High cancer-related expenses take a toll on quality of life

Reuters Health - Cancer survivors who face a higher financial burden with their treatment and recovery tend to report lower quality of life and higher distress, a new study shows.

High cancer costs affect patients physically, mentally, economically and socially, the study authors wrote in the Journal of Oncology Practice.

“When cancer patients spend more on their cancer treatment and other health care, they have less to spend on activities they enjoy and other needs, which can negatively affect their well-being,” said coauthor Joohyun Park, a doctoral student at the University of Wisconsin-Madison School of Pharmacy.

“It turns out that financial burden is directly related to health and well-being,” Park told Reuters Health by email. “The more a cancer patient spends on health care, the worse the quality of life and mental health.”

In the U.S., the number of cancer survivors is expected to reach 18 million by 2020, according to the National Cancer Institute.

Park and co-author Dr. Kevin Look, a pharmacy professor at UW-Madison, analyzed 2010-2014 data from the national Medical Expenditure Panel Survey, including responses from nearly 6,800 patients with cancer.

They found that 15 percent of cancer patients had medical costs greater than 10 percent of their family income, and 6 percent had costs greater than 20 percent of their family income. These two groups of patients were more likely to have a lower health-related quality of life and a higher tendency toward general distress.

“Cancer is becoming more and more expensive for patients because the treatments we are prescribing are becoming more expensive,” said Dr. Syed Yousuf Zafar of the Duke Cancer Institute in Durham, North Carolina. Zafar, who wasn’t involved with this study, researches cancer patients’ out-of-pocket expenses.

“Even those with insurance face growing financial stress,” Zafar told Reuters Health by phone. “We’ve known for some time that it impacts their well-being and access to care, and now we’re learning more about their health-related quality of life.”

“There is good evidence that outcomes are worse when financial burden is high for cancer patients,” said Dr. Louisa Gordon of the QIMR Berghofer Medical Research Institute in Brisbane, Australia. Gordon, who wasn’t involved with this study, has reported on financial burden and quality of life in colorectal cancer patients.

“For example, medications aren’t taken, appointments are missed, and mortality is higher,” she said.

Researchers are looking for ways to improve this strain on patients. At Duke, for example, Zafar is developing an app that would screen patients for financial strain and coach them on how to talk to doctors about costs. It also includes links to financial resources and gives advice about ways to reduce out-of-pocket costs.

“Providing supportive counseling of financial distress . . . should be part of health care strategies,” said Dr. Marvin Delgado Guay of the University of Texas MD Anderson Cancer Center in Houston, who studies financial distress and quality of life among advanced cancer patients but wasn’t involved in this study.

“Patients should have open communication with their clinicians and not wait until the issue becomes unbearable,” Delgado Guay told Reuters Health by email. “Living with a life-threatening illness is frightening, but in the middle of that adversity, always seek for help to have some balance in life.”

SOURCE: Journal of Oncology Practice, online January 30, 2018.