Understanding the Effects of Financial Toxicity on Head and Neck Cancer Patients
As a resident, Fumiko Chino, MD, mentored by Yvonne Mowery, MD, PhD and David Brizel, MD, at the Duke Cancer Institute began prospectively quantifying and investigating the impact of high treatment costs for head and neck cancer patients receiving radiation therapy. Patient costs are often overlooked and may be associated with increased symptom burden, poor treatment compliance and increased mortality. Patients being treated with radiation therapy for head and neck cancer are especially at-risk for high out of pocket costs as well as significant side effects that often require new medications, nutritional supplements and potentially hospitalization due to dehydration or feeding tube placement. These patients often cannot work during the six to seven weeks of treatment and either need to travel long distances daily or stay near a major medical center during this time. Drs. Chino and Mowery's research will shed important light on the effects of financial toxicity—a term for the hardship that patients face from their medical expenses—for head and neck cancer patients.
In the study:
- Participants are collecting all treatment-related bills in a provided binder, which also includes educational materials focused on managing treatment-related toxicity, including financial toxicity.
- Patients are completing a baseline survey and being surveyed again three and six months after completing radiation therapy. The surveys are assessing socioeconomic household information, treatment costs, quality of life, financial toxicity, self-reported quality of care and utility of the educational materials provided.
- The team is analyzing the data to understand patients’ out of pocket expenses, their coping mechanisms, their satisfaction with the care they received, their quality of life and their attitudes toward communications with their healthcare team about treatment costs and cost-related treatment decision making.
Dr. Chino’s passion to conduct research in the emerging field of financial toxicity stems from personal experience when she and her late husband went into massive debt to pay for his cancer treatment. Originally working in entertainment, Dr. Chino enrolled in medical school to pursue a new career in which she could bring attention to this issue and try to improve communication between patients and providers regarding treatment costs. Her ground-breaking research on financial toxicity has been covered by Forbes, National Public Radio (NPR), US News and World Report and JAMA Oncology.