Financial toxicity associated with treatment of localized prostate cancer Review


Authors: Imber, B. S.; Varghese, M.; Ehdaie, B.; Gorovets, D.
Review Title: Financial toxicity associated with treatment of localized prostate cancer
Abstract: Financial toxicity is a broad term to describe the economic consequences and subjective burden resulting from a cancer diagnosis and treatment. As financial toxicity is associated with poor disease outcomes, recognition of this problem and calls for strategies to identify and support those most at risk are increasing. Men with localized prostate cancer face treatment choices including active surveillance, prostatectomy or radiotherapy. The fact that potential patient out-of-pocket costs might influence decision making has rarely been acknowledged and, overall, the risk of financial toxicity for men with localized prostate cancer remains poorly studied. This shortfall requires a work-up in the context of prostate cancer and a multidimensional framework for considering a patient’s risk of financial toxicity. The major elements of this framework are direct and indirect costs, patient-specific values, expectations of possible financial burdens, and individual economic circumstances. Current data indicate that total cost patterns probably differ by treatment modality: surgery might have an increased short-term effect, whereas radiotherapy might have an increased long-term risk of financial toxicity. Specific thresholds of patient income levels or out-of-pocket costs that predict risk of financial toxicity are difficult to identify. Compared with other malignancies, prostate cancer might have a lower overall risk of financial toxicity, but persistent post-treatment urinary, bowel or sexual adverse effects are likely to increase this risk. © 2019, Springer Nature Limited.
Keywords: cancer chemotherapy; cancer surgery; review; cancer patient; cancer radiotherapy; cancer therapy; prostate cancer; health insurance; antiinfective agent; prostatectomy; quantitative analysis; brachytherapy; cancer registry; predictor variable; health care system; expectation; external beam radiotherapy; stereotactic body radiation therapy; decision making; conceptual framework; american; cost; hospital cost; income; knowledge; caregiver support; human; priority journal; patient risk; financial deficit; employment discrimination; out of pocket
Journal Title: Nature Reviews Urology
Volume: 17
Issue: 1
ISSN: 1759-4812
Publisher: Nature Publishing Group  
Date Published: 2020-01-01
Start Page: 28
End Page: 40
Language: English
DOI: 10.1038/s41585-019-0258-3
PUBMED: 31792431
PROVIDER: scopus
PMCID: PMC8010900
DOI/URL:
Notes: Source: Scopus
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  1. Behfar Ehdaie
    174 Ehdaie
  2. Brandon Stuart Imber
    214 Imber