Dealing with the financial burden of cancer: perspectives of older breast cancer survivors
- 545 Downloads
Financial burden among cancer survivors is often overlooked in survivorship care planning. Cancer survivors with limited incomes may be particularly affected. Yet, little data are available to address financial issues among them. Eliciting the survivors’ perspectives on how to deal with this financial burden is a first crucial step to identifying the means to provide this supportive care.
In this pilot study, three nominal group technique (NGT) sessions were conducted with a convenience sample of 23 older breast cancer survivors (age 52 to 83) recruited from a county safety net hospital and a Comprehensive Cancer Center. One single NGT question was posed in these sessions, namely “What could help women deal with the financial burden that cancer brings to them and their families?” Survivors responded in an iterative fashion and then ranked the most relevant responses.
The most relevant responses addressed the (1) need for affordable insurance; (2) need to have prompt information on treatment costs patients will face, insurance coverage, and agencies or programs that provide needed products and services; and (3) need to access social workers, navigators, support groups, or others knowledgeable about available resources. Survivors also suggested that physicians become aware of cancer costs and financial issues faced by patients and consider costs in their treatment plans.
Older survivors face financial challenges for which there are few available resources. They suggested several avenues to address cancer-related financial issues that may be considered in developing supportive interventions.
KeywordsSurvivorship Breast cancer Financial burden Financial toxicity Older women
The authors wish to thank the breast cancer survivors who participated in this study and Dr. Chastity McDavid and Ms. Aquila Brown-Galvan for their contribution. This project was supported by the National Institutes of Aging (P30AG031054), the National Institute of Nursing Research (1R01NR011885), and the National Cancer Institute (5R01CA120638). The content is solely the responsibility of the authors and does not necessarily represent official views of the NIA.
Conflict of interest
The authors have no financial conflicts of interest to disclose and have full control of all primary data. The authors agree to allow the journal to review the data if requested.
- 1.Fox M (2012) Medical bills drive many U.S. women into debt, report finds. www.NBCNews.com
- 2.Bach P, Saltz LS, Wittes RE (2012) In cancer care, cost matters. The New York TimesGoogle Scholar
- 3.Lewis Dolan P (2011) Oncologists confront “financial toxicity” of cancer care. American Medical News (www.amednews.com).
- 4.Pollack A (2013) Doctors blast cost of cancer treatment. The Boston GlobeGoogle Scholar
- 5.National Research Council (2008) Cancer care for the whole patient: Meeting psychosocial health needs. The National Academies Press, Washington, DCGoogle Scholar
- 10.Coons SJ, Chongpison Y, Wendel CS, Grant M, Krouse RS (2007) Overall quality of life and difficulty paying for ostomy supplies in the Veterans Affairs ostomy health-related quality of life study: an exploratory analysis. Med Care 45(9):891–895. doi: 10.1097/MLR.0b013e318074ce9b PubMedCrossRefGoogle Scholar
- 12.Institute of Medicine (2005) From cancer patient to cancer survivor: lost in transition. National Academy Press, Washington, DCGoogle Scholar
- 18.Brown ML, Yabroff KR (2006) Economic impact of cancer in the United States. In: Schottenfeld D, Fraumeni JF (eds) Cancer epidemiology and prevention, 3rd edn. Oxford University Press, New YorkGoogle Scholar
- 24.Timmons A, Gooberman-Hill R, Sharp L (2013) “It’s at a time in your life when you are most vulnerable”: a qualitative exploration of the financial impact of a cancer diagnosis and implications for financial protection in health. PLoS One 8(11):e77549. doi: 10.1371/journal.pone.0077549 PubMedCrossRefPubMedCentralGoogle Scholar
- 25.Timmons A, Gooberman-Hill R, Sharp L (2013) The multidimensional nature of the financial and economic burden of a cancer diagnosis on patients and their families: qualitative findings from a country with a mixed public-private healthcare system. Support Care Cancer Off J Multinatl Assoc Support Care Cancer 21(1):107–117. doi: 10.1007/s00520-012-1498-4 Google Scholar
- 30.Miller JJ, Frost MH, Rummans TA, Huschka M, Atherton P, Brown P, Gamble G, Richardson J, Hanson J, Sloan JA, Clark MM (2007) Role of a medical social worker in improving quality of life for patients with advanced cancer with a structured multidisciplinary intervention. J Psychosoc Oncol 25(4):105–119. doi: 10.1300/J077v25n04_07 PubMedCrossRefGoogle Scholar
- 31.American Cancer Society The Affordable Care Act: how it helps people with cancer and their families. Accessed 25 Apr 2013 from http://www.cancer.org/acs/groups/content/@editorial/documents/document/acspc-026864.pdf]. Atlanta GA