Study Suggests Many Providers Overlook Cancer’s “Financial Toxicity”

The out-of-pocket costs of cancer treatment can lead to economic hardship and debt, even for patients with insurance, and can often negatively affect patient health. While cancer is more treatable than it has ever been, research published in the journal Cancer suggests that health-care providers often underestimate this financial burden.

The authors surveyed thousands of patients with early-stage breast cancer and hundreds of doctors, who were asked whether they were aware of the financial burdens of cancer treatment. Just 40 percent of medical oncologists, 34.3 percent of radiation oncologists, and 27.3 percent of surgeons said they were “quite or very aware” of the out-of-pocket costs associated with the treatments they were recommending to their patients.

Reshma Jagsi, MD, DPhil, one of the authors of the study, was surprised by the lack of awareness of treatment costs among surgeons, in particular. “I think for many surgeons there may be an assumption that because of the seriousness of the illness, of course, costs should be covered by some form of insurance,” she told Reuters.

Women and ethnic minorities appeared to be more strongly affected by the financial burden of cancer diagnosis, reporting higher rates of debt following treatment and even cutting back on food spending, compared with other subgroups. More than half of women who wanted to talk to their health-care providers about the financial effects of breast cancer reported that they were unable to do so.

“We are seeing in our survey data, especially among vulnerable populations such as ethnic and racial minorities, non-trivial rates of terrible privation, including losing a home or having the utilities turned off,” said Dr. Jagsi. “We as physicians are ethically obligated to help.”

Sources: Jagsi R, Ward KC, Abrahamse PH, et al. Unmet need for clinician engagement regarding financial toxicity after diagnosis of breast cancer. Cancer. 2018 July 23. [Epub ahead of print]; Reuters, July 23, 2018.