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


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.

Nearly 1 out of 2 patients with gynecologic cancer reported some degree of financial distress or financial toxicity, according to a recent study, published in the 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. Int J Gynecol Cancer. 2021; 31:801-806. doi:10.1136/ ijgc-2021-002701.

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