General Discussions

Financial Hardships

By Lisa Schulmeister, MN, RN, ACNS-BC, OCN, FAAN
PUBLISHED THURSDAY, JANUARY 1, 1970
From the few studies that have been done, as well as our patients’ experiences, we know that financial hardships often accompany cancer treatment. In fact, some authors assert that this is an additional treatment-related toxicity and have named it financial toxicity. Robin Whitney, RN, BSN, from the University of California Davis School of Nursing, conducted a study on financial and work-related hardships and reported her findings at the Society of Clinical Oncology's inaugural Palliative Care in Oncology Symposium (PCOS), held in Boston on 10/24/14-10/25/14.

Data for the study came from the 2011 Medical Expenditures Panel Survey Experiences with Cancer Survivorship Supplement. Whitney found that a third of 1,592 cancer survivors reported financial or work-related hardships that persisted well beyond cancer treatment. Of these survivors, 27% reported high debt, bankruptcy, and other financial difficulties, and 37% of the patients reported that they had to modify work plans, which included extended periods of leave and delayed retirement. Financial difficulties were more common during active treatment among patients under age 65, uninsured patients, and nonwhite patients. Overall, 39% of the patients made alterations that affected their care, which included not filling a prescription (28%) and taking less than the prescribed dose (22%). In addition, 10% of patients reported skipping a test, 8% skipped a planned procedure, and 6% did not make a recommended appointment. Whitney’s findings confirm that financial distress impacts cancer survivorship, and suggest that financial and work-related concerns should be assessed frequently during treatment and periodically following treatment, with action taken when indicated.


Reference
Whitney RL, et al. Work and financial disparities among adult cancer survivors in the United States. ASCO PCOS 2014; Abstract 238.
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