Undue Burden: Understanding and Mitigating Cancer Survivors’ Increased Risks

Financial Impact of Cancer Care on Survivors: Results from the 2015 LIVESTRONG Survey

Authors:

Aditi Narayan (Presenter)
LIVESTRONG Foundation

Loyce Pace, LIVESTRONG Foundation
Carla Bann, RTI International
Katherine Treiman, RTI International
Linda Squiers, RTI International

Public Health Statement: The cost of cancer care in the United States was $124.5 billion in 2010, and is projected to increase by 27% to $158 billion in 2020. According to the American Society of Clinical Oncology (ASCO), cancer drugs cost an average of $24,000–$36,000 per year. Additionally, cancer survivors report high out-of-pocket costs. Financial distress can impact survivors’ treatment outcomes and daily quality of life.

Purpose: Cost and anticipated stress may be deterrents to accessing care for some survivors. With an estimated 1.7 million new cancer cases every year, it is imperative to understand the financial impact of cancer care on survivors’ decision-making and daily living.

Methods/Approach: In August of 2015, LIVESTRONG conducted an online survey to learn more about the financial impact of treatment on cancer survivors and their loved ones. Two similar surveys were distributed for survivors (n=1,704) and loved ones (n=739). Our analyses focus on the results from the survivor survey.

Results: Fifty-nine percent of survivors reported that they experienced a lot of or some financial problems as a result of cancer. Eighty-five percent of survivors reported that their provider did not discuss the costs of care with them, and 12% reported that they would have altered decisions about treatment if they had known then what they know now about the financial impact of cancer. Most survivors (59%) reported that they spent less than $10,000 on out-of-pocket costs while 27% reported that they spent between $10,000 and $24,999 on out-of-pocket costs. The majority of respondents reported that they paid out-of-pocket for doctor visit co-pays (77%), transportation (60%) and medications (51%). Additionally, 61% of survivors reported that they had to make financial sacrifices such as using retirement savings and spending less on day-to-day living expenses.

Conclusions/Implications: With costs of cancer care expected to continue rising for the foreseeable future, there is a need for more and better communication between patients and healthcare teams related to the potential financial impact of cancer care prior to treatment. Cancer institutions should consider including financial counselors as a part of care teams to inform patients of costs based on insurance status and type, and help them make educated and well-informed decisions related to their care.

Adult Cancer Survivors Receiving Flu Vaccination: The Importance of Follow-Up Care Instructions

Authors:

S. Cristina Oancea (Presenter)
University of North Dakota

Vinay K. Cheruvu, Kent State University

Public Health Statement: Cancer survivors are at increased risk for hospitalization and even death from complications due to the seasonal flu. The receipt of follow-up care instructions may be very important for them receiving the flu vaccination.

Purpose: The goal of the present study is to evaluate the importance of adult cancer survivors (ACS) receiving Follow-up Care Instructions (FCI) for their overall well-being, especially for protecting them against the seasonal flu. We hypothesize that the receipt of FCI would increase the likelihood of ACS receiving the annual flu vaccination (AFV).

Methods/Approach: The hypothesis was tested by using a representative sample of ACS who responded to the 2014 BRFSS survey. Weighted multivariable logistic regression models were used to investigate the association between FCI and AFV. Analyses were adjusted for gender, race, age at survey, marital status, education, employment, income, and health care coverage.

Results: Out of 5,737 final study participants, 54.45% received the AFV during the past 12 months from the survey date and 72.82% received FCI. The percent of ACS receiving AFV was approximately 51% among those who did not receive FCI and 56% among those who did receive FCI. The adjusted odds of receiving the AFV were almost 1.3 times higher (Adjusted Odds Ratio (AOR): 1.29 [95%CI: 1.04–1.62], p-value=0.02) for those who received FCI compared to those who have not received them.

Conclusions/Implications: The present study emphasizes the importance of receiving FCI. ACS may highly benefit from the receipt of FCI for receiving the AFV to protect themselves against the possible long-term health complications that may be caused by the seasonal flu.

Examining the Mutual Benefits of a Peer Support Program to Facilitate Adaptation Among Women Affected by Breast/Ovarian Cancer: The Sharsheret Experience

Authors:

Adina Fleischmann (Presenter)
Sharsheret

Elana Silber, Sharsheret
Kathryn Rehberg, Georgetown Lombardi Comprehensive Cancer Center
Suzanne O’Neill, Georgetown Lombardi Comprehensive Cancer Center
Kenneth Tercyak, Georgetown Lombardi Comprehensive Cancer Center

Public Health Statement: Riessman’s Helper Theory posits that peer support networks can be powerful tools to extend care delivery—benefitting both the giver and receiver of informal care. Our project describes the contribution of a telephone-based peer support network in achieving national breast cancer prevention and control objectives.

Purpose: Sharsheret supports those who have been diagnosed with or are at risk for breast/ovarian cancer. This abstract will describe factors associated with uptake and delivery of its unique 1-1 peer support program, a natural helper model.

Methods/Approach: Clients receiving services in 2016 participated in a self-report survey to evaluate programmatic engagements and outcomes. We examined the frequency of offering peer support, its uptake and delivery, and related measures.

Results: A total of N=461 individuals completed an evaluation (age range = 23–81 years; 71% married/partnered, 88% mothers). Most were breast/ovarian cancer survivors (58%) or at high familial risk for developing cancer (20%). Of those contacting Sharsheret, 31% were referred to the peer support program and 87% of those referred spoke with a peer supporter: the most common reason for not speaking with a peer supporter was lack of emotional readiness. Individuals who participated in the program and received peer support commonly found it helpful (75.2%), offering useful information (70%) and emotional support (73.1%) during a time of high need. Importantly, 74.1% of individuals reported that their peer supporter shared experiences that were beneficial to their cancer journey. Among the N=69 peer supporters completing an evaluation, 66.7% reported speaking with a client in the past 12 months. Of those, 66.7% reported deriving personal benefit from being in the program, 62.3% offered useful information, and 62.3% provided emotional support. Peer supporters’ primary reasons for joining the program were: to offer advice to others (75.4%) and give back to their community (63.8%). Engagement with peer support training was highly diverse and cost effective, including: participation in remote webinars (46.4%), reading manuals (59.4%), and consulting with a professional staff member (47.8%).

Conclusions/Implications: Peer support for Jewish women affected by and with breast/ovarian cancer benefited both givers and receivers of informal care, was well-utilized, and was sustained by a range of training modalities. In the future, these networks should be scaled up to better meet the increasing needs of this population.