For men who are newly diagnosed with prostate cancer and their families, there are many things to consider: What is my prognosis? What are my treatment options? What are the short and long-term side effects of treatment? How might this affect my family members? One of the questions that may not immediately come to mind but is very important is, “How will this affect my finances and those of my family?” A new cancer diagnosis comes with a number of financial implications:

  • Prostate cancer testing and treatment may have significant direct costs (“out-of-pocket” costs).
  • There are additional indirect costs including lost income due to missing work (for both the man diagnosed with prostate cancer and other family members who may be assisting in his care), transportation costs to the hospital, and others
  • This may affect your eligibility for certain kinds of insurance, including life insurance
  • It may affect premiums for health insurance

The National Cancer Institute defines financial distress as “problems a patient has related to the cost of medical care.” Numerous studies have shown that patients with cancer are more likely to have financial distress than people without cancer. Some studies have shown that cancer patients in the United States may spend more than 20% of their annual income on medical care.

Direct prostate cancer treatment is a large contributor to financial distress, but it is far from the only one. There also can be many out-of-pocket costs. Out-of-pocket costs include copayments, deductibles, and coinsurance. These costs may contribute to hospital stays, and outpatient services including testing or procedures, medical appointments, surgeries, radiotherapy, and prescription drugs.

Out-of-pocket costs may vary substantially depending on location. In Canada and many parts of Europe, direct out-of-pocket costs for medical care are low or negligible, but in the United States, they may be substantial. Within the United States, costs may also vary depending on the patient’s health insurance.

There are, however, many other ways that a new cancer diagnosis may affect your family’s finances. First, you are likely to need to take time off work for medical appointments, tests, treatments (such as surgery or radiotherapy), and recovery from treatment. Depending on employee benefits, this may mean a substantial loss of income. Family members including spouses or children may need to take time off work as well. On top of loss of income, there are other indirect costs including transportation, parking at the hospital, and more.

In addition to the stress of worrying about how to pay for health care costs, many patients worry about paying for other necessities (food, housing, etc.) as a result of the costs of their medical treatment. Financial distress is more common and may have a greater effect among men with lower incomes and assets, men who have other financial responsibilities including raising children, and (in some studies) among minority patients. Additionally, those with more advanced cancer, those with a poor prognosis, and those who have chronic conditions (such as heart disease or diabetes) as well as prostate cancer have a higher risk of financial toxicity.

Financial distress can lower the quality of life of cancer patients. They may experience more symptoms and greater pain. Additionally, the stress of managing financial concerns can affect mental health by contributing to anxiety and depression. One study demonstrated that financial distress may be more severe than the physical, emotional, or social distress that follows a cancer diagnosis.

However, there are ways to reduce financial distress. Do not hesitate to share financial concerns with your physicians when considering treatment approaches. Further, most institutions have a financial navigator or social worker who may assist with identifying cost-saving methods (such as indigent care plans for prescription drugs, which are available through most of the companies that supply prostate cancer drugs) for treatments that are appropriate for you.

Zachary Klaassen, MD, MSc
Urologic Oncologist, Georgia Cancer Center, Augusta University, Augusta, GA, USA