Patient-Provider Conversations Regarding Financial Impact of Cancer Therapy Lacking

Clinician engagement, assessment, and communication with cancer patients concerning financial toxicity require significant improvements, according to a poster presented at the 2018 American Society of Clinical Oncology (ASCO) Annual Meeting.

For this study, investigators sent surveys to nearly 3700 women with early-stage breast cancer between 2013 and 2015 along with their healthcare providers. Surgeons, medical oncologists, and radiation oncologists were also surveyed regarding their experiences with financial toxicity and its management. 

Of the responding physicians, 50.1%, 43.2%, and 15.6% of medical oncologists, radiation oncologists, and surgeons, respectively, stated that financial burden is frequently or always discussed with patients. 

Results showed that 31.1% of black, 30.3% of Latina, 25.4% of Asian, and 15.2% of white patients wanted to talk to their providers regarding the financial consequences of breast cancer. However, of the 945 women who expressed financial concerns, more than 72% responded that their healthcare providers and staff were not helpful. Of the 523 patients who wanted to discuss the potential impact on employment or finances, 55.4% reported that they did not have a conversation. 

Of responding patients, 17% reported spending at least 10% of their household income on out-of-pocket medical expenses, and 7% reported spending at least 10% of their household income on out-of-pocket nonmedical expenses. 

Many patients regardless of ethnicity incurred debt; 58.9%, 33.5%, 28.8%, and 27.1% of black, Latina, Asian, and white patients, respectively had treatment-related debt. Survey results also showed that 45.2% of blacks, 35.8% of Latinas, 22.5% of Asians, and 21.5% of whites had to cut spending on food. 

Only 1.4% and 1.0% of whites and Asians, respectively, reported losing their homes, but a greater number of Latinas (6.0%) and blacks (4.7%) did. 

The authors concluded that “improved clinician assessment and communication regarding financial toxicity are necessary. Even physicians who perceive that they are routinely offering necessary services may fail to meet patient needs. Cure at the cost of financial ruin falls short of physicians’ duties.”

Reference

Jagsi R, Ward KC, Abrahamse P, et al. Unmet need for clinician engagement about financial toxicity after diagnosis of breast cancer. Poster presentation at: 2018 ASCO Annual Meeting; June 1-5, 2018; Chicago, IL.