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Death, Debt and Cancer

As if having cancer isn’t hard enough. Layer in the potential for the disease wiping out your life savings and the problem magnifies. Yet, that’s exactly what’s happening at an alarming rate.

The American Journal of Medicine published the results of a 2018 research study that found cancer’s financial burden is substantial during treatment phases and often worsens with improving prognoses. Direct medical costs in the United States related to cancer exceed $80 billion and indirect costs of premature morbidity and mortality top $130 billion.

That’s billion – with a “b.”

Even with insurance, deductibles and copayments for treatment, supportive care and nonmedical or indirect costs (travel, caregiver time, time lost from your job) may be financially devastating.

The purpose of the “Death or Debt?” study was to assess the financial impact of cancer among the newly diagnosed in the U.S. Changes in net worth and debt (consumer, mortgage, and home equity debt) were analyzed according to numerous demographics, socioeconomic and clinical factors. (1)

An estimated 9,527,522 new diagnoses of cancer were observed from 2000-2012. By Year 2, 55.6 percent noted an improvement in their cancer status. By Year 4, 94.1 percent had cancer status improving or remaining the same.

We have discussed “financial toxicity” – the unintended financial consequences of medical treatment – and these factors are at the root of the problem. While the cancer patients were improving, their finances were taking a beating:

Approximately one-third (36.3 percent) continued to require cancer treatment at Year 2 and 30.1 percent at Year 4.

The average net worth at Year 2 decreased by $92,098. Some 42.4 percent had their entire life’s assets depleted at Year 2 … 38.2 percent at Year 4.

Further, significant decreases in net worth were independently associated with worsening cancer status: Year 2 – $221,082; Year 4 – $438,634.

The study noted, “At Year 2, financial toxicity was independently associated with worsening cancer, demographic and socioeconomic factors, and clinical characteristics. Additionally, a higher adjusted odds of complete loss of net worth was associated with increasing age (especially those 75 years of age and older), Medicaid, the requirement of continued cancer treatment, and being retired.

“At both Year 2 and Year 4, protection against financial toxicity was associated with private insurance, being currently married, and the 2008 fiscal crisis. Year 4 findings generally paralleled Year 2, although 75 years of age and older, current alcohol use, and black race were independently associated with greater monetary losses and odds of net worth depletion at Year 4.”

Notably, Medicare beneficiaries without supplemental insurance incurred substantially higher out-of-pocket expenditures when compared to beneficiaries with supplemental coverage.

Researchers said routine screening for psychological distress is recommended for all cancer patients, with the prevalence of depressive disorders in cancer ranging from 11 percent to 35-37 percent.

This investigation found that 42.4 percent of individuals depleted their life assets two years following a cancer diagnosis, extending to 38.2 percent at four years. A higher odds of asset depletion at Year 2 was noted among groups with known vulnerabilities, including worsening cancer and requirement of continued treatment) and socioeconomic factors among others.

The untold story of cancer, the “financial toxicity” – losing everything – is rarely discussed in the doctors’ offices or in the media. It is, however, a real factor when facing a cancer diagnosis.

Your financial situation may dictate decisions regarding cancer treatments. But do not allow cancer treatments to lead to financial hardship. This vicious cycle – questioning yourself while trying to save your life – can result in “financial toxicity.” There are means to pay for your treatment, and LifeGuide Partners can help you navigate those financial decisions.

 

Citations

  1. Death or Debt? National Estimates of Financial Toxicity in Persons with Newly-Diagnosed Cancer. https://www.amjmed.com/article/S0002-9343(18)30509-6/fulltext