Four years after being treated for breast cancer, a quarter of survivors say they are worse off financially, at least partly because of their treatment, according to a new study led by University of Michigan Comprehensive Cancer Center researchers.

In addition, 12 percent reported that they still have medical debt from their treatment.

Financial decline varied significantly by race, with Spanish-speaking Latinas most likely to be impacted. Debt was reported more frequently in English-speaking Latinas and Blacks, the study found. Results appear in the Journal of Clinical Oncology.

“As oncologists, we are proud of the advances in our ability to cure an increasing proportion of patients diagnosed with breast cancer. But as treatments improve, we must ensure that we do not leave these patients in financial ruin because of our efforts,” says study author Reshma Jagsi, M.D., D.Phil., associate professor of radiation oncology at the University of Michigan Medical School.

The researchers surveyed women in Detroit and Los Angeles who had been diagnosed with early stage breast cancer, based on data obtained from the National Cancer Institute’s Surveillance, Epidemiology and End Results population-based registry. Women were surveyed about nine months after diagnosis and again about four years later, with 1,502 women responding to both surveys.

The surveys asked about patients’ perceptions of whether they were worse off financially since their diagnosis, and whether that has caused long-term challenges. For example, patients were asked if they had altered their medical care because of financial concerns, by skipping medication or by missing a doctor’s appointment or a mammogram. Other questions looked at broader hardships, such as going without health insurance, having utilities turned off or moving out of their home.

Blacks and English-speaking Latinas were more likely than Whites to have experienced one of these issues. Other factors that made a woman more likely to experience these hardships include age under 65, household income under $50,000, part-time work at diagnosis, reduced work hours after diagnosis, lack of substantial prescription drug coverage, breast cancer recurrence, and undergoing chemotherapy.

“These patients are particularly vulnerable to financial distress,” Jagsi says. “We need to ensure appropriate communication between patients and their doctors regarding the financial implications of a cancer diagnosis and treatment decisions to help reduce this long-term burden.”
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Breast cancer statistics: 235,030 Americans will be diagnosed with breast cancer this year and 40,430 will die from the disease, according to the American Cancer Society

Additional authors: John A.E. Pottow, J.D.; Kent A. Griffith, M.S.; Steven J. Katz, M.D., M.P.H.; Sarah T. Hawley, Ph.D., M.P.H., all from U-M; Cathy Bradley, Ph.D., Virginia Commonwealth University; Ann S. Hamilton, Ph.D., University of Southern California; John Graff, Ph.D., Rutgers Cancer Institute of New Jersey

Funding: National Cancer Institute grants R01 CA109696, R01 CA088370 and K05 CA111340; American Cancer Society

Disclosure: None

Reference: Journal of Clinical Oncology, doi:10.1200/JCO.2013.53.0956, published online March 24, 2014

Resources:

U-M Cancer AnswerLine, 800-865-1125

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