
How your health can define your chances of seeing the world
The problem is travel insurance. Some insurers simply turn down flat people who have had cancer, regardless of the prognosis from the patient's doctor. Fortunately there are some excellent specialist companies who make it their business to offer policies for cancer patients. They typically provide cover for anyone who is deemed to be more likely than others to make a claim – whether because of advanced age or pre-existing medical conditions. You can find an expert through the Travel Medical Directory of the British Insurance Brokers Association. But the policy might end up costing more than the trip.
You may have read about Josh Cull, from Bournemouth – who, in 2021, received the devastating news that he had a brain tumour. He was just 25. Initially Josh was told he had only three months to live, but thankfully a combination of surgery, chemotherapy and radiotherapy meant he was, in his words, 'healthy and fully recovered'.
A number of people who have recovered from cancer have told me that a literal new lease of life spurs then to want to discover the world. So it was with Josh: 30 months after his treatment ended, he planned a South East Asian adventure with his brother and his fiancé.
'The trip was supposed to be a reward for everything we'd been through,' he says. 'However, I couldn't get an insurance quote for less than £3,000.'
Josh could have abandoned the trip. That is what the Foreign Office would advise. It says: 'If you're travelling abroad, you should take out appropriate travel insurance before you go.'
He might have been tempted not to disclose the cancer and treatment and just pick up a cheap policy. That could have ended badly. Should you fall ill as a result of a pre-existing condition returning, an insurer will immediately investigate your medical history. If there is a related condition you have not disclosed, the policy may be annulled and you could end up with medical bills running to tens of thousands of pounds.
Instead, Josh took a calculated risk to go anyway. Like many other young travellers who do not have insurance, he got away with it.
But for people who have recovered from cancer to have to face such a choice – travel uninsured or stay at home – is far from ideal.
Some say that premiums running into thousands of pounds show travel insurers are profiteering from people who have been through an extraordinarily difficult experience. Yet travel insurance is a competitive business. Regrettably, this is down to harsh arithmetic. Underwriters crunch the numbers on dealings with travellers who have been through cancer. Their conclusion: there is more chance of a claim than for most travellers, and the cost of a claim is likely to be higher.
Sometimes travel insurers' concerns are unfounded – and there is welcome evidence that insurers are now looking more closely at an individual's circumstances rather than refusing to insure cancer patients at any price, or applying outlandishly high premiums. But any traveller who comes with enhanced medical issues can expect to pay more.
For example, I have osteoporosis (brittle bones). I enjoy trekking in the Himalayas. But because I am more likely than most to break a bone at high altitude, I paid £228 extra to cover an expedition in Nepal last year.
Fortunately, there is one more option for people facing astronomical premiums: stay in Europe. The UK Global Health Insurance Card (GHIC) gives coverage for free or reduced-rate treatment in public hospitals in the EU and Switzerland. Some travellers with cancer or other conditions make a positive decision to rely on this asset rather than staying at home.
Simon Calder, also known as The Man Who Pays His Way, has been writing about travel for The Independent since 1994. In his weekly opinion column, he explores a key travel issue – and what it means for you
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Telegraph
8 hours ago
- Telegraph
Streeting should ‘channel Thatcher' and introduce prostate screening
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'In the 1970s, before breast cancer screening was introduced by Government dictat, the medical consensus was, and, you have guessed it, that early diagnosis through screening mammography would not save lives. 'Mrs T, regardless of the medical consensus, waved her handbag at the doctors, ignored the consensus, and launched a screening programme for breast cancer. And the result? Screening mammography, together with treatment advances, has led to a massive improvement in survival from breast cancer. 'Before screening, just 65 per cent of patients with breast cancer survived and now over 80 per cent are cured as a result of early detection and better treatment. 'And how does this improvement manifest in the real world? Around 3,000 fewer women die each year in the UK from breast cancer than before the screening programme was introduced.' The emeritus professor at Imperial College London said Prostate Cancer UK led a consortium of men's health charities to collectively inform the committee on the importance of targeted screening for those at highest risk. But he said the NHS should act now so that GPs do far more to help men at risk of prostate cancer. He urged the NHS to rewrite its guidance so that family doctors are told to proactively start conversations with men about the PSA blood tests which can detect the disease. Current guidance says that men can ask for a test, though some GPs rebuff them. For younger men, including those with a family history of disease, offering a test is down to the clinical judgment of GPs about. In both cases, the onus is on patients to seek help in the first place, with many men including those with family histories of prostate cancer unaware they are at heightened risk of the disease. Prof Waxman said the NHS should rewrite its advice so that GPs are told that they should bring up prostate cancer with all patients who might be at extra risk. He added that the guidelines should suggest that GPs start conversations with men from the age of 45 at highest risk, so those who wish to can obtain a PSA test. 'This puts the power of informed choice back in the hands of men who need it the most and is a crucial step on the path to early diagnosis,' he says. In the past, screening advisers have rejected the practice on the grounds that the tests are too unreliable, and could result in too many men undergoing needless procedures. However, in recent years the back-up diagnostics used to confirm the initial test findings have significantly improved. A Department of Health and Social Care spokesman said: 'This Government has been clear we would like to see screening in place, but the decision must be evidence-led. 'The UK National Screening Committee is looking at this as a priority – including reviewing the evidence for screening men with a family history of prostate cancer. 'While the review is taking place we are getting on with improving cancer treatment and prevention, as well as funding tens of millions of pounds of research – GPs should consider risk factors and use clinical judgment when considering if patients need a prostate cancer test.' Prostate cancer is a lot more than a nuisance By Jonathan Waxman Sixty years ago, around 10,000 people in the UK were diagnosed annually with prostate cancer. Currently over 50,000 men are diagnosed each year and prostate cancer has the dreadful distinction of being the commonest cancer in men. In parallel, the number of prostate cancer deaths has increased from 3,300 to over 12,000 men annually. So, what to do? We can hope that the treatment of prostate cancer will improve and improve, and cures are found. Treatment is getting better. Thankfully, in 2025, well over 80 per cent of men with prostate cancer that has not spread beyond the prostate will be cured and the duration of survival for men with cancer that has spread has doubled compared with 25 years ago. These improvements have come because of modern medicine's marvellous miracles, developing from brilliant university research and big pharma's R & D. Prostate Cancer UK has invested over £120m in research over the years. But clearly despite the gloss of shiny medical breakthroughs, prostate cancer remains a fundamentally unpleasant problem, and a lot more than a nuisance. What can be done? Find it early, you say? Yes, that would seem logical. How do we do this? Well, if we want to find prostate cancer early then the obvious answer is to screen for prostate cancer. There is no UK screening programme for the early detection of prostate cancer, a cancer which is often without symptoms. The National Screening Committee is currently considering the role of screening for prostate cancer. Prostate Cancer UK has led a consortium of men's health charities to collectively inform the committee, which advises government, on the importance of targeted screening for those at highest risk. There are interesting parallels between the prostate cancer and breast cancer screening stories. In the 1970s, before breast cancer screening was introduced by Government dictat, the medical consensus was, and, you have guessed it, that early diagnosis through screening mammography would not save lives. Mrs T, regardless of the medical consensus, waved her handbag at the doctors, ignored the consensus, and launched a screening programme for breast cancer. And the result? Screening mammography together with treatment advances have led to a massive improvement in survival from breast cancer. Before screening, just 65 per cent of patients with breast cancer survived and now over 80 per cent are cured as a result of early detection and better treatment. And how does this improvement manifest in the real world? Around 3000 fewer women die in the UK from breast cancer each year than before the screening programme was introduced. To return to the debate on screening for prostate cancer. We are now at a critical inflection point in the history of prostate cancer screening. Last year, Prostate Cancer UK published research that showed prostate cancer diagnosis is safer and more accurate than ever before, and this in part is thanks to research the charity funded leading to MRI – Magnetic Resonance Imaging – being introduced into the diagnostic pathway. The National Screening Committee, under the iron baton of its excellent chair, is currently deliberating on the evidence for and against screening for prostate cancer and will issue a report this year. In heavily trailed remarks, Wes Streeting has indicated that he is in favour of screening but not for everyone, just for selective high risk groups of men. We at Prostate Cancer UK welcome this ministerial support, for it is also our view that there is a need for screening, and we believe the evidence is now there for targeted screening. We welcome his remarks at a time when we are about to launch TRANSFORM, a multi-centre screening trial using sophisticated technologies based on current diagnostic tools, an adaptive trial that is open to new screening tests. Prostate Cancer UK's trial invests £42m in a very long-term campaign to assess the survival benefits of modern screening methods. So, who are Mr Streeting's selective high risk groups of men at increased risk of prostate cancer? These are men with family histories of prostate cancer who constitute 1 to 5 per cent of all diagnosed patients, and black men, who have a one in four risk of prostate cancer, which is twice the risk of white men. What to do whilst we await the Screening Committee's conclusions? Currently GP guidelines concerning testing for prostate cancer are outdated. We urgently need these NHS guidelines updated to empower GPs to proactively start conversations about PSA testing with men from the age of 45 at highest risk. This puts the power of informed choice back in the hands of men who need it the most and is a crucial step on the path to early diagnosis. So, yes, prostate cancer is a bit of a nuisance, but let us see if we can do something about that nuisance. Prof Jonathan Waxman OBE is the founder and president of Prostate Cancer UK


Daily Mail
9 hours ago
- Daily Mail
Sir Chris Hoy explains why he feels 'lucky' after cancer diagnosis granted him 'the time to really appreciate life'
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Reuters
14 hours ago
- Reuters
Dhaka like a local
Landing in Dhaka by air, looking down at the city from the plane window, your first impression is likely to be that you are arriving in a concrete jungle. The Bangladeshi capital is noisy and messy, and as the economic and political hub of a country of 180 million, it is a place where fortunes are made and ambitions converge. As local rock band Chirkut calls it in its popular number 'Jaadur Shohor,' it is also 'the city of magic.' I was born and raised in this city, and have spent the past 14 years reporting from here, most recently as a visual journalist for Reuters. In that time, I've seen it all — from the 2013 Rana Plaza collapse that killed over 1,100 garment factory workers to a recent student uprising that resulted in the ouster of the country's ruler of 15 years. Here's my guide on how to traverse this chaotic yet captivating metropolis like a local: Old Dhaka: Founded as the capital of Bengal by the Mughals in the early 1600s, Dhaka served as a provincial capital during British rule, then the administrative capital of East Pakistan, before finally becoming the capital of independent Bangladesh in 1971. The city has grown extensively since then, swallowing up many of the surrounding villages. The historic core of Puran Dhaka, or Old Dhaka, is a charismatic world of narrow alleys and crumbling buildings. A majority-Muslim country, Bangladesh is home to thousands of mosques, and Dhaka is often called 'the city of mosques.' Their minarets dominate the skyline, and five times a day the Islamic call to prayer echoes through the streets. Among the city's most significant mosques are the 19th-century Star Mosque (so named for its blue star motif), the vast national mosque Baitul Mukarram and the 18th-century Khan Mohammad Mridha Mosque. Getting around: Traffic in Dhaka is notoriously chaotic — the inevitable outcome of too many vehicles and too few road structures. Traffic lights are more suggestions than rules, and police direct traffic with a mixture of instinct and desperation. Footpaths are barely usable, packed with street vendors and shoppers, and crossing a street requires bravery. Jaywalking is often essential! While city buses are available, they are often overcrowded and uncomfortable. For short to medium distances, your best bet is the cycle rickshaw — ubiquitous, cheap and often dazzlingly decorated. Beware the speedy battery-powered ones, nicknamed "Desi Teslas,' for they can be fun, but risky. Alternatively, flag down a green-painted CNG (compressed natural gas-powered auto-rickshaw) — haggling is essential — or use ride-sharing apps like Uber or Pathao. The new Metro Rail system avoids road traffic entirely and is set to be a gamechanger once it is fully operational. What to see: One of the city's most vibrant areas is the Dhaka University campus – once dubbed the 'Oxford of the East.' It remains a bastion of secularism and youth politics, and is home to some of the city's rare green space. Look out for the Dhaka Gate, once the main entrance to the Mughal city, and still guarded by General Mir Jumla's rusty cannon. History buffs will also enjoy the nearby Bangladesh National Museum and the Shaheed Minar — a monument to those killed in 1952 as they protested the right for Bengali to be officially recognised as a language in East Pakistan. Other must-visit sights include the Sangsad Bhaban or National Parliament, designed by noted architect Louis Kahn, the Mughal-era Lalbagh Fort, and Ahsan Manzil, a pink palace by the Buriganga River. You can take a boat ride from the Sadarghat river port, though be warned: the water can be quite pungent. Ramna Park offers a rare moment of tranquillity, and the Armenian Church in Old Dhaka is a haunting relic of a forgotten community. Adventurous visitors should consider spending a night at Beauty Boarding, a colonial-era guesthouse once beloved by poets and writers. If sports are more your game, take in a cricket match at Mirpur Stadium. Tickets go for as little as 500BDT ($4). Retail therapy: Bangladesh is a paradise for bargain-hunters. As the world's second-largest exporter of ready-made garments, much of what's stitched for major Western brands can also be found in local markets. Head to New Market, Bongo Bazar or the Anannya Shopping Complex for export-quality clothes at a fraction of the price. Haggling is expected. For a more modern retail experience, the Bashundhara City and Jamuna Future Park malls offer everything from international fashion to cinemas and food courts. Aarong stores are great for Bangladeshi souvenirs like jute products and handloomed crafts. What to eat: Food is Dhaka's greatest love language. Street food, in particular, is vibrant and addictive, although caution is advisable for those with sensitive stomachs. 'Fuchka' are crunchy little orbs filled with mashed potatoes, lentils, tamarind water and spices that explode in your mouth. At Nazira Bazar in the old city, try Nanna Mia's Murg Polao, Haji's Mutton Tehari served on jackfruit leaves, Bakarkhani (a flaky, savoury biscuit), and Beauty's famous Lassi. The best kebabs, meanwhile, are made by Bihari chefs in the Mohammadpur and Mirpur Geneva Camps, in west and northwest Dhaka, respectively. Kacchi biryani is a Dhaka classic, made with tender mutton, fragrant rice, and potatoes cooked in ghee with authentic subcontinental spices in an airtight massive pot simmering over a coal fire. The best can be found at Sultan's Dine or Kacchi Bhai, with branches all over the city. Beyond the markets, you can also find food carts on each corner, selling an array of spicy snacks, fresh fruit, grilled meats, and drinks. If your stomach can handle it, dive in. But never drink tap water. Bottled water is cheap and essential. While you eat, don't be surprised if a stranger pays for your food or strikes up a conversation. Hospitality is a way of life here. You might even be invited home for lunch or dinner. What to drink: For a quintessential local experience, grab a cup of 'cha' or tea at a roadside 'tong' or tea shack. Everyone — from students to businesspeople — gathers here to discuss politics, cricket, or philosophy. Feel free to join the conversation. Public drinking is prohibited in Dhaka, but there are a few semi-dark bars (so called because of their deliberately low lighting) that serve foreigners and locals with permits, where you'll find local liquor called Carew's or the crisp Bangladeshi beer Hunter, easily mistaken for an Australian Foster's thanks to the similar packaging design. Local festivities: Festivals bring the city to life in glorious fashion. If you're in town during Eid or Durga Puja, don't be surprised if new friends pull you into family celebrations, stuff you with food and even gift you a new kurta, a traditional loose-fitting tunic. That's Dhaka for you — intense, generous, and unpredictable. CITY MEMO DATA POINTS Population: 24 million Price of a cup of tea: 10BDT ($0.08) from a tea shack or 250BDT ($2) from a top-tier restaurant. Price of a designer t-shirt: Between 250 and 600BDT ($2 and $5) from New Market or Bongo Bazar. Best place to see a sunset: The roadside food shacks next to Purbachal Express Highway and the posh rooftop cafes. Essential read: 'Dhaka: From Mughal Outpost to Metropolis' by Golam Rabbani provides a 400-year history of the city.