25,000 |
| Reconstructive Surgery (if opted) | RM5,000 – RM10,000 | RM20,000 – RM40,000 |
Note: Hospitalisation costs and hospital services costs excluded. Additional subsidies may apply in public healthcare for treatment done.
Breast cancer patients in Malaysia with HER2-positive tumours may benefit from a combination of trastuzumab (Herceptin) and pertuzumab (Perjeta) as part of their adjuvant (post-surgery) therapy. These therapies have been shown to improve survival rates by inhibiting the growth of cancer cells that overexpress the HER2 protein.
| Procedure | Public Healthcare | Private Healthcare |
| 9. Post-surgery recovery and assessment | 2-4 weeks | 1-2 weeks |
| Surgical Follow-Up: After surgery, patients attend follow-up appointments to monitor healing and discuss pathology results. | Minimal charges for follow-up consultations | RM 100 – RM 300 per consultation |
| Pathology Review: Confirmation of HER2-positive status through tumour analysis. | ||
| 10. Determining eligibility for targeted therapy | 1-2 months | 1-2 weeks |
| HER2 Testing: Immunohistochemistry (IHC): determines the over expression of HER2 protein | RM200 – RM500 | RM800 – RM1,500 |
| Fluorescence In Situ Hybridisation (FISH): Confirms HER2 gene amplification if IHC results are equivocal. | ||
| Cardiac Evaluation: Echocardiogram or MUGA Scan: Assesses heart function, as both drugs can affect the heart | RM20 – RM150 | RM500 – RM1,000 |
| 11. Oncologist consultation and treatment planning | 30 days | 1-2 weeks |
| Medical Oncology Consultation: Discusses the benefits and risks of targeted therapy and chemotherapy treatment. | Minimal charges | RM 150 – RM 500 per consultation |
| Treatment Plan Development: Outlines the schedule for trastuzumab, pertuzumab and docetaxel infusions | ||
| 12. Pre-treatment procedures | 2-3 weeks | 1 week |
| Baseline Blood Tests: To assess overall health | RM 30 – RM 100 | RM 100 – RM 300 |
| Placement of Venous Access Device: If necessary, for ease of infusion | RM 800 – RM 1,000 | RM 2,000 – RM 5,000 |
| 13. Initiation of targeted therapy | 2-3 weeks | 2-3 weeks |
| Scheduling Infusions: Typically administered every 3 weeks for 1 year (total 17 cycles) | RM 11,000 per cycle Total costs = RM 187,000 (17 cycles) | RM 18,500 per cycle Total costs = RM 314,500 (17 cycles) |
| Monitoring During Infusion: Vital signs and possible side effects are closely watched |
Note on costs in Malaysia for cancer treatment
These figures are approximate, and the cost of medical care can vary based on factors such as hospital policies, type of treatment, patient weight (since dosing is weight-based), and available subsidies via patient access programs.
In summary:
- Public healthcare: Lower costs but longer wait times.
- Private healthcare: Higher costs but faster access to surgery.
For seniors like Madam Halimah with limited savings and no insurance, the financial burden can be overwhelming in treating breast cancer. That’s why KALSIS exists: to bridge the gap and provide much-needed financial relief as cost of treatment can be a significant hurdle for many retirees.
PART C: KALSIS – An Innovative Solution To Mitigate Unaffordable Cancer Treatment Cost In Malaysia
KALSIS was designed to support seniors like Madam Halimah, especially those without insurance or sufficient retirement savings, in their battle against cancer. Backed by Kenanga Investors Berhad and other institutional partners, KALSIS uses a capital markets-driven approach to unlock wealth from fully-paid homes, ensuring seniors can stay in their homes while funding their healthcare and living expenses.
How KALSIS Works:
- Unlock Your Home’s Value: KALSIS acquires homes at market value through a transparent valuation process. It provides seniors with 10% of their home’s sale price for healthcare needs in Year 1 and 4% annually for life afterward for healthcare or living expenses.
- Lifetime Support: Seniors and their spouses continue to receive payouts for life, with no need to move out of their homes. If one spouse passes on, the remaining spouse will enjoy the Scheme benefits until they pass on.
- Nomination and Legacy Options: Seniors can nominate a loved one to receive part of the home’s proceeds if they pass away within 10 years of the Scheme ending and the home being sold.
With KALSIS, seniors like Madam Halimah can access RM210,000 across two years from an RM1.5 million home, giving them the financial ammunition to fight cancer without losing the roof over their heads and still enjoy lifetime payouts of RM60,000 per year for living expenses after beating cancer.
PART D: Madam Halimah’s financial strategy for her treatment options ahead
Madam Halimah can consider combining these options for maximum cancer care efficiency:
- Tap into existing financial aids: BSS, Zakat Selangor, and MAKNA – subject to eligibility, and the final amount disbursed is at the organizations’ sole discretion;
- Utilise patient access programs for cancer medication i.e., ‘buy 1 – free 1′;
- Leverage KALSIS: Unlock RM210,000 across two years
- Take up a 0% Instalment Payment Plan: Consider using the credit card to enjoy 0% interest with up to 12 months installment plan at the hospital, which can then be paid off fully in Year 3 with another KALSIS payout of RM60,000 for that year
Madam Halimah could opt for surgery in a private hospital (to reduce waiting time) and complete her therapy in a public hospital, combining financial aid and KALSIS resources for the best treatment outcome.
Cancer Advocacy Side Note: Given that breast cancer can have a hereditary component, although most cases are not inherited (i.e. no history of breast cancer) – Madam Halimah’s daughter would benefit immensely from proactive breast cancer screening for early detection of cancer (as she is at increased risk of developing breast cancer), taking up relevant cancer insurance plans or comprehensive medical insurance that covers all type and stage of cancer (including Stage 0 early-stage breast cancer).
Conclusion
Financial burdens should not stand in the way of life-saving treatment in the fight against cancer. With the support of existing financial aid and KALSIS, seniors like Madam Halimah can conquer this battle. Cancer is not fought alone—it’s fought with the strength of family, community, and innovative solutions like KALSIS.
Remember, the will to fight is your greatest asset. Let KALSIS be your ally in this journey. For more information, visit our website or contact us via WhatsApp at +6011 5638 8580.
Look out for our upcoming sections for treatment costs regarding cancers such as colorectal cancer/colon cancer, prostate cancer, and cervical cancer.