High financial toxicity in metastatic prostate cancer means less spending on basic goods, leisure

Patients with metastatic prostate cancer who report high financial toxicity tend to spend less on basic goods and leisure activity and use their savings to pay for care, according to the results of a cross-sectional study.

A survey, which included the Comprehensive Score for Financial Toxicity (COST-FACIT) and coping mechanism questionnaires, was administered to all patients seen at a single centre’s Advanced Prostate Cancer Clinic over a 3-month period. Those with metastatic disease (lymph nodes, bone, visceral) were included in the analysis.

Using Fisher’s exact test, the investigators then compared the coping mechanisms between patients experiencing low (COST-FACIT >24) vs high (COST-FACIT ≤24) financial toxicity. They also evaluated the characteristics associated with lower financial toxicity using multivariable linear regression.

A total of 281 patients were included, of which 79 reported high financial toxicity. Those with high vs low financial toxicity tended to reduce their spending on basic goods (35 percent vs 2.5 percent; p<0.001) and leisure activity (59 percent vs 15 percent; p>0.001), as well as use savings (62 percent vs 17 percent; p<0.001) to pay for their treatment.

On the other hand, multivariable analysis revealed that lower financial toxicity was associated with older age (estimate, 0.36, 95 percent confidence interval [CI], 0.21‒0.52), applying for patient assistance programs (estimate, 4.42, 95 percent CI, 1.72‒7.11), and an annual income of at least $100,000 (estimate, 7.81, 95 percent CI, 0.97‒14.66).

“Understanding the impact of financial toxicity on patients’ lives is crucial to inform shared decision-making and interventions designed to mitigate financial toxicity in this population,” the investigators said.