Following up on a study Roswell Park Comprehensive Cancer Center that showed how chronic stress affects immune systems, Anurag Singh, MD, began studying whether financial worries worsen survival for cancer patients.
Dr. Singh, the director of radiation research in the Department of Radiation Medicine, and his team found a definite answer.
“Does financial worry impact survival? The answer is resoundingly yes,” he says. “If you are worried about your finances, your risk of dying is roughly double.”
Dr. Singh noted his team found the increasing costs of cancer care are a significant burden to some patients undergoing treatment.
“We had a large group of head and neck cancer patients on whom we had extensive quality of life data,” he says. “Of this nearly 300 patient cohort, we found a substantial percentage had financial worries at baseline. So, coming into treatment, they were worried about money.”
Dr. Singh and his team did a statistical analysis to ensure there weren’t factors other than the financial worry that was driving the results.
“We took the 40 or so people who had financial worries and matched them up exactly with 40 or so similar patients who did not have financial worries. That’s called a match pair analysis,” he says.
“There was still a doubling of survival difference.
“We were actually very surprised at the degree of the effect. We were not expecting anything like a doubling of the risk of death with financial worries. It was because of the magnitude of the difference that we were able to see it with a relatively small number of patients.”
Patients had access to identical treatments
He notes that in the analysis, the patients who had worries over finances received the same care as those who were not worried.
“A common question asked about financial worries is whether these patients who are worried about their finances are therefore making different decisions about what cancer care to get. That was not the case in our patient population,” Dr. Singh says.
“In our population, everyone got the same chemotherapy and radiation for roughly the same stages of head and neck cancer.
It was clear that it was not access to care that was the problem, it was something else that was directly related to the patient’s perceived stress from being worried about their finances.”
From the results, Dr. Singh said they understood that a patient’s perceived quality of life and the internal stresses they are experiencing can actually have a significant impact on outcomes.
“We need to make sure we are doing everything possible to maximize quality of life. That includes maximizing pain control, minimizing the worries they have, either financial or otherwise, going into treatment, and doing financial counseling to lessen the fears that people may have,” he says.
Dr. Singh and his colleagues also are looking at a variety of other measures that could potentially improve outcomes, including if patients are sleeping well, and if not, how that affects their quality of life, their response to treatment and their side effects of treatment.
