English couple who retired abroad to Nicaragua shocked after NHS refuses cancer treatment – leaving them to pay more than £64,000

A British couple retiring in Nicaragua were shocked to be denied cancer treatment on the NHS after the former army engineer was diagnosed with a rare but aggressive blood cancer.

Michael and Kim West of Dover moved to San Juan del Sur, Nicaragua, last year after collecting their government pension and focusing on building their dream home in Central America.

But just months after completing the £230,000 build, Mr West, 69, was diagnosed with multiple myeloma, a blood cancer that affects the bone marrow (the spongy substance inside bones where blood cells are made).

Recalling the devastating diagnosis, his wife, 68, said: ‘He was losing weight and complaining of pain in his bones, chest and pelvis.

‘Michael is 6ft tall and has always been skinny but has lost a lot of weight recently; It was terrifying to watch.

‘One night the pain in his ribs got so bad he almost cried. I took him to a clinic where blood tests were done; The consequences were everywhere.

‘The healthcare here is better than anywhere else in the UK. ‘They saw it the next day, the consultant looked at the results and knew immediately what had happened.’

A bone marrow biopsy, in which a small piece of bone marrow was removed for testing, confirmed the doctor’s suspicions and the father-of-one was diagnosed with cancer in July.

The couple have spent more than £64,000 on treatment so far; They were unaware that when they left completely they would ‘no longer automatically qualify for medical treatment in the UK under normal NHS rules’.

‘A lot of people in the UK keep asking me why we’re not coming back,’ Ms West said.

‘I was born and raised in Britain, I’m as British as they come, and so is Michael. We didn’t realize we wouldn’t be able to access the NHS except in emergencies because we didn’t have a home there.

‘But this is a safer and more beautiful place than anywhere I’ve ever been in my life. “We were both always as healthy as possible,” he added.

There are an estimated 6,000 new cases of myeloma a year in the UK, of which more than 35,000 are in the US.

It occurs because changes in the DNA of plasma cells turn them into abnormal myeloma cells, which multiply faster and cause a range of problems.

It is often called multiple myeloma because it can be found in various locations wherever there is bone marrow.

But symptoms of the disease (including back pain, broken bones, fatigue and recurrent infection) are often overlooked, instead being attributed simply to general aging or minor ailments and injuries.

The couple moved to Nicaragua in 2024 after selling their home in the UK and collecting their state pension.

Before moving to Central America, Michael had always been healthy and was serving in the army as an engineer.

The former engineer immediately began treatment, which consisted of a combination of targeted drugs to kill cancer cells and other drugs to help prevent bone thinning and relieve pain; each treatment cost in excess of £3,270.

But then his hemoglobin (the protein in red blood cells responsible for delivering oxygen throughout the body) dropped so low that he needed a blood transfusion, which cost even more money.

Mr West spent 10 days in intensive care, where he was started on dialysis after he began showing signs of kidney disease as a result of abnormal proteins secreted by cancer cells that were damaging his organs.

‘I was absolutely shocked,’ his wife recalled. ‘I have a 1.90 tall husband whom I love and he has cancer. He’s never been sick and now he can barely walk.’

‘We bought a zimmer frame for the days when he felt a bit fragile, it was terrifying to watch. Even without chemotherapy it makes him feel very bad.’

Mr West still requires weekly dialysis, costing the couple around £460 a week and ‘draining over’ their savings as they try to raise the money needed to keep Mr West alive.

‘This is an aggressive enough cancer that it can be treated, but it requires a lot of money that we don’t expect to pay,’ Ms West said.

Her husband added that the diagnosis was a ‘huge shock’ and that although he ‘didn’t feel well at all’, they would have preferred to be in Nicaragua rather than the UK.

Kim, a former equestrian, says despite the high cost, they are much happier in Nicaragua and wouldn’t consider returning

Since his move, Michael is no longer entitled to medical treatment in the UK; This means the couple has to pay for their life-saving treatments, slowly depleting their savings

The couple moved to Nicaragua to build their dream home, which cost £230,000.

The couple, who previously had enough savings to build the house and live comfortably under normal conditions, now have to raise donations to cover Michael’s treatment costs

‘It’s a beautiful country, charming, small population, no tourism and prices here are much lower than in England. ‘Someone told us to look at Nicaragua, we came for two weeks and decided that was where we needed to be.’

Mr West now faces further treatment, which will be overseen by his pain management team, who are concerned about the effect of painkillers on his kidneys. GoFundMe page.

But myeloma cannot always be cured. Multiple myeloma is considered a rare form of the disease, accounting for just 2 per cent of all cancer diagnoses in the UK.

The NHS website says: ‘If you are moving abroad permanently you will no longer be automatically entitled to medical treatment in the UK under normal NHS rules.

‘This is because the NHS is a residence-based healthcare system.’

Almost 1.4 million cancer patients in the UK have been let down by the ‘postcode lottery’, according to a damning report.

Four in ten people living with the disease say they struggle to get the most appropriate treatment simply because of where they live.

Macmillan Cancer Support warns that this unfair variation, likened to ‘flipping a coin’, leaves some people with fewer treatment options and little choice but to travel long distances to get the treatment they need. Many are facing increased costs, stress, anxiety and fatigue as a result, the charity added.

Meanwhile, an estimated 60,000 more people each year in the UK would be able to access cancer treatment faster if waiting times across the country matched the best-performing areas, according to Macmillan’s analysis of NHS data.