Abstract
PurposeTo ascertain renal cell carcinoma (RCC) financial toxicity on COVID-19 during the COVID-19 crisis as patients are struggling with therapeutic and financial implications.MethodsAn online survey was conducted from March 22 to March 25, 2020. It included baseline demographic, clinicopathologic, treatment-related information, anxiety levels related to COVID-19, questions related to financial concerns about COVID-19 as well as the validated 11-item COST measure.ResultsFive-hundred-and-thirty-nine patients (39%:58% male:female) from 14 countries responded. 23% of the patients did not feel in control of their financial situation but 8% reported being very satisfied with their finances. The median COST score was 21.5 (range 1–44). Metastatic patients who have not started systemic therapy had a COST score (19.8 range 2–41) versus patients on oral systemic therapy had a COST score (23.9 range 4–44). Patients in follow-up after surgery had a median COST score at 20.8 (range 1–40). A low COST scores correlated (p < 0.001) were female gender (r = 0.108), younger age (r = 0.210), urban living situation (r = 0.68), a lower educational level (r = 0.155), lower income (r = 0.165), higher anxiety about acquiring COVID-19 (r = 0.198), having metastatic disease (r = 0.073) and a higher distress score about cancer progression (r = 0.224).ConclusionOur data highlight severe financial impact of COVID-19. Acknowledging financial hardship and thorough counseling of cancer patients should be part of the conversation during the pandemic. Treatment and surveillance of RCC patients might have to be adjusted to contemplate financial and medical needs.
Highlights
Much has been written about how the COVID-19 crisis is placing immense strain on healthcare systems worldwide
Our study reveals that while patients experience heightened anxiety about increasing financial hardship related to COVID-19, they remain substantially concerned about cancer recurrence and progression
The median comprehensive score for financial toxicity (COST) score in our cohort of renal cell carcinoma (RCC) patients is 21.5, which is somewhat lower than previously described cohorts of cancer patients in general, where it was at 23, indicating that pandemic might be increasing financial anxiety [8–10]
Summary
Much has been written about how the COVID-19 crisis is placing immense strain on healthcare systems worldwide. There has been a rush to develop guidelines around every element of cancer care, ranging from use of surgery, radiation, systemic therapy to supportive care modalities [1–4]. Less research has focused on how the crisis is impacting individuals being treated for cancer, including adverse effects of financial toxicity. Advances in care for patients with renal cell carcinoma have dramatically changed over the last decade, improving outcomes and increasing overall survival for patients. These advances have occurred during a time when insurance plans have increased cost-sharing, shifting a
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