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Financial Side Effects Of Cancer Treatments

01 December 2015

The last thing any parent is going to think when their child gets a diagnosis of cancer is: "This might ruin us financially."

Unfortunately, it should be one of the first concerns.

At a time when great strides are being made in the fight against most forms of paediatric cancer, a new study shows that one of the lingering, mostly undiscussed side effects of treatment is financial consequences that can last a lifetime, regardless of the outcome of any treatment.

A recent study released by the Dana-Farber/Boston Children's Cancer and Blood Disorders Center showed that nearly one-third of families whose children are being treated for cancer faced housing, food or energy insecurity, meaning they were in danger of having their power turned off, of not being able to eat or of losing their home, and that one-quarter lost more than 40 percent of their household income.

The results come from a survey of about 100 Dana-Farber/Boston Children's patients that started within a month of receiving a cancer diagnosis, and then revisited the issue six months later.

Researchers were surprised to find such high levels of need.

At the time of diagnosis, 20 percent of the families studied were "low-income households," but six months later another 12 percent had fallen below that poverty line.

By six months after diagnosis, a majority of adults responsible for supporting their families had experienced a disruption of their work, running from quitting jobs or suffering a layoff as a result of their child's illness (15 percent) to reduced hours or leaves of absence (37 percent).

"When we think of a rare and scary diagnosis like childhood cancer, what we immediately think about are the medical, physical and emotional consequences, but I think the financial consequences are incredibly real," said Dr. Kira Bona, a pediatric oncologist at Dana Farber and the lead author on the study.

She noted that even in a setting where medical insurance pays for care and treatment, "there are so many costs of care that are not covered by medical insurance that add up," running from the out-of-pocket expenses to get to the hospital and park in the city to the lost wages from missing work to make the trip in for treatment.

The study was designed to see how well families maintained themselves during the first six months of treatment, and the results were alarming, Bona noted. The results were especially telling, since they occurred in a major academic medical center where patient families get significant support from social workers and resource specialists, assistance that might be less available elsewhere.

Families told us they had lost more than 40 percent of their annual household income

"A full quarter of our families told us they had lost more than 40 percent of their annual household income as a result of work disruptions due to their child's illness," Bona said. "That's having to take time off from work to be in clinic, or in hospital, or being laid off from their job, or having to quit their job to take care of their child."

Bona noted that while the research applied only to families dealing with childhood cancer, the results could be extrapolated to children with other acute and chronic conditions, as well as to adult populations.

"What I hope will be one outcome of the data from this study is a wider awareness of what an enormous issue this is," she said. "If one of three pediatric cancer families are struggling with food, housing or energy insecurity during therapy or if one in four of our families are losing almost half of their annual household income as a result of treatment-related work disruptions, that says education about this has to happen at the very beginning."

It feels crass to talk about money in the context of a dreaded diagnosis, to say that at a time when a family is dealing with something no one ever wants to face, that it somehow quickly becomes about dollars and cents. But it's not so much about what is being spent on treatment as it is trying to avoid the problems that not only showed up in the Dana-Farber study.

The problems can be seen in the empirical evidence showing that many personal bankruptcy cases are the result of insurmountable medical expenses and the financial troubles that are a symptom of many treatments.

Perhaps if more attention is devoted to the issue, families will ultimately get financial guides and suggestions along with the information they get explaining the diagnosis and treatments.

Bona suggested that as much as families may not want to think about or discuss the money, the finances are important when it comes to getting through the medical issues and returning to a normal life.

Chuck Jaffe is senior columnist for MarketWatch

Further Reading : - Financial Impact Of A Cancer Diagnosis

Watch Sue, Bill & Alan discuss how their cancer diagnosis impacted each of their lives

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