In this post, we feature Biswadeep Dhar‘s early stage-research with Priyanshi Sharma and Michael Gutter on financial toxicity faced by cancer survivors in the United States.
The team spotlights how cancer survivors experience significant financial challenges due to the high costs of treatment, a problem known as financial toxicity. This financial strain can greatly affect survivors’ quality of life, worsen health disparities, and hinder long-term recovery. While financial toxicity is increasingly recognized, the link between this financial distress and broader measures of financial well-being has yet to be thoroughly studied. This research examines financial toxicity and financial well-being among cancer survivors and identifies the demographic and clinical factors influencing these outcomes.
In this study, financial distress was measured using the 11-item Comprehensive Score for Financial Toxicity (COST), with lower scores indicating greater financial distress. Differences in COST scores across demographic groups were analyzed. Linear regression analyses were conducted to identify significant COST score predictors.
The study included 300 cancer survivors, 50.6% aged 65+, 70.3% female, and 37.9% having a household income below $35,000. The mean COST score was 34.7 (SD=3.7). For the COST score, Colorectal cancer patients scored lower than Breast cancer patients (-1.8, [-3.4, -0.1], p<0.05), with Leukemia patients scoring even lower (-3.1, [-4.9, -1.3], p<0.001).
The findings reveal significant disparities in financial toxicity and well-being among cancer survivors, varying by sex, race, income, and cancer type. Addressing these differences is crucial for improving cancer survivors’ quality of life and overall well-being. The larger objectives of this research are to identify and explore behavioral health interventions to reduce cancer-related financial toxicity.
Potential Ways for Future Studies in India
Biswadeep considers that there are potential ways to expand the above said research study in a low-middle income nation like India. There are genuine gaps on how family environment influences the financial burden, particularly debt which may play a key role in financial toxicity among cancer patients and survivors in India (such as financial debt, where family is taking debt to meet their disease associated expenses, and/or financial sacrifice, where patients working less hours, unpaid leave from work, or having to a pay a caregiver -indirect costs increasing the debt burden). To be specific, there is a paucity in financial toxicity-based interventions that has been developed for the communities coming from rural areas of the nation. So, a needs assessment could be conducted among the practitioners, local and national financial navigators and advocates, and rural cancer patients and their caregivers experiencing financial toxicity to inform a community-engaged intervention development study focused on rural financial toxicity.
About the contributor: Dr. Biswadeep Dhar is an Assistant Professor of Human Ecology at the University of Maryland, Eastern Shore (UMES). He has a PhD in Human Development / Health Behavior at the University of Florida and did his postdoctoral research at the University of Illinois Chicago. His research is focused on health behavioral changes in chronic disease prevention among low income, vulnerable populations in the US, particularly associated with health promotion relating to diet and chronic diseases. His present research at the UMES focuses in designing culturally tailored, digital lifestyle interventions with relation to diet, targeted to at-risk, marginalized, and diverse (racial/ethnic) populations living in US and in LMICs to lower the prevalence of risk factors in higher obesity, type 2 diabetes, CVD, and cancer incidence. He has been working on financial toxicity among cancer patients in the US and aims to do similar studies in India.
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