Study: GU cancer survivors report difficulty affording mental health, dental care

In this interview, Laura Bukavina, MD, MPH, MSc, highlights the background and key findings from the study, “Financial Distress in Genitourinary Cancer: Insights From CDC National Health Interview Survey.” Bukavina is an assistant professor of urologic oncology at Cleveland Clinic Glickman Urologic Institute and the translational science lead in GU oncology at Cleveland Clinic Lerner College of Medicine in Cleveland, Ohio.

Video Transcript:

Could you describe the background/rationale for this study?

We wanted to look at the financial distress in GU cancers by utilizing what's called the CDC National Health Interview Survey, which is a great database that evaluates patients who've had bladder cancer, or who've had any kind of cancer, including bladder cancer, or healthy individuals, and it's able to follow them through a couple of years. They ask multiple survey questions that relate to financial distress, including are you able to pay for medications? Are you not seeing a physician, including specialists such as your eye doctors or your dentist? Are you able to afford mental health [care]? A lot of the questions are aimed not only for care, but also for being able to establish even primary care, not just a specialist care. So, it's a great resource to gauge our ability to see how our treatments are affecting people's ability to afford further care, food, travel, specialist care after their cancer is cured, which is all part of toxicity that many, many of our cancer patients and our chronic illness patients are suffering even after their cancer has been cured from the oncology standpoint.

What were the key findings from the analysis?

We were going in expecting that we were going to find people have trouble affording medications and affording being able to see their primary care doctor or splitting medications. But surprisingly, we did not see that. We even looked at patients less than 65 and over 65 because of Medicare coverage, which changes a lot of your ability for medication coverage. But what we found, which is really interesting, is that mental health is incredibly ignored, and not a lot of patients, especially our bladder and kidney cancer [patients], were not able to afford mental health [care]. That is anywhere from between 15% to 25% of those patients were not able to get specialized mental health treatment. We all know that bladder cancer particularly is such a long disease, including our non–muscle-invasive bladder cancer patients. Those patients have the burden of being under oncology care for sometimes even a decade. We know that many of those patients are just not able to get the care that they need with their diagnosis.

The second thing we found that was really interesting is dental care. No one really talks about dental care, but it's also incredibly important. Not only is that important because of infection risk and self-image, but because a lot of the medications we give, including medications in prostate cancer, dental health is vital to make sure that these things don't happen. What we found is our patients are just not able to afford dental health, and really it has to do with the insurance coverage. While the medications might be covered, while the surgical treatment might be covered, we all know that mental health and dental care are one of those things where people have large copays, long delays to care, and it is very clear to see that from our study.

This transcription has been edited for clarity.