GU Cancers 2023 | The financial impact of bladder cancer
Vidit Sharma, MD, MS, Mayo Clinic, Rochester, MN, discusses the financial impact of bladder cancer and the impact of cost on the quality of life of a patient. The cost of bladder tends to be disease-related, including disease stage, complications and surveillance, whereas toxicity may be related to the patients personal circumstances including income, employment and age. This interview took place at the ASCO GU Cancers Symposium 2023 in San Francisco, CA.
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Transcript (edited for clarity)
It was a privilege of mine to give this talk. Basically I think it’s an under covered topic. Bladder cancer patients face a wide range of costs, and it’s no surprise that it’s one of the most expensive cancers on a per patient basis, and this cost is actually projected to increase over the next 15 years. But when we look at the types of costs they face, the costs we can measure are often just the tip of the iceberg of the cost they actually face...
It was a privilege of mine to give this talk. Basically I think it’s an under covered topic. Bladder cancer patients face a wide range of costs, and it’s no surprise that it’s one of the most expensive cancers on a per patient basis, and this cost is actually projected to increase over the next 15 years. But when we look at the types of costs they face, the costs we can measure are often just the tip of the iceberg of the cost they actually face. Oftentimes the indirect costs, lost work, opportunity cost of time, make up a large chunk of the cost they face, and then the quality of life impacts of that cost, called financial toxicity, can also have a major impact on their quality of life and also their treatment ramifications. So we basically value that quality of life equally. If you look at that quality of life and its impact on bladder cancer patients, it actually can be larger than the costs we can measure. So in bladder cancer, the costs we measure are a small chunk of the costs that patients actually face.
The sources of the costs are basically cancer related, so stage of disease, complications and progression and surveillance. But the financial toxicity may not be related to the disease. It may actually be related to patient-related factors such as income, employment, younger age. So that’s basically what my talk highlighted. And then at the end, I covered some strategies to potentially mitigate this. There’s no easy solution. It’s going to take broad policy change to have a major impact, but on the ground, three easy strategies I think are to understand the financial conditions and concerns of your patient, and then identify at risk patients and direct those at risk patients to resources at our institutions such as social workers, financial navigators, early. And then last, I think we should incorporate cost discussions and financial toxicity discussions into shared decision making with our patients.
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