Cancer brings emotional anguish, harsh treatments — and a financial toll on patients, families: report
Despite Canada's universal health care, people with cancer bear a considerable financial cost
During her cancer treatment, Vanessa Percoco felt forced to choose between paying to feel better or making rent.
Percoco, 33, of Laval, Que., had just started on a short contract working with some Grade 3 students with special needs. A diagnosis of advanced colorectal cancer in 2022 put those plans on hold.
During more than two years of treatment, which included surgery to remove part of the colon as well as 12 rounds of chemotherapy, Percoco paid more than $4,000 out of pocket for prescription drugs, including medications to cope with the side-effects and complications. On top of that, there were costs for colostomy bags, which she had to restock every four days, bandages, physiotherapy sessions and osteopathic consultations, as well as travel and parking.
Her diagnosis left her unable to work, and the 15 weeks of employment insurance she was entitled to quickly ran out each week. Percoco had to rely on her loved ones for financial support.
"When you're doing cancer treatment … you should be thinking about surviving and focusing on feeling better," Percoco told CBC News.
Instead, she says she was constantly worried about money. "I [had] to pay to get better."
The Canadian Cancer Society included Percoco's story, along with other people recounting their lived experience with the financial costs and stress of living with and beyond cancer, in a report released on Monday about the costs associated with cancer treatment.
While in-hospital costs such as surgery and chemotherapy are publicly covered, the report reveals that in total, and averaged across all cancer types, an individual is expected to incur $32,778 in costs related to cancer over their lifetime. These include out-of-pocket expenses like prescribed medications, transportation to hospital and accommodation as well as lost income during treatment and recovery.
Forgo or delay cancer treatment
Ioana Nicolau co-chaired the scientific advisory committee behind the report, which she called the first of its kind.
"For people with cancer and their caregivers, their cost was $7.5 billion this year alone," Nicolau said.
The society put together the estimates in its report using a modelling tool in collaboration with Statistics Canada and the Public Health Agency of Canada, with analysis conducted by the Canadian Partnership Against Cancer.
The four most commonly diagnosed cancers in Canada — breast, colorectal, lung and prostate — are expected to have a large economic impact on health systems, the report's authors said, based on factors such as incidence, demographics, stage of malignancy at the time of diagnosis and survival time. They expect these four cancers to account for 47 per cent of health system costs, projected at $14.2 billion this year.
On average, individuals paid 20 per cent of the total cost to society, with the rest stemming from direct health system costs, such as surgery, expected to total $30.2 billion, according to the report.
Nicolau says some opt to delay or forgo aspects of their treatment, so the squeeze on the pocketbook can contribute to worse health outcomes.
"There are individuals that are at lower income or fixed income individuals and [in] rural and remote locations which can really feel this impact and this burden significantly," she added.
Dr. Christopher Booth, a medical oncologist at Kingston General Hospital and professor at Queen's University, said the strength of the report came from the stories from people with cancer and how financial barriers affected their treatment, care and recovery.
"Probably the most worrisome finding is the proportion of this cost that is directly borne by patients and families," Booth said. "We need to be able to recognize when there's cracks in the system."
Percoco says her father helped pay the bills for her basic necessities, while her sister shut down her hair salon to take her to appointments. She says she's grateful for their assistance.
Financial assistance to offset travel-related costs are offered by the Canadian Cancer Society as well as some cancer specific groups.
Nicolau, who is an epidemiologist at the University of Calgary, hopes the report stimulates conversations and prompts policymakers to focus on finding solutions to reduce the financial burden on people facing a potentially life-threatening illness.
For her part, Percoco returned to working in special education in May. She said she wanted to share her story because she knows there are others with cancer who are at the end of their lives who are stressed about money. "I don't think that's fair," she said.
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With files from CBC's Jennifer Yoon