The
hours spent sitting in doctors'
waiting rooms, in line for
the CT scan, watching chemotherapy
drip into veins: Battling
cancer steals a lot of time
at least $2.3 billion
worth for patients in the
first year of treatment alone.
So says the first study
to try to put a price tag
to the time that people
spend being treated for
11 of the most common cancers.
Even more sobering than
the economic toll are the
tallies, by government researchers,
of the sheer hours lost
to cancer care: 368 hours
in that first year after
diagnosis with ovarian cancer;
272 hours being treated
for lung cancer, 193 hours
for kidney cancer.
That doesn't count the
days spent home in bed recovering
from surgery or weak from
chemo, just time spent actively
getting care chemo
or radiation therapy, blood
tests or cancer scans, surgery
or checkups, driving to
medical appointments and
waiting your turn.
It's a study, to be published
Wednesday in the Journal
of the
National Cancer Institute,
that sheds new light on
the human costs of cancer.
"What we see here is a
measure of the patient's
burden of commitment," wrote
Drs. Larry Kessler of the
Food
and Drug Administration
and Scott Ramsey of the
Fred Hutchinson Cancer Center,
in an accompanying editorial.
"Cancer is more than the
just the dollars and cents
for the medicines and the
treatments and the doctors.
It's also the lost opportunities
for the patients," added
Dr. Len Lichtenfeld of the
American
Cancer Society, who
praised the research for
attempting to quantify that
often overlooked reality.
How much a disease costs
society plays an important
role in policy-making, such
as how much to invest in
medical research, but it's
hard to calculate the value
of a patient's time spent
getting care.
NCI epidemiologist Robin
Yabroff and colleagues culled
the records of 763,000 cancer
patients covered by Medicare,
the government's insurance
program for those 65 and
older, and estimated the
time involved in traveling
to, waiting for and receiving
both in-hospital and outpatient
care. They compared the
results to time spent in
medical care by 1 million
other Medicare recipients
without cancer.
Although most of these
patients were retired, the
researchers assigned a monetary
value to their time
$15.23 an hour, the median
U.S. wage rate in 2002.
Then they estimated the
national toll by including
the number of patients diagnosed
with cancer in 2005.
It is almost certainly
an underestimate, the researchers
said, noting that younger
cancer patients often receive
more intensive treatment.
Whatever the dollar figure,
the study showed something
important to patients' day-to-day
lives, Lichtenfeld noted:
Cancers that often are diagnosed
early, when they're more
curable, require less treatment
time.
Men with prostate cancer
spent 55.3 more hours getting
medical care in the first
year after diagnosis, compared
with similar people without
cancer. Breast cancer patients
spent 66.2 hours. Also,
both groups spent about
four days in the hospital.
Compare that to cancers
with worse survival rates,
largely because they're
usually caught late: Ovarian
cancer patients struggled
the most, spending about
21 days in the hospital
that first year, and 368
extra hours getting care.
Gastric cancer and lung
cancer patients fared almost
as badly, spending about
21 days and 15 days in the
hospital, respectively,
and 351 and 272 hours in
treatment.
The difference shows that
investing in research for
better early detection of
cancer "has real benefits,"
Lichtenfeld stressed.
The study also highlights
the importance of newer
"targeted" cancer treatments
that promise fewer severe
side effects and often allow
patients to be treated with
pills at home instead of
in a clinic, added Kessler
and Ramsey. The pair called
on manufacturers to do research
on patients' time toll,
and for insurers to better
cover new drugs that reduce
it.
One puzzling finding: The
shortest treatment time
was for melanoma, the deadliest
form of skin cancer, at
17.8 hours the first year.
Early-stage melanoma can
be surgically removed with
good survival, but it's
often discovered late. The
study didn't address if
the shorter treatment time
was because melanoma patients
had fewer treatments to
try, or some other reason.
Differences in patients'
treatment times persisted
during their last year of
life, largely because of
increased hospitalization,
longest for gastric, lung
and ovarian cancers
35.4, 32.4 and 31.9 days,
respectively.