Cumulative financial stress as a potential risk factor for cancer-related fatigue among prostate cancer survivors

Abstract

Introduction Cancer-related fatigue (CRF) is the most commonly reported treatment-related side effect of prostate cancer (PCa). Recognition of financial hardship among cancer survivors is growing. We investigated, for the first time, associations between levels of financial stress and CRF among PCa survivors. Methods We used data from PCa survivors who had been identified through two population-based cancer registries covering the Republic of Ireland and Northern Ireland and had completed a postal questionnaire. CRF was measured by the fatigue subscale of the EORTC QLQ-C30. Financial stress was assessed as household ability to make ends meet (i) pre-diagnosis and (ii) at questionnaire completion (post-diagnosis). Multivariable logistic regression was used to relate financial stress to clinically important CRF (fatigue subscale score ≥ 39 of a possible 100). Results Two thousand four hundred fifty-eight PCa survivors were included. Of these, 268 (10.9%) reported pre-diagnosis financial stress only, 317 (12.9%) post-diagnosis stress only and 270 (11.0%) both pre-and post-diagnosis stress (cumulative stress); 470 (19.1%) reported clinically important CRF. After controlling for confounders, survivors with cumulative financial stress exposure were significantly more likely to have CRF (OR = 4.58, 95% CI 3.30-6.35, p < 0.001), compared with those without financial stress. There was a suggestion of a dose-response relationship (OR = 1.83, 95% CI 1.27-2.65, p = 0.001 for prediagnosis financial stress only; and OR = 4.11, 95% CI 3.01-5.61, p < 0.001 for post-diagnosis financial stress only). Conclusions Financial stress may be an independent risk factor for CRF. Implications for Cancer Survivors There may be benefits in targeting interventions for reducing CRF towards survivors with financial stress, or developing strategies to reduce financial stress.

Adolescent and Young Adult (AYA) Cancer Survivorship Practices: An Overview

“…Which (long-term) physical issues develop mainly depends on the location of the primary tumor and the type of treatment received [ 42 , 43 , 44 ]. Compared to siblings and the general population with no history of cancer, AYAs are at greater risk of potentially life-threatening chronic medical conditions [ 43 , 44 , 45 ]. These long-term complications can lead to significant medical expenses and healthcare utilization [ 45 ].…”

“…Compared to siblings and the general population with no history of cancer, AYAs are at greater risk of potentially life-threatening chronic medical conditions [ 43 , 44 , 45 ]. These long-term complications can lead to significant medical expenses and healthcare utilization [ 45 ].…”

Rationale and Methods for a Randomized Controlled Trial of a Dyadic, Web-Based, Weight Loss Intervention among Cancer Survivors and Partners: The DUET Study

“…As with all studies, DUET has limitations which include a significant overrepresentation of breast cancer survivors (many of whom are upper-socioeconomic), and few dyads with rural residence. These are common limitations that have been reported by other research teams [ 47 , 48 , 49 ]. To address these concerns, future studies might consider preferentially accruing from support groups that focus on other types of cancer and community cancer centers in smaller towns (rather than major tertiary oncologic care centers).…”

Financial toxicity among cancer patients, survivors, and their families in the United Kingdom: a scoping review

“…The majority of the studies (21/29 or 72%) were published between 2011-2021 [20-25, 27-32, 35, 36, 38-40, 42-45] and from authors in academia (22/29 or 76%) [18-27, 29-34, 36-41]. Regarding geographic coverage, all but one study [25] (97%) included English data and 10 studies (35%) reported UK-wide data [18,20,28,29,36,[41][42][43][44][45]. 24 were peerreviewed articles [17][18][19][20][21][22][23][24][25][26][27][29][30][31][32][33][34][35][36][37][38][39][40][41] and 5 were grey literature (in the form of reports from charity organisations [42][43][44][45] and commentary from a freelance writer and welfare rights adviser [28]).…”