Financial toxicity and mental well-being of the oral cancer survivors residing in a developing country in the era of COVID 19 pandemic – A cross-sectional study
Ce dossier présente un ensemble d'articles concernant la prise en charge des cancers durant la crise sanitaire liée au COVID-19
OBJECTIVES : The primary outcome measures evaluated the financial toxicity and mental well-being of the oral cancer survivors.
METHODS : A cross-sectional study of oral cancer survivors who were disease-free for more than six months after treatment and visited the hospital for a routine follow-up is included in the study. Mental well-being and financial toxicity were evaluated using the Depression, Anxiety, and Stress Scale - 21 (DASS 21) and Comprehensive Score for financial Toxicity (COST- FACIT) questionnaires. A literature review was done to compare the results with financial toxicity and mental health in cancer patients from the pre-pandemic era.
RESULTS : A total of seventy-nine oral cancer survivors were included in the study, predominantly males (M: F=10:1). The age ranged from 26 to 75 years (The median age is 49). The full-time employment dropped from 83.5% in the pre-treatment period to 21.5% post-treatment. Depression was observed in 58.2% and anxiety in 72.2%. Unemployed survivors were observed to have more depression (OR =1.3, 95% CI=0.3 -5.4, p=0.6), anxiety (OR= 3.5, 95% CI= 0.3 -21.2, p= 0.1) and stress (OR =1.6, 95% CI= 0.3 -6.6, p= 0.5) than rest of the cohort. On univariate analysis, unemployed survivors (M=11.8±3.8, p=0.01) had significantly poorer financial toxicity scores. Survivors with depression (M=16.4±7.1, p=0.06) and stress (M=14.4±6.8, p=0.002) had poor financial toxicity scores. On multifactorial analysis of variance, current employment (p=0.04) and treatment modality (p=0.05) were significant factors impacting the financial toxicity.
CONCLUSION : There is a trend towards increased incidence of depression, anxiety, and stress among oral cancer survivors compared to the literature from the pre-COVID era. There is significant financial toxicity among either unemployed or part-time workers. This calls for urgent public/government intervention to prevent the long-term impact of financial toxicity on survival and quality of life.
Psycho-Oncology , article en libre accès, 2021