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Studies examine cancer’s effect on work and finances

A porcelain, white piggy bank sits on wooden table next to notebooks and a cup of coffee, while a women in the background wearing an orange shirt places a coin in it

July 10, 2023

In the United States, cancer is among the most expensive medical conditions to treat. National costs for cancer care were estimated to be $190.2 billion in 2015. For people with cancer, the mounting medical expenses can lead to a startling side effect: financial toxicity. 

Financial toxicity is a term used to describe the economic burden a cancer patient experiences related to treatment costs. Several studies show that cancer patients and survivors are more likely to experience financial toxicity than people without cancer. For Dinesh Pal I. Mudaranthakam, PhD, member of The University of Kansas Cancer Center’s Cancer Prevention and Control research program, this issue is personal. Growing up in India, he witnessed family members and friends grapple with the high costs of cancer treatment and the adverse effects it may have later. Dr. Mudaranthakam recently led two studies to better understand the toll a cancer diagnosis has on an individual’s finances, career and overall health.

“We have effective treatments and drugs, but money runs out quickly. Then they're unable to manage their financial, personal and professional situations,” Dr. Mudaranthakam said. “It’s what drove me to investigate this topic and look at things from a different angle.”

Data insights

In the first study, Dr. Mudaranthakam’s team evaluated financial factors that lead to adverse health outcomes. It was published in Cancer Research Communication

Researchers scrutinized data from the University of Michigan Health and Retirement Study, a longitudinal panel study that surveys about 20,000 people every two years. It contains health records as well as financial information including income and medical debt. 

“The dataset captures information that may indicate whether an individual is experiencing work impairment due to cancer,” Dr. Mudaranthakam said. “That's the beauty of this data, and it’s exactly what a researcher like me loves to explore.”

Dr. Mudaranthakam and his team found that among people diagnosed with lung, breast, prostate or colon cancer, work impairment and out-of-pocket treatment costs significantly contributed to worse health outcomes. Patients who experienced work impairment had a three-fold increase in worsening health outcomes compared to the patients without work impairment.  

Patient perspectives

Next, the team sought to clarify the indirect costs of cancer by interviewing cancer survivors. There is a scarcity of qualitative studies focusing on financial toxicity, which makes this research particularly important. The team partnered with members of the cancer center’s patient research advocacy program, PIVOT. This program is comprised of cancer survivors and co-survivors.

Most patients had to quit their jobs or take extended absences to handle treatment challenges, Dr. Mudaranthakam found. People with longer tenures at their jobs had more flexibility to balance their time between cancer treatment and work. In addition, younger cancer patients were more likely to be financially burdened. The results were published in JNCI Cancer Spectrum

“Every interviewee reported that their career was irreparably impacted,” Dr. Mudaranthakam said. “They can’t turn back time to make up for income loss.”

Dr. Mudaranthakam suggested that more education is needed to help patients understand and better manage the financial aspects of cancer care. Financial navigators can explain and help optimize a patient’s insurance coverage. Next, Dr. Mudaranthakam intends to evaluate The University of Kansas Cancer Center’s financial navigator program, and he expects to conduct a randomized study comparing the effectiveness of nurse navigators and financial navigators.

“More and more people survive cancer. Just as we have made progress in treating cancer more effectively, we can find better ways to help cancer patients navigate and overcome the potential financial and career hardships,” Dr. Mudaranthakam said. 

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