Does Financial Stress Impact Cancer Survival?

A new study from researchers at Roswell Park Cancer Center evaluated whether financial toxicity impacts survival in patients with cancer.

“Does financial worry impact survival? The answer is, resoundingly, yes,” says senior author Anurag Singh, MD, professor of oncology and director of radiation research at Roswell Park, in a press release.

For this study, the investigators retrospectively reviewed outcomes of 284 patients with head and neck cancer treated with definitive or postoperative radiation therapy between 2013 and 2017. The median patient age was 61 years, and 77.5% of the study cohort were men. Survival outcomes were compared to patient-reported financial burden.

“We know head and neck cancer patients have the highest level of financial burden among any cancer patients because these are cancers where you can need surgery as well as extended courses of chemotherapy and radiation, along with substantial supportive care and rehabilitation,” said Dr. Singh. “Many patients are unwell enough they cannot go to work, which creates additional stress and uncertainty. And we now know that this financial toxicity affects not just their mental and emotional well-being but their physical health, how they respond to cancer treatment.”

Overall, 41 patients (14.4%) reported high baseline financial toxicity. Upon analysis, those with higher financial burden had worse overall survival (hazard ratio [HR], 1.75; 95% confidence interval [CI], 1.05-2.94; P = 0.03) and worse cancer-specific survival (HR 2.28; 95% CI 1.31–3.96; P = 0.003) compared to patients without significant financial burden.

A matched pairs analysis was conducted for 66 patients, which confirmed that financial toxicity was associated with lower overall (HR 2.72; 95% CI 1.04–7.09; P = 0.04) and cancer-specific survival (HR 3.75; 95% CI 1.22–11.5; P = 0.02).

“Financial toxicity could be a major unknown factor that could be affecting the results of even major clinical trials,” said Dr. Singh. “We want everyone to be aware of these impacts. Doctors should consider how financial toxicity may be impacting their patients and do everything we can to improve our patients’ quality of life, and we want to encourage patients to take advantage of financial counseling and every other resource that can lessen their burden.”

The findings of this study were published in Oral Oncology.