Finances after Cancer
This is an interesting and most distressing editorial from the Journal of Clinical Oncology about the possible long-lasting financial impact of cancer. We all know about the short term costs of reduced or lost income, medical bills not fully covered by insurance, extra expenses related to childcare, hiring more help at home, etc. This editorial, however, speaks to something even worse. There are families who are financially ruined by cancer costs. This is not a space that allows for much expression of political views, but it is very clear that we have a national crisis about health care costs, and it is also clear that our government, tied up in politics and self-interest, seems unable to address the problem.
Financial Hardship: A Consequence of Survivorship?
Cathy J. Bradley, Virginia Commonwealth University, Richmond, VA
Despite this success on the treatment front, we have done little in a concerted and well-planned fashion to investigate and address the problems of survivors. It is as if we have invented sophisticated techniques to save people from drowning, but once they have been pulled from the water, we leave them on the dock to cough and splutter on their own in the belief that we have done all that we can. -Fitzhugh Mullan, MD, physician, survivor of cancer, and founding president of the National Coalition for Cancer Survivorship.1(p273)
Medicare and other insurers are paying for ever-increasing costs for chemotherapy treatment for cancer.2 Depending on the regimen, these costs can exceed $30,000 for an 8-week regimen. Bach3 reported that Medicare spending on cancer drugs administered in the doctor's office was $11 billion in 2004. By 2020, the cost for the management of colorectal cancer alone in the United States is expected to increase to more than $14 billion.4 In a provocatively titled article, "When Will the U.S. Flinch at Cancer Drug Prices?," Vanchieri5 interviewed physi- cians who discussed the societal costs of these drugs and the trade-offs purchasers make to supply these drugs in their treatment centers. In this article, Robert Wittes, physician-in-chief at Memorial Sloan-Kettering, noted that "nothing will happen [about rising costs] until patients start yelling when they are denied treatment or have to mortgage their homes to get it."5(p626) This last point brings us to the research by Shankaran et al6 published in the article that accompanies this editorial.