For Cancer Patients, Treatment Decisions Involve a Heavy Dose of Consideration

Finding out that there are treatment options for your cancer can bring about feelings of relief, gratitude, and hope. However, as patients learn more about their treatment options, some begin to worry about how those treatments will impact their physical and mental health, their quality of life, and their finances. CSC’s Research and Training Institute (RTI) asked patients to share their perspectives on this in two different research studies, and the findings highlighted that when it comes to deciding which cancer treatment to pursue, there’s a lot to consider.

For example, patients with Metastatic Breast Cancer (MBC) reported that when it came to choosing between oral chemotherapy (medication that you take by mouth) or intravenous chemotherapy (medication that has to be injected through a needle or tube in the skin), they were concerned about how the treatment might impact their daily life.  Overall, patients reported that they believed taking an oral medication would have less of a negative impact on certain aspects of their lives than an intravenous one. For example: 

• 81% of patients surveyed believed that they would have less need to travel to a treatment center if they took oral chemotherapy instead of intravenous chemotherapy
• 76% believed that oral chemotherapy would be an easier medication to manage at home
• 73% believed that they’d have freedom to travel or work while on oral chemotherapy treatment 

These findings highlight that for patients with MBC, medical decision-making is about more than the clinical impact of the medicine. Patients also have practical concerns about the logistical impacts different types of treatment may have on their lives. 

These logistical impacts of cancer treatment are not the only concerns that patients with cancer face. Many patients also report significant financial concerns when pursuing a treatment. The RTI asked patients with Multiple Myeloma (MM) and patients with Chronic Lymphocytic Leukemia (CLL) to weigh in on this. The RTI learned that:

• While many patients reported distress about money and health insurance, the majority did not discuss cost of care with their health care team
• 41% of patients reported being moderately to seriously concerned about health insurance or money
• Financial concerns seemed to impact patients’ well-being as well as their cancer care—for example, financial concerns in this sample were shown to impact how often patients postponed doctor’s appointments and skipped taking their medications

Overall, these findings highlight the role that practical and financial concerns play in medical decision-making for patients with cancer. Medical professionals must work to ensure that patients are involved in treatment decision-making and have the opportunity to discuss these concerns both up front and as their treatment progresses so that they have the best chance of choosing a treatment that makes the most sense for them. Additionally, it is important for patients to feel prepared with the knowledge and tools they need to engage in meaningful shared decision-making with their health care providers.

CSC is working hard to make sure medical professionals are aware of these important issues. In December 2020, we presented the findings about logistical concerns and treatment decision-making for patients with MBC at the virtual San Antonio Breast Cancer Symposium. We also presented the findings about financial concerns at the 62nd American Society of Hematology Annual Meeting and Exposition, the largest hematology conference in the world. And, as always, we are using these findings to inform our own work as we design future research, develop support programs, and seek to inform public policies that impact the cancer community.

Read more about RTI’s research.