Breast cancer survivors with lymphedema face high long-term costs, and there are several strategies for healthcare providers to help.
Many breast cancer survivors carry a crushing economic burden long after their initial treatment, new research shows.
Costs associated with ongoing care are particularly heavy for breast cancer survivors with lymphedema, the researchers wrote this month in the journal Supportive Care in Cancer.
"Interviews suggested that the cascading nature of economic burden on long-term savings and work opportunities—and insufficiency of insurance to cover lymphedema-related needs—drove cost differences. Higher costs delayed retirement, reduced employment, and increased inability to access lymphedema care."
The research featured a mixed-methods study of 129 breast cancer survivors from New Jersey and Pennsylvania.
Excluding productivity losses, annual out-of-pocket costs for breast cancer survivors with lymphedema totaled $2,306 compared to $1,090 for patients without lymphedema. When productivity losses were included, annual out-of-pocket costs for patients with lymphedema totaled $3,325 compared to $2,792 for patients without lymphedema.
The ongoing cost of care resulted in many patients foregoing treatment such as compression garments, the researchers wrote. "When patients could not cover their costs, family members or social service organizations were sometimes able to help, but often patients simply went without the care they needed."
Easing the burden
Earlier research and policy statements give guidance on how healthcare providers can help breast cancer patients manage and reduce treatment costs.
- Oncologists should make sure they recommend care that has maximal value as opposed to interventions with low benefits and high costs.
- Oncologists should initiate conversations about cost. These discussions can help direct patients to financial resources and give physicians opportunities to advocate for patients with insurance companies.
- Oncologists should be prepared to help patients deal with financial costs. This preparation includes gaining familiarity with cost issues such as using the American Society of Clinical Oncology Value Framework. Physicians should also enlist other members of their care team such as pharmacists who can help patients address cost challenges.
There are several other recommendations for healthcare providers to help cancer patients who struggle with the cost of care:
- A recent study in the Journal of Cancer Research and Clinical Oncology says that physicians can improve health outcomes and reduce financial burdens by encouraging patients to modify health-related factors such as sedentary lifestyles.
- A policy statement from the American Society of Clinical Oncology makes multiple suggestions to ease the financial burden on patients such as tackling obesity, providing evidence-based care, optimizing cancer prevention techniques, and including patients in all decision making.
Christopher Cheney is the senior clinical care editor at HealthLeaders.