Summary
A recent study found recurrent ovarian cancer patients who reported high financial toxicity also demonstrated higher mean scores for depression and anxiety, as well as persistently lower quality of life.
The study authors, who presented their findings at the ASCO 2020 Annual Meeting, suggest that targeted interventions aimed at decreasing financial toxicity could offer improvements in the mental health and quality of life of cancer patients (Abstract 6079).
To explore additional resources offered by Oncology Times and to subscribe, visit https://journals.lww.com/oncology-times/pages/default.aspx
Original Article
Financial Toxicity Among Women With Recurrent Ovarian Cancer
Oncology Times
By Catlin Nalley
A recent study found recurrent ovarian cancer patients who reported high financial toxicity also demonstrated higher mean scores for depression and anxiety, as well as persistently lower quality of life.
The study authors, who presented their findings at the ASCO 2020 Annual Meeting, suggest that targeted interventions aimed at decreasing financial toxicity could offer improvements in the mental health and quality of life of cancer patients (Abstract 6079).
“Financial toxicity is a term describing problems a patient has related to the cost of medical care. This is a defined term from the NCI’s dictionary for cancer related terms,” noted study author Larissa Meyer, MD, Associate Professor of Gynecologic Oncology at the University of Texas MD Anderson Cancer Center.
“The chronic nature of ovarian cancer can place women in increased risk of financial toxicity from both the direct as well as indirect costs associated with a cancer diagnosis, including potential loss of income,” she said, during her ASCO presentation. “In this study, we explored financial toxicity and its association with anxiety, depression, and quality of life over time in women who were diagnosed with recurrent ovarian cancer.”
Methods & Results
Women with recurrent ovarian cancer were recruited from MD Anderson Cancer Center for this longitudinal study. This included patients with both platinum-sensitive and platinum-resistant disease.
“Participants completed validated instruments at baseline and then every 3 months,” Meyer explained. “These instruments included the FACIT Comprehensive Score for Financial Toxicity (COST), GAD-7 (anxiety), CES-D (depression), and FACT-Ovary, which measures quality of life. Mixed models were performed on 12 months of longitudinal PRO data, and multivariable analysis was performed on the demographic and clinical data.”
Using baseline COST scores, 225 patients were divided into low financial toxicity (top 2 terciles, n=152) and high financial toxicity (bottom tercile, n=73). The median patient age was 59 years (range 22.9-78.9).
“Median time since diagnosis was 36.7 months, with a range of follow up from 5.6 to 260.7 months,” Meyer said. “All patients included in this study had some form of health care coverage.”
The researchers observed no significant differences between the groups in regard to marital status, number of people in household, or education level.
However, there were differences between the low and high financial toxicity groups in terms of median age (low=61 years vs. high=54 years, p < 0.0001) and race (5.4% black in low financial toxicity vs. 15.1% in high financial toxicity, p = 0.04). Other differences were seen in terms of the number of children under 18 years in the home (p = 0.02), employment status (p < 0.0001), and annual income (p < 0.0001).
“Income and age were significantly associated with financial toxicity after multivariable analyses with a p value less than 0.0001 for both variables,” Meyer emphasized.
“The mean baseline COST score in the low financial toxicity group was 34 versus 16 in the high financial toxicity group,” the study authors wrote. “Interestingly, patients with low baseline financial toxicity had significant worsening of financial toxicity over the 12-month time period, while those with high financial toxicity had slight improvement over time.
“Consistently, the high financial toxicity group had higher scores on screening measures for anxiety and depression, as well as lower overall quality of life which persisted over time,” they reported.
The researchers concluded that “financial toxicity is a measurable and clinically relevant outcome. As survival improves with novel therapies, patients live longer with cancer. Targeted interventions to decrease financial toxicity may provide more global improvements in mental health and quality of life.”
Catlin Nalley is a contributing writer.