Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2018

Cancer costs experienced by Western Australian cancer patients (#221)

Jade C Newton 1 , Harry Hohnen 1 , Claire E Johnson 1 2 3 , Angela Ives 1 , Sandy McKiernan 4 , Violet Platt 5 , Christobel Saunders 1 , Neli Slavova-Azmanova 1
  1. The University of Western Australia, Crawley, WA, Australia
  2. Monash University, Melbourne
  3. Eastern Health, Melbourne
  4. Cancer Council Western Australia, Perth
  5. WA Cancer and Palliative Care Network, Perth


Limited research has been published which qualitatively investigates the financial dimension of a cancer diagnosis in the Australian context.

The aim of this study was to describe Western Australian cancer patients’ experiences of out-of-pocket expenses (OOPE) during diagnosis and cancer .


Semi-structured interviews were conducted over the phone with a purposive convenience sample of 40 Western Australian cancer patients diagnosed with breast, lung, prostate or colorectal cancer, who were recruited from within a mixed-methods study exploring patient OOPE and had finished primary treatment. Participants were asked about their experience and costs incurred during treatment. A phenomenological approach was utilized and interview transcripts were analysed using thematic content.


Participant OOPE experiences fell into three key themes: (1) personal circumstance, (2) communication from health service providers, and (3) coping strategies used to deal with OOPE. Personal circumstance encompassed sub-themes such as proximity to treatment locations and personal financial and employment situation. Patient OOPE experiences were further ameliorated or exacerbated by their patient-provider communication, which in turn affected the coping strategies they used to deal with the costs  incurred. Building on these findings and existing models in the literature, we developed a modified version of Carrera et al.'s flowchart of Economic Consequences of Cancer Treatment on the Patient and Patient Coping, to describe patient experiences in mixed health care systems.1


These findings reflect the broad variation in cancer patients’ OOPE experiences. The proposed model recognises the multitude of factors that influence the initial treatment seeking behaviour in the mixed healthcare setting, and aims to conceptualise the economic consequences of a cancer diagnosis that service providers should be aware of. Further research is necessary to quantify the extent of financial distress in Western Australian cancer patients and develop strategies to ensure they are adequately supported.

  1. Carrera PM, Kantarjian HM, Blinder VS. The financial burden and distress of patients with cancer: Understanding and stepping-up action on the financial toxicity of cancer treatment. CA Cancer J Clin. 2018;68(2):153-65.