Coping with cancer treatment-related financial burden.

Session Type and Session Title: 
General Poster Session A: End-of-Life Care, Patient-Reported Outcomes, and Survivorship
Abstract Number: 
J Clin Oncol 32, 2014 (suppl 31; abstr 161)
Ryan David Nipp, Leah L. Zullig, Gregory Samsa, Jeffrey M. Peppercorn, Deborah Schrag, Donald H. Taylor, Amy Pickar Abernethy, Yousuf Zafar; Dana-Farber Cancer Institute, Boston, MA; The University of North Carolina at Chapel Hill, Chapel Hill, NC; Duke University, Durham, NC; Duke Cancer Institute, Durham, NC; Duke University Medical Center, Durham, NC

Abstract Disclosures


Background: Growing evidence suggests that financial distress is a side effect of cancer care needing attention. Little is known about how patients cope with treatment-related financial distress. This study describes how patients with cancer cope with treatment-related costs and identifies those at greatest risk for using potentially harmful cost-coping strategies. Methods: Eligible patients for this cross-sectional, survey study were adults being treated for solid malignancies enrolled June 2010 to May 2011 in a national copay assistance program. Coping strategies were grouped as lifestyle-altering or care-altering. Descriptive statistics and analysis of variance assessed coping strategies and relationships between covariates. Results: Among 174 participants, 89% used at least one lifestyle-altering strategy to cope with costs, while 39% used a care-altering strategy. Most common care-altering coping strategies included: not filling a prescription (28%); and taking less medication than prescribed (23%). Lifestyle-altering strategies included: spending less on leisure activities (77%); spending less on basics (57%); borrowing money (54%); and spending savings (50%). The mean number of coping strategies was higher for patients < 65 than for those ≥ 65 (Table). Lower-income patients used more care-altering strategies than higher-income patients. Patients with more education and shorter duration of chemotherapy adopted more lifestyle-altering strategies than their counterparts. Conclusions: Patients were generally more likely to use lifestyle-altering approaches to cope with treatment-related financial burden, but more than one-third adopted care-altering strategies. Younger patients and those with lower incomes were more likely to alter their care. Screening for and anticipating potentially harmful cost-coping behavior in the oncology clinic is important to reduce patient distress and promote optimal care.

Coping by demographic.
Mean number of coping strategies
Care-altering - mean P Lifestyle-altering - mean P
< $20,000 0.9 0.02 3.2 0.16
≥ $20,000 0.6 2.9
≤ High school 0.6 0.14 2.7 0.02
> High school 0.8 3.4
Chemotherapy duration
≥ 1 year 0.6 0.30 2.8 0.04
< 1 year 0.8 3.5
≥ 65 0.4 <0.01 2.4 <0.01
< 65 1.2 3.9