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Cancer Financial Burder Related to Survival

Posted 1/28/2016

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  This is a very troubling study from the Fred Hutchinson Cancer Center in Seattle that suggests some patients with colon and thyroid cancer who filed for bankruptcy, presumably often related to high medical bills, had an almost 80% higher chance of dying during the study period than other patients who were more solvent. I have lots of immediate reactions and thoughts, but suspect there is much more to this story.

  Were these people less financially secure prior to their cancer diagnosis? If so, had they been receiving similar rates of good health care throughout their lives or did they have delayed diagnoses and poorer health partly due to inadequate or no insurance? Were treatment decisions made based on cost? Were they equally compliant with suggested treatments or did they miss appointments, not fill prescriptions, not receive the same level of care? 

  One thing that was not a factor was the very real stress related to filing for bankruptcy. Over and over again, I have written that stress neither causes cancer nor stimulates recurrence or faster growth. It is worth saying again in this context. Of course their financial worries reduced their QOL (quality of life) and may be negatively impacted some important medical decisions, but stress, in and of itself, has nothing to do with cancer.

  Here is the start of the story from Consumer Health Day and a link to read more:

Cancer's Financial Burden Tied to Poorer Survival,
Study Finds

TUESDAY, Jan. 26, 2016 (HealthDay News) -- The staggering cost of cancer care forces many patients to file for bankruptcy, and that financial stress may play a role in cutting their lives short, new research suggests.
In fact, patients suffering from colon, prostate or thyroid cancers who went broke had almost 80 percent higher odds of dying during the period compared with similar patients who remained financially sound, the researchers said.
"Bankruptcy, for reasons that we don't know, is a serious threat to survival for cancer patients," said lead researcher Dr. Scott Ramsey, from the Fred Hutchinson Cancer Research Center in Seattle.
While the study found a link between financial strain and cancer death, the research wasn't designed to prove a definitive cause-andeffect relationship between these factors.
Still, medical costs are one of the most common reasons why people go bankrupt, Ramsey said. "We think that what happens is that when people are diagnosed, they had to leave their job, use up all their savings, go into debt and at some point the debt was overwhelming," he explained.
When patients go bankrupt, they may stop getting care or stop their treatment early, or they don't go for recommended treatment, he said.. The link between bankruptcy and dying "is probably a failure to get necessary care," Ramsey said.
In addition, the stress of bankruptcy on top of cancer may also play a role, he suggested.
Patients with financial pressures should ask their doctor to consider cost of treatment options, Ramsey said. "Many of the treatments that are recommended equally can vary 10 or 100 times in price," he said. "Choosing a therapy that's less expensive might be better because the patient may be able to complete it."


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