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Acute skin toxicity-related, out-of-pocket expenses in patients with breast cancer treated with external beam radiotherapy

A descriptive, exploratory study

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Abstract

Purpose

Acute skin toxicity is one of the most common side effects of breast cancer radiotherapy. To date, no one has estimated the nonmedical out-of-pocket expenses associated with this side effect. The primary aim of the present descriptive, exploratory study was to assess the feasibility of a newly developed skin toxicity costs questionnaire. The secondary aims were to: (1) estimate nonmedical out-of-pocket costs, (2) examine the nature of the costs, (3) explore potential background predictors of costs, and (4) explore the relationship between patient-reported dermatologic quality of life and expenditures.

Methods

A total of 50 patients (mean age = 54.88, Stage 0–III) undergoing external beam radiotherapy completed a demographics/medical history questionnaire as well as a seven-item Skin Toxicity Costs (STC) questionnaire and the Skindex-16 in week 5 of treatment.

Results

Mean skin toxicity costs were $131.64 (standard error [SE] = $23.68). Most frequently incurred expenditures were new undergarments and products to manage toxicity. Education was a significant unique predictor of spending, with more educated women spending more money. Greater functioning impairment was associated with greater costs. The STC proved to be a practical, brief measure which successfully indicated specific areas of patient expenditures and need.

Conclusions

Results reveal the nonmedical, out-of-pocket costs associated with acute skin toxicity in the context of breast cancer radiotherapy. To our knowledge, this study is the first to quantify individual costs associated with this treatment side effect, as well as the first to present a scale specifically designed to assess such costs.

Relevance

In future research, the STC could be used as an outcome variable in skin toxicity prevention and control research, as a behavioral indicator of symptom burden, or as part of a needs assessment.

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Acknowledgements

Preparation of this manuscript was supported by the National Cancer Institute (K07 CA131473, CA159530 and CA129094) and by the American Cancer Society (RSGPB-04-213-01-CPPB). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute, National Institutes of Health, or American Cancer Society. We would like to express our sincere gratitude to Ms. Bari Scheckner, Ms. Bianca Love, and Ms. Frances Harfouche for their invaluable help in the data collection. Most importantly, we would like to thank all of the study participants for so graciously sharing their experiences.

Conflict of interest

None of the authors have a financial relationship with the NCI or the ACS, which sponsored the research. Authors have full control of all primary data, and we agree to allow the journal to review the data if requested.

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Authors and Affiliations

  1. Department of Oncological Sciences, Integrative Behavioral Medicine Program, Mount Sinai School of Medicine, 1425 Madison Avenue, Box 1130, New York, NY, 10029, USA

    Julie B. Schnur & Guy H. Montgomery

  2. Graduate School of International Relations and Pacific Studies, University of California, San Diego, 9500 Gilman Drive, Office #1313, La Jolla, CA, 92093-0508, USA

    Joshua Graff Zivin

  3. Department of Radiation Medicine, Breast Program in Radiation Medicine, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY, 14263, USA

    David M. K. Mattson Jr.

  4. Department of Radiation Oncology, Mount Sinai School of Medicine, FPA/Radiation Oncology Associates, 1184 Fifth Avenue, 1st Floor, Box 1236, New York, NY, 10029, USA

    Sheryl Green

  5. Department of Oncological Sciences, Cancer Community Outreach Program, Mount Sinai School of Medicine, 1425 Madison Avenue, Box 1130, New York, NY, 10029, USA

    Lina H. Jandorf

  6. Department of Stitch Radiation Oncology, Weill Cornell Medical Center of Cornell University, 525 East 68th Street, Box 575, New York, NY, 10065, USA

    A. Gabriella Wernicke

Authors
  1. Julie B. Schnur
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Correspondence to Julie B. Schnur.

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Schnur, J.B., Graff Zivin, J., Mattson, D.M.K. et al. Acute skin toxicity-related, out-of-pocket expenses in patients with breast cancer treated with external beam radiotherapy. Support Care Cancer 20, 3105–3113 (2012). https://doi.org/10.1007/s00520-012-1435-6

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  • DOI: https://doi.org/10.1007/s00520-012-1435-6

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