Financial Worries Add to Cancer Patients’ Burden

WEDNESDAY, June 6 (HealthDay News) — A small study gives a
snapshot into the financial anxieties that plague many patients with
advanced cancer and their spouses, even as they struggle against the
disease itself.

Four of every five such American patients and their spouses-caregivers
in the study said they had concerns about meeting medical costs and
suffered “financial stress.” Worries about paying medical costs also were
tied to lower mental and physical health, the study found.

“Across the board, the longer they were in treatment or reaching the
end of life, there were [financial] concerns. There were concerns whether
it came to their own well-being or their families’ well-being,” said study
lead author Fay Hlubocky, a clinical psychologist and ethicist at the
University of Chicago Pritzker School of Medicine.

She reported the findings this week at the annual meeting of the
American Society of Clinical Oncology (ASCO), in Chicago.

The study involved 52 patients with advanced cancers, all of whom were
enrolled in clinical trials, and their spouses. While patients in clinical
trials are a slightly different group than that seen in the general
population (because some expenses of treatment may be paid for), Hlubocky
said the numbers from her study “are borne out in the literature
generally” for patients battling cancer outside of such trials.

Patients ranged in age from 28 to 78, with a median age of 61. All
were married, two-thirds had more than a high school education, and just
over half made less than $65,000 a year. Forty-five percent of the
patients were employed, as were two-thirds of spouses-caregivers. Each
patient and their spouse were asked about a wide range of financial
concerns, and they also took part in standard tests assessing depression,
anxiety, quality of life and mental/physical health.

The researchers found that at the beginning of the study, 82 percent of
the patients and 69 percent of the spouses reported “medical cost
concerns,” while 79 percent of the patients and 81 percent of spouses said
they had “financial stress.” Queried a month later, the level of
“medical cost concerns” had risen — 85 percent of patients and 72 percent
of spouses now cited such worries.

People who encountered “unexpected” costs related to care had higher
anxiety and depression scores than those who did not, the study found.
Quality-of-life scores were lower for patients who had financial worries,
and the physical and mental health of the spouses-caregivers seemed to
decline as medical care cost worries persisted, the study found.

What were patients and their spouses worried about? According to
Hlubocky, it ranged from the “little things” — parking and hotel
accommodations, gas and mileage getting to and from doctors’
appointments — to much larger concerns, including insurance coverage (or
lack thereof), how to provide for loved ones after death, and even

Some participants expressed real anxiety in meeting their financial
obligations. “We had to pay for an additional hospitalization for a
small-bowel obstruction, and insurance would not cover it,” one patient
told the researchers. “If we had to sell our house to pay, we’d do

Other patients felt their illness threatened their livelihood. “My
employer has an attendance policy that if violated too many times will
result in termination,” the patient said. “My appointments have to be
midday usually.” The patient considered going on disability, “but that
would not pay for my insurance.”

One expert said these types of fears are all too common for people
coping with cancer.

“It is certainly true that the impacts beyond diagnosis and treatment
are tremendous for cancer patients,” said Dr. Sylvia Adams, ASCO
spokeswoman and assistant professor in the department of medicine at NYU
Langone Medical Center, in New York City. “They do face several
challenges. And as this article shows, there is a substantial number of
patients who feel that there is anxiety and depression and lower quality
of life associated with worries about financial stability.”

Adams said that, even for people with insurance, costs can quickly
escalate. These include medication co-pays, transportation costs, time
missed from work, child-care issues and the cost of in-home medical

However, both Hlubocky and Adams stressed that, as challenging as
things can be for cancer patents, help and resources are out there. First
and foremost, they said, is to make sure you have a social worker on your
cancer-care team who can point you in the right direction for help.

“There’s lots of different foundations and coalitions out there that
are willing to help,” Hlubocky said. “Certain hospitals, you can just go
and talk to the social worker and try and find out what’s the best way to
help cover some of the financial problems. Many patients don’t know. A
social worker is an absolutely wonderful person to have on your team.”

Adams agreed. “It is very important that the treating team has a
multidisciplinary aspect, and that it involves psychological support as
well,” she said, since the stress of dealing with cancer and its treatment
can be overwhelming.

Findings presented at medical meetings are typically considered
preliminary until published in a peer-reviewed journal.

More information

There are resources for cancer patients and their caregivers at the American Society
of Clinical Oncology

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