Time-related and financial burdens may be detrimental to the quality of life of patients with gynecologic cancer as well as cancer survivors, according to the findings from two new studies presented by Ackroyd et al and Adjei et al at the Society of Gynecologic Oncology (SGO) 2023 Annual Meeting on Women’s Cancer.
First Study Methods and Findings
In the first study, investigators examined the treatment-related quality of life and relative time toxicity between treatment courses among 75 patients with a median age of 67 years—51% of whom identified as White and 41% of whom identified as Black—who had advanced or recurrent endometrial cancer. Time toxicity was defined as the number of days spent away from home at health-care facilities to receive required cancer care during a specific treatment regimen.
The investigators discovered that patients with advanced or recurrent endometrial cancer spent substantial time tending to their health-care needs while receiving treatment, which was correlated with worse quality-of-life scores.
"Patient-centered outcomes are important to consider as we make difficult treatment decisions in the recurrent setting,” emphasized first-study lead author Sarah Ackroyd, MD, MPH, a gynecologic oncology fellow in the Department of Obstetrics and Gynecology at the University of Chicago. “Time toxicity is a potential new outcome measure that can help us understand the treatment-related time demands our patients experience. I hope that this framework can be further developed and used to improve the workflow of cancer care and the quality-of-life of our patients,” she underscored.
Second Study Methods and Findings
In the second study, the investigators analyzed the financial and social impacts of ovarian cancer care and strategies implemented by patients and their support networks. They asked 40 patients with a median age of 59.3 years who had recurrent, advanced stage ovarian cancer—with a median time from diagnosis of 44.7 months—to participate in qualitative interviews in which they were asked to describe their experiences regarding the financial impacts of cancer care.
The patients reported covering their cancer-related expenses by cutting back on necessities and leisure activities, and many of them acknowledged financial and social support that they received through their social networks and via crowdsourcing strategies to fund their cancer care.
Conclusions
The investigators suggested that these interpersonal support systems and funding mechanisms may be unsustainable in the long term and called on more reliable systems to alleviate cancer-related financial distress.
“Participants in our study had health insurance and were receiving care at a comprehensive cancer center, yet they reported significant financial distress causing them to lose their employment, insurance, homes, and other assets,” stressed second-study lead author Naomi Adjei, MD, MPH, MSEd, a resident physician in the Department of Obstetrics and Gynecology at Yale New Haven Hospital. “How are patients [with cancer] in less affluent settings with fewer safety nets coping? Policies and interventions that promote timely cancer care accessibility, innovative insurance models, and value-based care will [potentially] protect patients, their families, and their interpersonal social networks—as well as ensure more sustainable health-care spending by the United States health-care system,” she concluded.
