For kids who beat cancer, the battle isn't over: Why 'financial toxicity' lingers for decades

For many survivors of childhood cancer suffer, "financial toxicity"—the economic consequences of the disease—can last into adulthood, leading some to skip or delay necessary care or medication altogether, according to a study from the St. Jude Children's Research Hospital

Learn more about cost of treatment—the biggest threat to cancer program growth

The financial consequences of surviving childhood cancer

The study, published in the Journal of the National Cancer Institute, looked at 2,800 childhood cancer survivors, to better understand the determinants and outcomes of financial hardship among childhood cancer survivors. The mean age of survivors upon review was 31.8 and the mean number of years since their diagnosis was 23.6.  

During that post-diagnosis timeframe, the researchers found roughly 33% of the 2,800 childhood cancer survivors studied skipped or delayed necessary screenings, recommended medications, or trips to see a health care provider because of financial concerns.

I-Chan Huang, the lead author of the study, said financial concerns are "more widespread among pediatric cancer survivors than among survivors who were diagnosed with cancer as adults." He added that some of the financial problems patients faced resulted from insurance coverage denials for needed services, such as mammograms or radiation-induced heart disease.

Greg Aune, a pediatric oncologist at UT Health San Antonio and cancer survivor who was not involved with the study said he witnesses the results of the study firsthand at his clinic for childhood cancer survivors. "It's pretty routine—a patient gets hit with a high co-pay for a screening test and is not happy about it, and then decides not to come for the next one," he said.

Doctors don't communicate about financial concerns well enough

Another study published in July in the journal Cancer found that several breast cancer patients were dissatisfied with the extent to which their doctors had explained the financial challenges of breast cancer, saying doctors should have provided more information.

The study surveyed over 2,500 patients and more than 800 surgeons, medical oncologists, and radiation oncologists in the United States. The researchers found:

  • 51% of medical oncologists discussed financial issues with patients;
  • 43% of radiation oncologists discussed financial issues with patients; and
  • 16% of surgeons discussed financial issues with patients.

These financial issues posed a major obstacle to many patients, McGinley writes. The survey found some patients lost their homes as a result of financial issues related to cancer costs. In addition, more than 21% of white and 22% of Asian American patients spent less on food after they were diagnosed, while 45% of black patients and 36% of Latino patients did the same.

The study also found that, of the 945 women in the study who were concerned about finances, 73% of them said their doctors and staff did not assist them with their financial issues.

Reshma Jagsi, a radiation oncologist at the University of Michigan and lead author of the study, said, "We are supposed to promote the health of our patients—their mental, physical, and social well-being," she said. "This falls within our duties" (McGinley, "To Your Health," Washington Post, 8/1).

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