Be the Boss Over Cancer

With rising health care costs in the United States, anxiety caused by financial worry is becoming an increasingly significant side effect of cancer.

The University of Chicago just announced their new tool to measure a patient’s risk for, and ability to tolerate, financial stress: the COST (Comprehensive Score for financial Toxicity) measure. The tool consists of 11 questions in which patients choose from five responses: not at all, a little bit, somewhat, quite a bit, or very much. The 11 questions are:

  • I feel financially stressed
  • I am satisfied with my current financial situation
  • I worry about the financial problems I will have in the future as a result of my illness or treatment
  • I am frustrated that I cannot work or contribute as much as I usually do
  • My cancer or treatment has reduced my satisfaction with my present financial situation
  • I feel in control of my financial situation
  • I am able to meet my monthly expenses
  • I know that I have enough money in savings, retirement, or assets to cover the costs of my treatment
  • I am concerned about keeping my job and income, including working at home
  • I feel I have no choice about the amount of money I spend on care
  • My out-of-pocket medical expenses are more than I thought they would be

The study author, Jonas de Souza, MD, a head-and-neck cancer specialist at the University of Chicago Medicine, says, "Few physicians discuss this increasingly significant side effect with their patients. Physicians aren't trained to do this. It makes them, as well as patients, feel uncomfortable”. He hopes that this tool will open the lines of communication between patients and physicians.

At Cancer and Careers, we are firm believers in open dialog between patients and physicians around work and cancer issues. Healthcare providers are the most visible—and, given proper resources, the best equipped—source to provide the essential information patients need to continue working and manage financial stress during and/or after treatment.

In addition to the 11 questions from the COST measure, we have a list of questions to guide healthcare professionals through discussions of cancer, work, and finances with their patients. You can download this checklist here. We also offer a free Guide to Helping Patients Manage Cancer & Workand a free webinar series every spring and fall and also archived here.

Patients should also be proactive in reaching out to their healthcare team to discuss their financial and work concerns during and/or after treatment. Our Living and Working with Cancer Workbook is an excellent guide to prepare yourself for your appointments and these discussions. Download a free copy here.


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