People diagnosed with cancer often have many concerns, including "financial toxicity," the hardship and stress associated with the cost of treatment.
New research found that for men with early-stage prostate cancer, choices about initial treatments can be a source of stress. And the cost is a big reason why.
"Cost of treatment and the associated financial burden could be an important factor in treatment decisions," said study senior author Dr. Daniel Barocas. He's associate professor of urology and medicine at Vanderbilt University in Nashville, Tenn.
For their study, Barocas and his team analyzed data on more than 2,100 patients from a follow-up study of treatment for localized prostate cancer.
About 190,000 cases of prostate cancer will be diagnosed this year in the United States, making it one of the most common cancers in men. Those whose cancer has not spread beyond the prostate can choose treatment options that include active surveillance, radiation or surgery.
According to lead author Dr. Benjamin Stone, a resident in Vanderbilt's department of urology, "Modern treatments for localized prostate cancer provide comparable outcomes, with high rates of cancer control and patient survival."
The study included a questionnaire asking about the direct and indirect costs of prostate cancer and its treatment, and the researchers compared costs for three initial treatment options.
In the first six months after treatment, 15% of patients said they had "a large or very large" burden of treatment costs.
Patients who chose surgery had higher initial financial burdens than those who chose surveillance, but these two groups were similar after one year.
The financial burden was highest for those who had external beam radiation therapy (EBRT), the researchers noted. About 11% of patients who had EBRT said they had experienced financial burdens that were consistent with financial toxicity.
That's the term used to describe the financial distress that comes with not having health insurance or incurring treatment costs not covered by insurance, according to the U.S. National Cancer Institute. It can lead to debt and bankruptcy.
In this study, patients' financial burdens decreased over time: five years after treatment, 1% to 3% of patients were still experiencing financial toxicity. The financial burdens associated with EBRT were as much as double that for surgery or active surveillance, after adjusting for other factors, according to the report published Nov. 30 in The Journal of Urology.
It's unclear why the financial impact of EBRT is larger than for other treatment options, the study authors noted.
"Future studies should include data on out-of-pocket treatment costs as well as various types of indirect costs affecting the financial impact of prostate cancer treatment choices," Stone said in a journal news release.
The U.S. National Cancer Institute has more about prostate cancer treatments.
SOURCE: The Journal of Urology, news release, Nov. 30, 2020