Background: Improvements in cancer treatment have resulted in substantial growth in the costs of care, and patients can bear significant out-of-pocket costs for their treatment. In addition, studies have shown that up to one third of patients do not return to work following cancer treatment. These factors can culminate in financial toxicity for cancer survivors, which has a debilitating effect on quality of life and optimal cancer care.”
Aim: To describe changes in employment and household income due to advanced cancer treatment in the Australian setting.
Methods: We conducted a prospective cross-sectional observational pilot study examining adults treated with anticancer therapy in both adjuvant and palliative settings in the outpatient department of a tertiary cancer hospital in Sydney, Australia. Patients had to be currently receiving anti-cancer therapy, with the aim for treatment to continue for at least 3 months. At the time of pariticipant recruitment, data was collected using a questionnaire comprising socio-demographic characteristics, employment/income history, health insurance and treatment information; and analysed using descriptive statistics.
Results: Of 31 participants, the median age was 59 years (range 37 - 80 years), 52% females. 7 patients (23%) were receiving adjuvant therapy for their cancer.
At time of data collection, 12 patients (39%) were in paid employment. 7 patients were not in any paid employment prior to the diagnosis of cancer (4 retired, 2 unemployed, 1 volunteer). The majority of patients were in full-time jobs (21/31) with others being self-employed (2/31) or in part-time employment (1/31). 30% of patients (9/31) described a reduction in their hours and duties as a result of their cancer treatment. A further 38% (12/31) patients had retired or ceased working during the course of their cancer treatment. Over half (16/31, [52%]) of the patients reported a reduction in their household income level during the course of their treatment. One patient reported an increase in income level due to an inheritance.
Conclusions: This study highlights the substantial changes in patients' financial status as a result of cancer, and a significant issue with a growing population of cancer survivors. There are considerable effects on patients’ ability to return to workand income which can have long-term consequences despite completion of therapy. Patient-physician discussions about potential loss of income due to cancer and its treatment are recommended.