Penalised for having cancer

Kathy Redmond

Many cancer patients are being tipped into poverty as a direct result of their illness, which adds stress and misery to an already very difficult situation. In this editorial, Cancer World looks at the many ways that a having cancer can hit people’s living standards.

Much attention is given to the spiralling cost of treating cancer, yet the financial cost to survivors is rarely given any consideration. A recent Dutch study published in the European Journal of Cancer (vol 48, pp 2037–42) throws some light on the problem. Nearly a third of survivors experienced a change in their work situation as a result of their cancer. Some chose to give up work, others were unable to work because of their disease or had to switch to part-time work. A few were sacked. People also faced problems obtaining health and life insurance as well as mortgages. While many survivors did finally manage to obtain loans and insurance, they had to pay a higher premium or interest rate. This study mirrors findings from other countries, which have shown that having cancer often leads to a loss of income and/or increased expenditure.

In some countries patients have to bear the costs, either fully or partially, of their medication, tests, procedures and physician visits. But there are also many hidden costs. People can find themselves out of pocket because of higher utility bills, the need to buy new clothes because of weight changes, and the cost of special diets, wigs and prostheses. Travelling to a treatment centre can be very expensive, especially for those who live a long way away, and family members may also be hit financially if they need to accompany the patient, or stay close by while the patient is hospitalised.

As many cancers are becoming chronic conditions, these financial burdens can persist in the long term, and can be highly stressful for patients and their families at a time when they are already struggling to cope with the disease. Finding solutions won’t be easy given the current economic climate in Europe, with rising unemployment, cuts in welfare benefits, and recent increases in living expenses.

Greater awareness of the social and economic burden of cancer could help ensure that patients are routinely asked about how they are coping financially, and are given advice about their rights and entitlements. The patient survey recently launched by the European Cancer Leagues, to build a better picture of social and economic problems, could be a very helpful contribution. Policy initiatives aimed at reducing the financial burden of cancer are also needed. These should include protecting employment rights and removing obstacles to accessing welfare benefits when needed. A number of organisations across Europe are currently addressing this issue, but these efforts are sporadic and not delivering for all cancer patients. It makes sense to join forces at an EU level to raise awareness about the financial consequences of cancer and to advocate for changes that could make all the difference to patients’ lives.

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