Qualitative Evaluation of Financial Toxicity and Supportive Care Needs of Women with Metastatic Breast Cancer

The cost of cancer treatment is higher for breast cancer than any other cancer diagnosis, leaving women with metastatic breast cancer vulnerable to challenges given the extended length of cancer treatment, including financial, physical, and psychological burdens. The purpose of this study was to examine the lived experiences of women diagnosed with MBC in the realm of financial concerns and unmet support needs specific to their cancer treatment. This qualitative, phenomenological study included individual interviews that were audio-recorded and transcribed verbatim. Applied thematic analysis was completed using Atlas.ti. Inter-rater reliability using Cohen's Kappa was established at .80. Participants were recruited from a National Cancer Institute-designated cancer center in the United States. Sixteen participants were interviewed. A majority were white, non-Hispanic, married, unemployed, had obtained at least a bachelor's degree level of education. Nearly 19% of participants reported a gross household income of below $50,000. The mean age of participants was 55.6 years. Two major themes were identified, with each having three corresponding subthemes, including: 1) financial toxicities (cost of cancer treatments and medications, limitations of health insurance, and effect on employment); and 2) unmet support needs (managing usual responsibilities, emotional support, community, and organizational support). The results highlight the financial and psychosocial needs of women with MBC. Treatment costs take a huge financial toll on patients and their families, including insured women with higher household incomes. Participants expressed a desire for specific metastatic breast cancer resources and support.