Nearly 1 out of 2 patients with gynecologic cancer reported some degree of financial distress or financial toxicity, 

International Journal of Gynecologic Cancer

Oncology Nursing News spoke to corresponding author, Kate Esselen, MD, Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, about how the number of patients who reported financial toxicity was higher than expected, and how providers need to normalize the financial conversation with their patients.

The data showed that nearly half of patients with gynecologic cancer experienced some degree of financial distress and that patients with severe financial toxicity were significantly more likely to engage in behavioral cost-coping by medication non-compliance (adjusted risk ratio, 4.6; 95% CI, 1.2-18.1). However, Esselen, who described herself to have a personal research interest in how cost of care affects patients with cancer, acknowledged that money and financial strain are not currently a part of normal conversations between providers and patients. She continued to share that normalizing that conversation, and letting patients know it is okay to talk about it, can often offer insights into how to help specific patients manage the financial burden of treatment.

“I think, though, that the first step is addressing it with patients and feeling comfortable talking about it, just even acknowledging it, and letting them know it’s okay to bring up these issues, because there may be small things you can do as providers that you don’t even think of,” Esselen said. “If a patient tells you she is worried about coming to the 5 next appointments she has because it is affecting her work schedule, you might look at those 5 appointments and decide, ‘Well, actually, 2 of those appointments aren’t necessary, we can consolidate,’ but if you’re not asking or having these conversations with patients, you may not even know that is a problem.”

Esselen KMck, Gompers A, Hacker MR, et al. Evaluating meaningful levels of financial toxicity in gynecological cancers

2021; 31:801-806. doi:10.1136/ ijgc-2021-002701.

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Nearly half of patients with gynecologic cancer reported financial distress as a result of the high costs of cancer treatment, yet money is still not commonly discussed between patients and providers. 

Normalize Conversations Between Patients and Providers on the Financial Costs of Cancer 

Nearly 1 out of 2 patients with gynecologic cancer reported some degree of financial distress or financial toxicity, 

. Oncology Nursing News spoke to corresponding author, Kate Esselen, MD, Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, about the results of the study and which factors were associated with higher levels of financial toxicity.

The data showed that nearly half of patients with gynecologic cancer experienced some degree of financial distress and that patients with severe financial toxicity were significantly more likely to engage in behavioral cost-coping by medication non-compliance (adjusted risk ratio, 4.6; 95% CI, 1.2-18.1). Young age, unemployment, or having private insurance instead of public or federal insurance, resulted in a higher likelihood of financial distress for the patients. The data also demonstrated that changes in employment such as moving from full time to part time put patients at risk, but that being retired was protective, since patients were less dependent on their income.

“Certainly these are things that if you are hearing from your patients–that their insurance deductibles are high or that they are having to change their job and their employment–should be sort of cues to their provider to say, ‘Hey, how is everything? How are you feeling about your care? Are you feeling overwhelmed in any way related to the financial burden of it, or how it is impacting your family?’” Esselen said. “And [find] ways to open the conversation. Because when we have asked patients, they do want to talk about it, they just are not sure how.”

Patients with gynecologic cancer are at higher risk for financial distress if they are enrolled in private insurance, are young in age, or are undergoing an employment change. 

Kate Esselen, MD

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Normalize Conversations Between Patients and Providers on the Financial Costs of Cancer

Private Insurance and Changing Employment are Risk Factors for Financial Distress