Some Patient Characteristics Lower Financial Toxicity in Metastatic Prostate Cancer

Financial hardship related to treatment costs is a common reality for many men with metastatic prostate cancer, according to a study published in the Journal of Urology.

Knowing that financial toxicity is a well-documented phenomenon associated with cancer treatment, a group of researchers explored the prevalence of financial toxicity among patients with metastatic prostate cancer.

Of 417 patients who completed the survey, data were analyzed from 281 men at a single quaternary-care referral center who met the inclusion criteria. Median age was 69 years, and most were married, White, retired, had some college education, and an annual household income of more than $80,000.

The researchers used the 12-item Comprehensive Score for Financial Toxicity (COST-FACIT) and coping mechanism questionnaire to assess for financial toxicity among the participants. The COST-FACIT score range is 0 to 44, with lower values signifying greater financial toxicity. The median score for participants in this study was 30 (IQR, 24 to 36).

“Overall, 54% (151) of patients described at least some degree of financial hardship because of their illness,” the researchers wrote. “Among those with high financial toxicity, the impact was more profound, with 89% (70) of these patients reporting at least some degree of financial hardship due to illness.”

Multivariable analysis revealed older age (95% CI, 0.21-0.51), higher household income (more than $100,000/year; 95% CI, 0.97-14.66), prior surgical management of prostate cancer (95% CI, −0.18 to 4.28), and application for financial assistance programs (95% CI, 1.72-7.11) were characteristics associated with lower financial toxicity.

Patients who reported high levels of financial toxicity were more likely to reduce their spending on basic goods (35% vs 2.5%; P <.001) and leisure activities (59% vs 15%; P >.001), borrow money, and use savings (62% vs 17%; P <.001) to pay for their care. However, the researchers cautioned that medication nonadherence may not serve as an accurate indicator as to who may be experiencing financial toxicity, as these findings indicated that patients who did report high levels of financial toxicity rarely reported cost-related medication nonadherence.

“These findings offer important insights into previously undescribed aspects of financial toxicity among patients with advanced prostate cancer,” the researchers concluded.

“Such data are crucial to understand how to include financial toxicity in shared decision-making and to guide future interventions designed to reduce financial toxicity in this population,” they added.

Reference
Joyce DD, Schulte PJ, Kwon ED, et al. Coping mechanisms for financial toxicity among patients with metastatic prostate cancer: A survey-based assessment. J Urol. 2023;210(2):290-298. doi:10.1097/JU.0000000000003506