Financial Toxicity in Older Adults With Cancer and Their Caregivers

With advances in cancer treatment, long-term survival rates have improved in recent decades, resulting in extended life expectancies for many patients. This progress brings substantial challenges, however, particularly in terms of the costs associated with cancer care. The financial burden, often considerable, poses difficulties for older adults with cancer and their caregivers. Financial toxicity refers to the unintended financial consequences and distress that patients and families incur from cancer and its treatment. The prevalence of financial toxicity varies (some estimates with over half experiencing this challenge), and certain subgroups (eg, race other than White and those with lack of social support) are at greater risk. Although studies focusing on older adults are limited, existing research has shown that financial toxicity is associated with adverse outcomes, including delayed care, poorer physical, social, and psychological well-being, and lower overall quality of life. Moreover, financial toxicity may result in negative caregiver health outcomes, which can in turn affect patient outcomes. These negative caregiver effects may persist into the bereavement phase. Various methods are available to assess financial toxicity, and they consist of three domains: material, psychological, and behavioral. Available interventions focus on identifying those at risk and providing financial counseling, navigation, and literacy, as well as tangible assistance. Although the impact of financial toxicity is increasingly recognized, studies in older adults and their caregivers are lacking. A better understanding of their needs is important to develop interventions aimed at mitigating financial toxicity in older adults with cancer and their caregivers.