Surviving cancer and financial toxicity: Is there really hope?

Last Friday, a new strategic plan, the third for Kenya, was unveiled yet again with renewed hope and commitments made to tackle the disease. 

The burden of cancer is increasing worldwide, placing significant strain on populations across all income levels and healthcare systems.

In Kenya, it causes an estimated 27,000 deaths annually, the equivalent of 54 Boeing 747 plane crashes! Last month we celebrated National Cancer Survivors’ Month to honor cancer survivors and celebrate life beyond a cancer diagnosis.

As we aimed to create an opportunity for individuals with a history of cancer to connect, acknowledge milestones, and express gratitude to those who have supported them on their journey, the question that none of us could answer was, if really there was hope.

Here’s why, surviving cancer often brings forth a myriad of challenges, including physical, emotional, and financial hardships that persist long after the diagnosis and treatment.

Undoubtedly, financial hardship remains a common consequence of cancer treatment. A study conducted by Khera et al. found that between 48 per cent and 68 per cent of cancer patients in the USA experienced financial hardship.

While local studies are lacking, the prevalence in Kenya is likely even higher, given that only about 24 per cent of the general population have insurance coverage, with the majority, therefore, relying on out-of-pocket expenditure.

Although NHIF provides an oncology package, many patients are unable to complete their treatments through this avenue, leading to either out-of-pocket expenditures to fill the financial gaps or discontinuation of treatment, revealing a prevailing situation of underinsurance even for the insured.

Various factors, such as geographic barriers to care with few treatment centers, poor health literacy, gender, and race, further contribute to financial hardships, with the underinsured or uninsured being particularly vulnerable.

Patients facing financial hardships are at an increased risk of resorting to harmful coping mechanisms, such as delaying or skipping treatments or sacrificing basic needs to pay hospital bills.

As the costs of cancer treatments continue to escalate globally, largely due to the emergence of newer targeted and immune therapies, there is an increasing responsibility for clinicians and patient support groups to address and alleviate financial hardships in patients.

Education-based interventions, aimed at improving financial literacy and empowering patients with income-generating activities, could make a significant difference alongside traditional health literacy initiatives.

Providing tips for managing healthcare costs, enhancing price transparency among healthcare institutions, and establishing connections to available financial support and resources would be beneficial for both patients and clinicians when making treatment decisions.

Lastly, the integration of social workers as financial navigators for cancer survivors, as a core service, would be instrumental in preventing financial toxicity.

The author of this article is a Global Health Physician and Cancer Policy expert who currently serves as the Head of the National Cancer Control Program at the Ministry of Health, Kenya.