People who encountered "unexpected" costs related to care had higher anxiety and depression scores than those who did not, the study found. Quality-of-life scores were lower for patients who had financial worries, and the physical and mental health of the spouses-caregivers seemed to decline as medical care cost worries persisted, the study found.
What were patients and their spouses worried about? According to Hlubocky, it ranged from the "little things" -- parking and hotel accommodations, gas and mileage getting to and from doctors' appointments -- to much larger concerns, including insurance coverage (or lack thereof), how to provide for loved ones after death, and even bankruptcy.
Some participants expressed real anxiety in meeting their financial obligations. "We had to pay for an additional hospitalization for a small-bowel obstruction, and insurance would not cover it," one patient told the researchers. "If we had to sell our house to pay, we'd do it."
Other patients felt their illness threatened their livelihood. "My employer has an attendance policy that if violated too many times will result in termination," the patient said. "My appointments have to be midday usually." The patient considered going on disability, "but that would not pay for my insurance."
One expert said these types of fears are all too common for people coping with cancer.
"It is certainly true that the impacts beyond diagnosis and treatment are tremendous for cancer patients," said Dr. Sylvia Adams, ASCO spokeswoman and assistant professor in the department of medicine at NYU Langone Medical Center, in New York City.
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