Chemotherapy For Colon Cancer May Come With Financial Strain

Dr. Christine Marie Veenstra MD Department of Internal Medicine, Division of Hematology/Oncology Division of Colorectal Surgery Center for Healthcare Outcomes and Policy Division of General Medicine Cancer Surveillance and Outcomes Research Team University of Michigan, Ann ArborMedicalResearch.com Interview with:
Dr. Christine Marie Veenstra MD
Department of Internal Medicine, Division of Hematology/Oncology Division of Colorectal Surgery
Center for Healthcare Outcomes and Policy Division of General Medicine Cancer Surveillance and Outcomes Research Team
University of Michigan, Ann Arbor

Medical Research: What is the background for this study?

Dr. Veenstra: Nearly 50,000 patients are diagnosed with stage III colorectal cancer each year. Chemotherapy is known to increase survival by up to 20% and is the standard recommendation for these patients after surgery. However, use of chemotherapy may be associated with financial strain.

In order to better understand the financial burden and worry associated with colorectal cancer treatment, we surveyed 956 patients being treated for stage III colorectal cancer. We asked patients to answer questions about financial burden such as whether they had used savings, borrowed money, skipped credit card payments, or cut back on spending for food, clothing or recreational activities because of their cancer treatment. We also asked patients how much they worry about financial problems because of their cancer or its treatment.

Medical Research: What are the main findings?

Dr. Veenstra: 62% of patients reported some degree of financial burden. Nearly half of all patients said that they had cut back on expenses in general because of their cancer or its treatment. Worry about finances was closely associated with financial burden; 70% of patients had concordant worry and burden scores. Not unexpectedly, financial burden and worry were highest among patients getting chemotherapy. Patients who had chemotherapy were significantly more likely to endorse each item of financial burden. Notably, burden was highest of all in the younger, working, low-income patients.

Medical Research: What should clinicians and patients take away from your report?

Dr. Veenstra: It is important to recognize that this financial burden is experienced on top of everything else that patients go through with the cancer itself. The financial burden hits hard. We hope that our findings will encourage dialogue about financial burden between clinicians and patients. There are some financial supports currently available that may benefit patients undergoing cancer treatment, but only if they’re aware that they exist. This may not be enough to fully cover patients’ financial burden, but it could help. We also want insurance providers and employers to know that patients may feel tremendous financial strain in addition to the burden of cancer.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Veenstra: Future studies could further explore the association between out-of-pocket costs, which we did not measure in our study, and financial burden and worry. We urge policy changes to job support measures such as mandatory paid sick leave and disability benefits that could help working patients receive potentially life-saving cancer treatment

Citation:

A Composite Measure of Personal Financial Burden Among Patients With Stage III Colorectal Cancer

Veenstra CM1, Regenbogen SE, Hawley ST, Griggs JJ, Banerjee M, Kato I, Ward KC, Morris AM.

Med Care. 2014 Nov;52(11):957-62. doi: 10.1097/MLR.0000000000000241.