SUO 2018: Cancer as a Health Shock: Adverse Financial and Employment Outcomes

Phoenix, Arizona ( Health shock is defined by the world health organization as a large unanticipated adverse health event. In this session, Dr. Veenstra discussed her research and patient experiences with health shock in order to help attendees better advocate for their patients.

She started with a clinical context of a 32 year old male with newly diagnosed stage IIB seminoma, treated with 3 cycles of BEP, asking the audience to consider the potential financial and employment impacts of cancer diagnoses?

Dr. Veenstra reviewed surveys from 1300 patients with stage III colorectal cancer from Detroit and Georgia SEER registries. These patients were primarily 50-74 years old, white, with approximately 50% reporting a household income of $20,000-89,000. As expected, patients’ worry regarding their finances was closely correlated with patients whose illness had a significant impact on their finances. Patients who were the most vulnerable to the financial burden were those who underwent chemotherapy, experience complications, African-Americans, younger patients, and those with an annual income of $20,000-49,000. Patients with jobs that had a flexible schedule, paid or extended leave, unpaid time off, and disability all were reported to be beneficial.

Cycling back to the initial patient that was discussed, this patient was unable to work due to chemotherapy size effects and did not have paid leave. He then fell behind on his bills and struggled to afford basic needs.

In conclusion, Dr. Veenstra states that health shock results in extensive financial toxicity with significant impact on personal finances and employment. It was suggested that clinicians should ask their patients about financial burdens during oncologic treatments and to understand the resources that are available at your institution. Be willing to discuss with patients employers and be mindful of the stress these situations can cause for patient families or spouses as well.

Presented By: Christine Veenstra, MD, University of Michigan

Written by: David B. Cahn, DO, MBS, Fox Chase Cancer Center, Philadelphia, PA, @dbcahn, at the 19th Annual Meeting of the Society of Urologic Oncology (SUO), November
28-30, 2018 – Phoenix, Arizona