Newswise — So you’ve been diagnosed with cancer. Perhaps you've undergone chemotherapy, radiation, surgery, or a combination of these. Your doctors tell you that you are doing well or perhaps not… Now, the bad news. The bills start piling up: medical bills, pharmacy bills. You haven’t been able to return to work. How often does this scenario happen? In the January issue of Diseases of the Colon & Rectum, researchers from Newcastle, United Kingdom, and from Cork and Dublin, Ireland, surveyed nearly 500 survivors of colorectal cancer in Ireland. Forty-one percent of the survivors reported that their diagnosis of cancer had made it harder for their household to make ends meet (financial strain: an objective assessment of financial hardship due to cancer). In addition, 39% of patients stated that they were more concerned about their household’s financial situation since their cancer was diagnosed (financial stress: a subjective assessment of cancer-related financial hardship). Roughly one-third of patients reported both financial strain and stress. The chance of having a low health-related quality of life was 40% lower in patients receiving chemotherapy. Patients who had a stoma, those who had completed secondary education, and those with children, were more likely to have a better quality of life. After adjusting for these factors, there was a significant relationship between financial stress and a low health-related quality of life (odds ratio 2.5, 95% confidence limits 1.62-2.39). Even though this study is done in a country with a public health system, the data are similar to those reported for US cancer survivors. In an accompanying editorial, Drs. Sitlinger & Zafar of Duke Cancer Institute highlight that this study adds to the growing body of literature suggesting that financial aspects of cancer care can have a harmful impact on cancer patient outcomes. They describe other studies in which 38% of colorectal cancer patients were reported as experiencing financial hardship, and one in which approximately 40% of colorectal cancer patients receiving chemotherapy had to use their savings to make ends meet. In addition, they quote results of still another report in which Medicare patients with cancer who did not have any supplemental insurance were found to have average out-of-pocket costs equaling 24% of their household income! Drs. Sitlinger and Zafar urge physicians to keep their patients informed about all aspects of treatment including the financial ones!
Professor Linda Sharp, who led the study, noted: "Given the large numbers of survivors of colorectal cancer internationally, it is important that the different aspects of the impact of cancer on survivors' lives is investigated. Most previous studies which have considered financial distress in colorectal cancer survivors have not clarified whether the hardship was a result of the cancer itself or simply reflected pre-existing hardship; this study, by contrast, focused specifically on the financial impact of the cancer. Even more importantly, it showed that the financial impact of the cancer was strongly related to poorer quality of life. This suggests that strategies to alleviate the adverse financial effects of cancer on patients are urgently required."
Study Citation: Sharp L, O'Leary E, O'Ceilleachair A, Skally M, Hanly P. Financial impact of colorectal cancer and its consequences: associations between cancer-related financial stress and strain and health-related quality of life. Dis Colon Rectum 2018;61:27-35. (January 2018 issue.)
Accompanying this article is an editorial by Sitlinger AP, Zafar SY. With colorectal cancer treatment, physical toxicity is not the only concern. Dis Colon Rect 2018;61:4-5. (January 2018 issue.)
A prepublication copy is available upon request. Please email Margaret Abby, Managing Editor, Diseases of the Colon and Rectum, at email@example.com