Impact of Financial Burden of Cancer on Survivors' Quality of Life

Fenn, Kathleen; Evans, Suzanne B.; McCorkle, Ruth; DiGiovanna, Michael P.; Pusztai, Lajos; Sanft, Tara; Hofstatter, Erin; Killelea, Brigid K.; Knobf, M. Tish; Lannin, Donald R.; Abu-Khalaf, Maysa; Horowitz, Nina; Chagpar, Anees B.

doi:10.1200/jop.2013.001322

Cited by 362 publications

(326 citation statements)

References 17 publications

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“…Compared with non-CCEP participants, those enrolled in the CCEP were younger and had lower incomes. Studies have shown that, in general, younger patients and those with lower incomes experience considerable cancer-related financial problems [24,[48][49][50][51]. We also found that a higher proportion of CCEP participants were enrolled in phase I clinical trials and had metastatic disease.…”

Section: Discussionsupporting

confidence: 57%

Financial Burden of Cancer Clinical Trial Participation and the Impact of a Cancer Care Equity Program

et al. 2016

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Introduction. Cancer clinical trial (CT) participation rates are low and financial barriers likely play a role. We implemented a cancer care equity program (CCEP) to address financial burden associated with trial participation. We sought to examine the impact of the CCEP on CT enrollment and to assess barriers to participation. Methods. We used an interrupted time series design to determine trends in CT enrollment before and after CCEP implementation. Linear regression models compared trial enrollment before and after the CCEP. We also compared patient characteristics before and after the CCEP and between CCEP and non-CCEP participants. We surveyed CCEP and non-CCEP participants to compare preenrollment financial barriers. Results. After accounting for increased trial availability and the trends in accrual for prior years, we found that enrollment increased after CCEP implementation (18.97 participants per

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Section: Discussionsupporting

confidence: 57%

Financial Burden of Cancer Clinical Trial Participation and the Impact of a Cancer Care Equity Program

et al. 2016

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“…[1][2][3][4][5] As the cost of cancer care escalates 6 and the burden of cost shifts to the patient, 7-10 more patients are incurring debt, 11 filing for bankruptcy, 12 deviating from cancer treatment plans, 1 and forgoing treatment. 13 Recent evidence also suggests that severe financial distress as a result of cancer treatment may itself be a mortality risk factor.…”

Section: Introductionmentioning

confidence: 99%

“…Research has found that financial toxicity is an emotional stressor. 3,4 Thus, patient perceptions of social support were examined because social support has been found to be a buffer to financial stress. 44,45 Patients reported the amount of social support they received and their satisfaction with that social support.…”

Section: Introductionmentioning

confidence: 99%

Do Patients and Oncologists Discuss the Cost of Cancer Treatment? An Observational Study of Clinical Interactions Between African American Patients and Their Oncologists

Hamel

Penner

Eggly

et al. 2017

JOP

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Purpose: Financial toxicity negatively affects patients with cancer, especially racial/ethnic minorities. Patient-oncologist discussions about treatment-related costs may reduce financial toxicity by factoring costs into treatment decisions. This study investigated the frequency and nature of cost discussions during clinical interactions between African American patients and oncologists and examined whether cost discussions were affected by patient sociodemographic characteristics and social support, a known buffer to perceived financial stress. Methods Video recorded patient-oncologist clinical interactions (n = 103) from outpatient clinics of two urban cancer hospitals (including a National Cancer Institute–designated comprehensive cancer center) were analyzed. Coders studied the videos for the presence and duration of cost discussions and then determined the initiator, topic, oncologist response to the patient’s concerns, and the patient’s reaction to the oncologist’s response. Results: Cost discussions occurred in 45% of clinical interactions. Patients initiated 63% of discussions; oncologists initiated 36%. The most frequent topics were concern about time off from work for treatment (initiated by patients) and insurance (initiated by oncologists). Younger patients and patients with more perceived social support satisfaction were more likely to discuss cost. Patient age interacted with amount of social support to affect frequency of cost discussions within interactions. Younger patients with more social support had more cost discussions; older patients with more social support had fewer cost discussions. Conclusion: Cost discussions occurred in fewer than one half of the interactions and most commonly focused on the impact of the diagnosis on patients’ opportunity costs rather than treatment costs. Implications for ASCO’s Value Framework and design of interventions to improve cost discussions are discussed.

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“…Ideally, medical interventions required to treat cancer would extend beyond dealing with the physical affects of disease, to include a range of measures that attend to the whole person and thus financial [6], psychological [7] and social domains [8]. Evidence has shown exercise to be safe and effective with various cancer types that enable wide reaching benefits for the recovery of patients both before, during and after treatment [9,10].…”

Section: Introductionmentioning

confidence: 99%

Impact of an exercise programme on sustaining physical activity for recovering cancer patients: A qualitative study.

Queen

Cotton

Brown

et al. 2016

EJPCH

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Background Pedometers have been shown to improve adherence to exercise programmes. Evidence suggests that PA can improve physical function, wellbeing and reduce the negative impact of some cancer related side-effects. Yet, there are limited PA guidelines for cancer patients in the UK. The aim was to examine the impact of an 8-week exercise programme on sustaining physical activity (PA) at 3-month follow-up. Method A qualitative study with 12 mixed site cancer patients aged 43-70 (10 women, 2 men), involved in an 8-week exercise programme. The Programme took place at a University in the South West of England, UK. Semi-structured interviews with patients took place 3 times over 6 months. A grounded theory approach was used to analyse the data. Results We found that the number of patients perceived to be physically active prior to take-up of the physical activity programme were low (20%). At completion, most patients reported being physically active (84%), sustained but to a lesser extent (67%) at 3-month follow-up. Explanations for sustained PA at follow-up included application of knowledge gained from the Programme in relation to walking technique and use of pedometers and perceived health and fitness gains. Explanations for those not physically active included new diagnosis, reduced mobility following surgery and lack of clear exit route or progression to another structured opportunity. Conclusion Our study has provided valuable insight into how a supervised multi-modal physical activity programme can enable recovering cancer patients to develop a physically active lifestyle.

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Impact of Financial Burden of Cancer on Survivors' Quality of Life

Abstract: Increased financial burden asa result of cancer care costs is the strongest independent predictor of poor quality of life among cancer survivors.

Cited by 362 publications

References 17 publications

Financial Burden of Cancer Clinical Trial Participation and the Impact of a Cancer Care Equity Program

Financial Burden of Cancer Clinical Trial Participation and the Impact of a Cancer Care Equity Program

Do Patients and Oncologists Discuss the Cost of Cancer Treatment? An Observational Study of Clinical Interactions Between African American Patients and Their Oncologists

Impact of an exercise programme on sustaining physical activity for recovering cancer patients: A qualitative study.

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