Cancer Survivors Face Mounting Costs of Continuing Medical Care: Study

Their annual expenses were almost twice that of people who never had cancer, researchers report

Thursday, June 12, 2014

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Cancer--Living with Cancer

THURSDAY, June 12, 2014 (HealthDay News) -- People who survive cancer are likely to face a lifelong drain on their finances as they pay for mounting medical expenses year after year, a new government report finds.

According to the researchers from the U.S. Centers for Disease Control and Prevention, male and female cancer survivors incur annual medical costs that are almost two times greater than those of people who haven't had cancer.

"Throughout their lifetime, they will still be going through treatments and checkups and long-term side effects and late effects that can come as a result of survival," explained study author Donatus Ekwueme, a senior health economist at the CDC's division of cancer prevention and control.

Cancer survivors also face an increased risk of having another cancer, which means they have to undergo more regular screenings and tests than the average person, said Dr. Richard Schilsky, chief medical officer of the American Society of Clinical Oncology.

These patients may need treatment for chronic health problems caused by their cancer treatment, too, particularly due to chemotherapy and radiation therapy, Schilsky added.

"It's not surprising that cancer survivors would incur a greater economic cost and have a greater economic burden," Schilsky said. "One could say this is a good problem to have, because before we had survivors we didn't have to face these problems."

The losses aren't just limited to the survivors and their families, however. Their ongoing health struggles also will cost society in the form of lost workplace productivity, Ekwueme said.

"Some of them have problems with concentration, or physical issues that go with the treatments they have received," the study author said. "Rejoining the workforce can be really tough on them, and the system has to take notice of these effects."

More people than ever before are surviving cancer. The CDC estimates there were 13.4 million cancer survivors in the United States in 2012, compared with 3 million in 1971.

Given advances in early detection and treatment, the number of cancer survivors is expected to increase by more than 30 percent during the next decade, to approximately 18 million, the CDC researchers added.

In the report, published in the June 13 issue of the CDC publication Morbidity and Mortality Weekly Report, the researchers analyzed data from the U.S. Agency for Healthcare Research and Quality's 2008-2011 Medical Expenditure Panel Survey. They estimated annual medical costs and productivity losses among male and female cancer survivors aged 18 and older.

The investigators estimated lost productivity by reviewing employment disability, health-related missed work days, and days spent in bed due to ill health.

Male cancer survivors had annual medical costs of more than $8,000 per person, compared with $3,900 for men without a history of cancer, the researchers found. Female survivors had $8,400 in yearly medical costs, compared with $5,100 for women who never faced cancer.

About 10 percent of cancer survivors aged 65 or younger were uninsured, which means their financial burden is likely greater. However, the Affordable Care Act is expected to help get these people coverage and reduce their medical expenses, Ekwueme said.

Society also absorbs the cost, in the form of lost productivity. Male cancer survivors had annual productivity losses of $3,700, compared with $2,300 for men without a history of cancer. Female survivors had $4,000 in lost productivity each year, compared with $2,700 for women who haven't had cancer.

Employment disability accounted for about 75 percent of lost productivity among cancer survivors. Among those who are employed, an estimated 42 percent had to make changes to their work hours and duties.

The aftereffects of chemotherapy can make it tough for cancer survivors to think clearly, which might affect their workplace performance. "Problem solving may become more difficult for some of these patients," Schilsky said.

Survivors also may face ongoing physical disabilities or emotional problems related to their cancer. "They have persistent, long-lasting disability, all of which may require some medical intervention and limits their productivity when they re-enter the workforce," Schilsky said.

About a quarter of survivors said cancer and its treatment interfered with physical job tasks, and 14 percent said they had trouble performing mental tasks, the researchers reported.

Cancer experts have started to recognize the struggles faced by survivors, and are exploring ways to improve their long-term outlook, Schilsky said.

Doctors also are exploring ways to lessen the harmful effects of cancer treatment. "Research is now focusing on whether we can reduce the intensity of the treatment and maintain the same cure rate," Schilsky added.

Another avenue of research involves examining a person's genetics to determine which side effects they are likely to suffer, and tailoring cancer treatment to minimize those effects, he said.

SOURCES: Richard Schilsky, M.D., chief medical officer, American Society of Clinical Oncology; Donatus Ekwueme, Ph.D., senior health economist, division of cancer prevention and control, U.S. Centers for Disease Control and Prevention; June 13, 2014, Morbidity and Mortality Weekly Report

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