Financial stress is associated with worse treatment outcomes in people with head and neck cancer, report researchers at Roswell Park Comprehensive Cancer Center in Buffalo, in a study published in the journal Oral Oncology. The results implicate pronounced or prolonged concern about the cost of medical care—aka “cancer-related financial toxicity”—in some cancer deaths.

“Does financial worry impact survival? The answer is, resoundingly, yes,” senior study author Anurag Singh, MD, a professor of oncology and director of radiation research, told the Roswell Park Newsroom.

Head and neck cancer includes cancers of the lips, nose, mouth, throat, larynx, sinuses and salivary glands. (Cancer of the lips is technically a form of skin cancer). Common risk factors include HPV infection, alcohol use, tobacco use and exposure to environmental pollutants and other chemicals.

The researchers focused their study on head and neck cancer patients because these cancers often impose a heavy financial burden. They are particularly demanding in terms of both type and length of treatment. These “are cancers where you can need surgery as well as extended courses of chemotherapy and radiation, along with substantial supportive care and rehabilitation,” Singh said.

The researchers surveyed 284 people who had been treated for head and neck cancer at Roswell Park between 2013 and 2017 about their quality of life before and after treatment, noting that 41 (14.4%) reported significant financial stress. They then compared individual survey results to their corresponding clinical outcomes.

The comparison revealed a striking correlation between financial toxicity and mortality: Participants who reported higher levels of financial stress were about two times as likely to die of cancer or any other cause than participants who reported lower levels of financial stress.

“The association we found was very strong, very concerning,” Singh said. ”If you are worried about your finances, your risk of dying is roughly double." 

The study further illuminates the little-understood link between mental and physical health. We “now know that this financial toxicity affects not just [head and neck cancer patients’] mental and emotional well-being, but their physical health, how they respond to cancer treatment,” Singh said.

To read more about the financial burden of cancer care, read “Many People With Cancer Face Serious Financial Hardship.” For a list of strategies that could help manage the costs of cancer treatment, read “Financial Lifelines,” “10 Ways to Control Cancer Costs,” “Fighting Cancer’s Financial Toxicity” and “Resources: Financial Assistance.”