Cancer survivors join calls for federal government to fund facial prosthetics

Wed 18 Dec 2024 at 5:59am
By Nick McLaren Health

Cancer survivors say there is inequality in their access to prosthetics. (Stateline NSW)

In short:

• Cancer survivors needing a facial or neck prosthetic cannot access government funding, unlike people with prosthetic limbs or breasts.
• Head and Neck Cancer Australia is calling on the federal government to back a $13 million fund to change this.

What's next?
A Department of Health and Aged Care spokesperson says funding
for such "products and devices" is available through some private
insurers.

Almost a year after undergoing life-saving surgery to remove a malignant tumour from her face, Tracey David is still adjusting to her new reality.

Readers are advised this article contains images of people who have had surgery.

The operation removed the type of skin cancer, squamous cell carcinoma, along with her nose and her identity.

"It is debilitating and you don't want to go out," she said.

"A lot of my family haven't seen me.

"It affects my grandchildren. The other day my grandson finally saw me with just this [bandage] on and he went, 'Oh my goodness, nanny, you poor thing.'"

After developing depression after the operation, the grandmother from the New South Wales far south coast town of Dalmeny said she had been looking into prosthetics.

But the one thing stopping her from rebuilding her face and her life is the cost. "My objective for me to live a 'normal' life was to get the magnets," Ms David said.

"With the magnets, I can just put the nose on and not have to worry about it falling off or anything like that. "Projected costs would be anywhere between $6,000 and $8,000 for the operation and then you have your prosthesis, which on top of that could be up to $8,000."

'Like a mechano set'

Unlike prosthetic limbs and breast implants, facial prosthetics are not
covered under Medicare and in most cases cannot be claimed through
private medical insurance.

Jamberoo resident Mark Robinson attributes his skin cancer diagnosis to a lifetime of working outdoors and a love of cricket and baseball.
He also had his nose and part of his upper jaw removed to treat the same cancer as Ms David.

Mark Robinson had to dip into his life-savings to be able to afford his prosthetic nose. (ABC Illawarra: Justin Huntsdale)

Mr Robinson has undergone extensive reconstruction surgery and uses an implant he described as "a mechano set" screwed into the bone structure.

"I had no choice they had to insert implants into my face and this prosthetic nose that I have, it's got magnetic indents in it," he said.
"So it is just a take on and off nose."

Mr Robinson was able to dip into his retirement nest egg to pay for his
prosthetic nose and is currently cancer free.

Head and Neck Cancer Australia estimates that around 2,000 Australians require head and neck prosthetics a year, and the cost of providing prosthetics for those in need is estimated to be $13 million a year.

The group is lobbying the federal government to bring the country into line with other countries like the United Kingdom, where prosthetics are
funded by the government or insurance regardless of where it is on the
body.

Chief executive Nadia Rosen said the system should not discriminate.
"In Australia, since 2008, if you have had one of your breasts or both of your breasts removed you can claim a reimbursement for an external breast prosthesis," she said.

"Most people would be horrified to learn that if you have had part of yo
face removed, your nose or your ear or your eye socket [or] part of your cheek, and it can't be reconstructed in surgery and you need an external facial prosthetic made, these are not covered in Australia.

"Even if you have private health insurance they are not necessarily covered, they are considered cosmetic."

Sophie Fleming is one of the few people in the state and around the
country making facial prosthetics.

The anaplastologist works out of her Alstonville clinic and the Chris O'Brien Lifehouse cancer hospital in Sydney.

She said making each individual prosthesis is a detailed process.
"We take an impression of the lost anatomy, we'll be either mirror imaging body parts if it's an ear or sculpting a new nose or eye depending on what's missing," she said.

"We'll make a mould of that then create that prosthesis in silicon by using custom colour matching, layers of silicon that we paint into the mould and then cure it in an oven."

Mark Robinson says he knows many people needing a prosthetic nose, ear or eye who simply cannot afford it.

The model developed by Ms Fleming re-purposes the External Breast
Prosthesis Reimbursement Program, which has been operating since 2008. "We strongly believe that the framework is already there, it just needs to be adapted for the needs of head and neck cancer patients," she said.

"It's a much smaller group of people, we have outlined that to the
government very clearly."

The ABC directed enquiries to Health Minister Mark Butler and received a response from the Department of Health and Aged Care.
"There are a number of Medicare rebates available for surgical facial
reconstruction for patients, including for head and neck cancer surgery,
when performed by a medical practitioner," a spokesperson said in a
statement.

"Medicare funds medical services but does not fund products or devices such as prostheses [for facial procedures]."

The spokesperson said funding for devices is available through some
private insurers. They also said that the government was currently considering a report by the Community Affairs References Committee, which includes a recommendation "to identify the barriers faced by cancer patients requiring rehabilitation, prosthetics and implants as a result of their treatment, with a view to ensuring they have financial support for those services."

Posted Wed 18 Dec 2024 at 5:59am

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Read more about Head and Neck Cancer Australia's for a 2025 pre-election submission:

Download The Missing Piece: 2025 Pre-Election Submission

Watch the Parliament Event: Head and Neck Cancer, a Critical Gap in Recovery

How you can help:

You can write to your local MP and ask them to support the funding proposal in the upcoming federal budget. See how to here.