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Symptom Burden Higher in Newly Diagnosed Patients Reporting Financial Strain

Thursday, March 24, 2016
Christopher Lathan, MD, MS, MPH

Christopher Lathan, MD, MS, MPH

A study published by researchers at the Dana Farber-Cancer Institute recently discovered that financial status plays a large role in the level of symptom burden and quality of life for patients newly diagnosed with lung or colorectal cancer.

The aim of the study, published online in the Journal of Clinical Oncology, was to assess any relationship between a patient’s financial strain and the symptoms and quality of life (QOL) the patient reported upon diagnosis—earlier time points than the focus of previous research.

“Most of the studies looking at financial stress look at what cancer does to your finances after diagnosis,” Christopher Lathan, MD, MS, MPH, lead author of the study and a thoracic oncologist at Dana-Farber, said in a statement. “We were interested in looking at what happens when you have financial distress, defined in our study as little or no savings at the time of your diagnosis, and how that factor can impact quality of life.”

Study participants were drawn from patients in the Cancer Care Outcomes Research and Surveillance study. Patients were asked about their experienced QOL, symptom burden, and financial reserves, using validated assessments, such as the Brief Pain Inventory, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30, and  the EuroQoL-5 Dimension scale to gage responses for QOL.

Forty percent of patients with lung cancer and 33% of patients with colorectal cancer reported having limited financial reserves equivalent to 2 months or less. When compared with patients who had more than 12 months of financial reserves, these financially-strained patients with either lung or colorectal cancer reported significantly more pain, greater symptom burden and poorer quality of life.

The investigators also reported that as a patient’s financial resources decreased, a dose–response relationship emerged across all well-being measures, and this relationship persisted in outcomes reported by survivors after 1 year.

In follow-up interviews conducted 1 year after the baseline assessments, researchers found that patients across both tumor types who initially reported greater financial strain at diagnosis to have worse overall health, impairment in activity level, more pain, and more depression as compared with those with greater financial reserves.

“We found that patients who had financial distress at the time of diagnosis were more likely to have poorer outcomes in physical and mental quality of life measures, pain, and symptom burden. This effect persisted after adjusting for stage of disease, co-morbidity, income, age, and insurance,” Lathan added.

Study investigators hope that these findings will prompt healthcare professionals to evaluate patients for signs of financial distress at the time of initial diagnosis. Additionally, the research team urged clinicians to seek the appropriate resources and treatment options for patients who are already struggling financially before diagnosis.
Lathan C, Cronin A, Tucker-Seeley R, et al. Association of financial strain with symptom burden and quality of life for patients with lung or colorectal cancer [published online ahead of print February 29, 2016]. J Clin Oncol.

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