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Understanding the strategies rural cancer patients and survivors use to manage financial toxicity and the broader implications on their lives

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Abstract

Purpose

To explore strategies rural Australians use to cope with the financial consequences of their cancer diagnosis and how that impacts on their lives.

Methods

Twenty adult cancer patients/survivors residing in regional-remote areas of Australia were purposively sampled and participated in audio-recorded, semi-structured interviews. When data saturation was reached, thematic analysis was employed to analyse the data.

Results

Participants were 20–78 years (M=60), 70% female, 35% were undergoing treatment and the remaining 65% had finished treatment within the past 5 years. Three themes provide context to rural financial toxicity-related experiences (travelling to access cancer treatment away from home is expensive, being single or lacking family support exacerbates the financial strain, and no choice other than to adopt cost-saving strategies if wanted to access treatment). Strategies commonly employed to minimise financial toxicity include: accessing travel-related support, changes to lifestyle (buying cheaper food, saving on utilities), accessing savings and retirement funds, missing holidays and social activities, reduced car use and not taking a companion to cancer-related appointments at metropolitan treatment areas. Although cost-saving strategies can effectively increase the ability of rural people to cover cancer treatment-related and other costs, most have broader negative psychological, social and practical consequences for them and their families.

Conclusions

Increasing rural cancer patients’ and survivors’ awareness of various cost-saving strategies and their impact (positive and negative) may decrease their risk of experiencing financial toxicity and unexpected unintended consequences of adopting cost-saving measures.

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Data availability

We have control of all primary data and agree to allow the journal to review our data if required.

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Funding

This project was funded by the University of South Australia Cancer Research Institute and the University of South Australia’s Research Theme Investment Scheme.

Author information

Authors and Affiliations

  1. Cancer Research Institute, University of South Australia, Adelaide, South Australia

    Xiomara Skrabal Ross & Kate M. Gunn

  2. Department of Rural Health, Allied Health and Human Performance, University of South Australia, North Terrace, Adelaide, South Australia

    Xiomara Skrabal Ross & Kate M. Gunn

  3. School of Psychology, The University of Adelaide, Adelaide, South Australia

    Ian Olver

Authors
  1. Xiomara Skrabal Ross
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  2. Kate M. Gunn
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  3. Ian Olver
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Contributions

Xiomara Skrabal Ross: project administration, data collection, data analysis, writing–original draft; Kate M. Gunn: conceptualisation, methodology, funding acquisition, supervision, project administration, data analysis, writing–review and editing; Ian Olver: conceptualisation, methodology, funding acquisition, writing–review and editing.

Corresponding author

Correspondence to Kate M. Gunn.

Ethics declarations

Ethics approval and consent to participate

This study was approved by the University of South Australia Human Research Ethics Committee. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

Consent for publication

Study participants provided consent for the publication of de-identified information gained during the study.

Conflict of interest

The authors declare no competing interests.

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Skrabal Ross, X., Gunn, K.M. & Olver, I. Understanding the strategies rural cancer patients and survivors use to manage financial toxicity and the broader implications on their lives. Support Care Cancer 29, 5487–5496 (2021). https://doi.org/10.1007/s00520-021-06086-z

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  • DOI: https://doi.org/10.1007/s00520-021-06086-z

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