Preexisting Financial Stress Increases Symptom Burden and Lowers Quality of Life for Patients With Cancer

Patients with cancer who have limited financial reserves are more likely to have a higher burden of symptoms and a lower quality of life, according to study results published in the Journal of Clinical Oncology. Assessing financial reserves may help to identify patients who need more intensive support.1

"Most of the studies looking at financial stress look at what cancer does to your finances after diagnosis," explained Christopher Lathan, MD, MS, MPH, a thoracic oncologist at Dana-Farber Cancer Institute in Boston, Massachusetts, and lead author of the study. "We were interested in looking at what happens when you have financial distress, defined in our study as little or no savings at the time of your diagnosis, and how that factor can impact quality of life."

This study measured how patient financial strain was associated with symptom burden and quality of life (QoL) among patients with new diagnoses of lung or colorectal cancer. The study interviewed patients about their financial reserves, QoL, and symptom burden at 4 months after diagnosis and, for survivors, at 12 months after diagnosis. Researchers assessed the association of patient-reported financial reserves with patient-reported outcomes, including the Brief Pain Inventory, symptom burden on the basis of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30, and QoL on the basis of the EuroQoL-5 Dimension scale.

Limited financial reserves were reported by 40% of the patients with lung cancer and by 33% of the patients with colorectal cancer. Relative to patients with more than 12 months of financial reserves, those with limited financial reserves reported significantly increased pain for lung and colorectal symptoms, greater symptom burden, and poorer QoL. With decreasing financial reserves, a clear dose-response relationship was present across all measures of well-being. These associations were also manifest for survivors reporting outcomes again at 1 year and persisted after adjustment for stage, comorbidity, insurance, and other clinical attributes.

"We found that patients who had financial distress at the time of diagnosis were more likely to have poorer outcomes in physical and mental quality of life measures, pain, and symptom burden," noted Lathan.

Based on the findings, the researchers conclude that patients should be evaluated for potential financial distress at diagnosis. Then, appropriate resources and treatments can be targeted to those patients who are already struggling prior to their cancer diagnosis.


1. Lathan CS, Cronin A, Tucker-Seeley R, et al. Association of financial strain with symptom burden and quality of life for patients with lung or colorectal cancer [published online ahead of print February 28, 2016]. J Clin Oncol. doi:10.1200/JCO.2015.63.2232.

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