The Cost of Cancer

Financial Concerns Plague Even Insured Women with Breast Cancer
by Teddi Fine

For many women, the challenges of breast cancer treatment are heightened further by today’s difficult economic and employment climate. While healthcare costs have long been known to increase stress and deter treatment for uninsured women with breast cancer, PhD candidate Rachel Klimmek, BSN, RN, and assistant professor Jennifer Wenzel, PhD, RN, have found economics also affect women with breast cancer who are insured by managed-care organizations.

In “Insurance-related and financial challenges reported by managed care enrollees with breast cancer,” [Clinical Journal of Oncology Nursing, October 2010], women reported considerable stress related to the loss of personal control over treatment, care, and cost decisions; and to the dearth of speed and transparency in managed-care decisions, resulting in delayed treatment and unanticipated, patient-borne costs.

According to Klimmek, “Many women find managed-care processes dehumanizing, time-consuming, and demoralizing, at the very time they may be struggling with body image, the impact of cancer on work and family, and survival itself.” Wenzel adds, “As unthinkable as it might seem, some patients report financial uncertainties can be harder to manage than the disease itself.”

Yet, most women don’t raise their concerns about coverage and cost with healthcare providers. That’s where nurses can help by anticipating cost concerns, encouraging dialogue about them, and helping to identify solutions.

Klimmek notes, “While patients can feel overwhelmed, nurses can act as navigators through the experience, an approach we’re now testing with older African-American women.