The Cost Burden of Breast Cancer: Patients Want Provider Communication to Address Concerns

Advancements in breast cancer treatment have improved survival rates, but financial hardships related to the cost of these lifesaving therapies can weigh heavily on patients.
 
Based on responses from a survey of 2500 patients treated for early-stage breast cancer and 845 treating surgeons, medical oncologists, and radiation oncologists, the authors identified an unmet need for clinician engagement regarding financial concerns after breast cancer diagnosis. The survey respondents were identified through population-based sampling from 2 Surveillance, Epidemiology, and End Results regions and their physicians.
 
Among the women diagnosed with breast cancer who were surveyed, 38% were at least somewhat worried about finances related to their treatment, and some experienced extensive hardships. Overall, 14% reported losing more than 10% of their household income and 17% spend more than 10% of their household income on out-of-pocket medical expenses. African-American and Latina women were more likely to report experiences with financial burden, including debt from treatment, losing their home, having utilities turned off for unpaid bills, and cutting back on spending for food.
 
Additionally, 73% of patients concerned about their finances reported that their physician’s office did not help. While 523 women indicated a desire to talk to providers regarding the impact of their diagnosis on employment or finances, 55.4% reported no relevant discussion.

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Among the physicians surveyed, half of all medical oncologists and 43% of radiation oncologists said someone in their practice often or always discusses financial burden with patients, compared with only 16% of surgeons.
 
The survey findings indicate a need for improved clinician engagement and communication with patients regarding the financial impact of their diagnosis and treatment, the authors concluded.
 
“To cure a patient’s disease at the cost of financial ruin falls short of our duty as physicians to serve,” lead study author Reshma Jagsi, MD, DPhil, deputy chair and professor of radiation oncology at Michigan Medicine, said in a press release. “It’s simply not acceptable to ignore patients’ financial distress any longer.”
 
References
 
Jagsi R, Ward KC, Abrahamse PH, et al. Unmet need for clinician engagement regarding financial toxicity after diagnosis of breast cancer. Cancer. 2018. https://doi.org/10.1002/cncr.31532

Breast Cancer Patients Report Heavy Financial Toll of Treatment [news release]. Michigan Medicine’s website. https://labblog.uofmhealth.org/industry-dx/breast-cancer-patients-report-heavy-financial-toll-of-treatment. Accessed July 24, 2018. 


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