gms | German Medical Science

Background: It has been acknowledged that pre-treatment general health quality of life (HRQL) is predictive for survival of cancer patients. A lack of systematic research on pre-treatment HRQL of lung cancer (LC) and breast cancer (BC) patients applying integrative oncology (IO) treatment has been detected. HRQL of patients with LC and BC at time of diagnosis being treated within an Anthroposophic-integrative concept at two certified German cancer centers for LC and BC was evaluated in a real-world observational study.

Methods: Clinical and demographic data were retrieved from the Network Oncology cancer registry. Pre-treatment HRQL was evaluated by analysing EORTC QLQ-C30 and HADS questionnaires in people with LC and BC.

Results: In total 314 all-stage cancer patients (87 LC – and 247 BC patients) were eligible for the questionnaire analysis. 29.9% of the LC cohort and 18.2% of BC patients reported financial difficulties at first diagnosis. Self-reported pre-treatment financial burden was associated with younger age (p=0.007 LC, p=0.002 BC), pre-treatment pain (p=0.006 LC, p=0.005 BC), anxiety (p=0.04 LC, p < 0.0001 BC) and feeling of discourage (p=0.03 LC) or depression (p < 0.0001 BC) while tumour stage was not an association factor. In addition worsening of role (p=0.03), emotional (p=0.02) and social functioning (p < 0.0001) as well as insomnia (p=0.01) and fatigue (p=0.0008) were closely associated with pre-treatment financial burden in breast cancer patients.

Conclusions: Pre-treatment financial problem is an issue in oncology but has until now not recognized for lung and breast cancer patients who are treated within IO concepts. Financial burden which is significantly more often reported in younger patients may be a sensor for altered role and social functioning, increased pain and poor emotional outcomes in these patients. LC and BC-specific similarities and differences of financial difficulties are discussed.