A cancer patient’s quality of life during treatment can significantly be impacted by the financial burden and might even increase their risk of death, according to the result of an analysis presented at the ESMO 2016 Congress in Copenhagen.
This is true even in countries where the national public health system covers most of the expenses. It is our duty to understand what the determinants are of such difficulties and whether some of them are actionable. This information was reported by the principal investigator, Dr. Francesco Perrone who is the director of the Unità Sperimentazioni Cliniche at the National Cancer Institute of Naples, Italy. Data of 16 prospective multicenter trials in Italy were involved with a total of 3670 patients with lung, breast or ovarian cancer. The EORTC quality of life C30 questionnaire was used. One of the questions of this questionnaire asks the patient to rate their financial difficulties related to their disease or treatment on a scale from not difficult at all to very difficult.
The analysis showed that the financial burden, defined as any financial difficulty, was present in 26% of the patients and associated with a 35% greater risk of a worse global quality-of-life response.
The financial toxicity defined as a worsening of the financial score in the questionnaire was shown in 22.5% of the 2735 that filled out the questionnaire and associated with a 20% increase in the risk of death.
According to Perrone the researchers had expected to find an impact on quality of life from their financial hardship but were surprise to see their increasing financial problems during treatment was associated with a higher risk of death throughout their treatment. According to Perrone, this impact is moderate but not negligible and that it is similar in size to the effect that pushed some new drugs into the market over the past twenty years. It was not possible to completely disentangle the financial toxicity from the worsening of the patient’s disease progression and clinical condition. This analysis shows that those observed in other analysis conducted in the U.S. are based on common sense. The oncologists should pay attention to the social status and the economic status of the patients and make an effort to advise them of their rights in terms of public support and the respect that is due to their condition.
Dr. Nathan Cherny from the Shaare Zedek Medical Center in Jerusalem commented that the study demonstrates that even if the patients do not have to pay for their treatment, as in a clinical trial, a large number of them still begin treatment with some amount of financial burden.
This confirms that even in the absence of payment or even co-payment of medications, being ill with cancer can often have severe and progressive financial impact on the patients and their families. This may not compromise only the quality of life, but also the patient outcome as well.
This being said, remember, stress is terrible on the mind and body. Give someone you know who has cancer a big hug and ask if there is anything you can do to help. Most of the time they will say thank you but no. Sometimes people are afraid of appearing weak. I believe we are born to help each other. Maybe surprise them with a salad for lunch or their dinner. Its amazing what little kind acts can do for one’s heart and their immune system.
-Dr Fredda Branyon