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“It was kind of a nightmare, it really was:” financial toxicity among rural women cancer survivors

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Abstract

Purpose

The purpose of this study was to examine how rural women cancer survivors experience and manage financial toxicity.

Methods

A qualitative descriptive design was used to explore experiences of financial toxicity among rural women who received cancer treatment. We conducted qualitative interviews with 36 socioeconomically diverse rural women cancer survivors.

Results

Participants were categorized into three groups: (1) survivors who struggled to afford basic living expenses but did not take on medical debt; (2) survivors who took on medical debt but were able to meet their basic needs; and (3) survivors who reported no financial toxicity. The groups differed by financial and job security and insurance type. We describe each group and, for the first two groups, the strategies they used to manage financial toxicity.

Conclusions

Financial toxicity related to cancer treatment is experienced differently by rural women cancer survivors depending on financial and job security and insurance type. Financial assistance and navigation programs should be tailored to support rural patients experiencing different forms of financial toxicity.

Implications for cancer survivors

Rural cancer survivors with financial security and private insurance may benefit from policies aimed at limiting patient cost-sharing and financial navigation to help patients understand and maximize their insurance benefits. Rural cancer survivors who are financially and/or job insecure and have public insurance may benefit from financial navigation services tailored to rural patients that can assist with living expenses and social needs.

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Data availability

The deidentified data underlying the results presented in this study may be made available upon reasonable request from the corresponding author, Dr. Emily Hallgren, at ehallgren@uams.edu.

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Funding

This research was supported by graduate research awards from the Midwest Sociological Association, Sociologists for Women in Society, and the Provost Research Award at the University of Illinois at Chicago.

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Authors and Affiliations

  1. College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St, Springdale, AR, 72762, USA

    Emily Hallgren, Ramey Moore, Britni L. Ayers, Rachel S. Purvis, Peter DelNero & Pearl A. McElfish

  2. Department of Radiology, University of Arkansas for Medical Sciences, 4301 W. Markham St. – Slot 556, Little Rock, AR, 72205, USA

    Gwendolyn Bryant-Smith

Authors
  1. Emily Hallgren
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  2. Ramey Moore
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  3. Britni L. Ayers
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  4. Rachel S. Purvis
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  5. Gwendolyn Bryant-Smith
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  6. Peter DelNero
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  7. Pearl A. McElfish
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Contributions

All authors contributed to the study conception and design and/or the analysis and interpretation of data. Material preparation and data collection were done by Emily Hallgren. Data analysis and validation were performed by Emily Hallgren, Ramey Moore, Britni L. Ayers, Rachel S. Purvis, and Pearl A. McElfish. The first draft of the manuscript was written by Emily Hallgren and Ramey Moore. All authors critically reviewed manuscript drafts. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Emily Hallgren.

Ethics declarations

Ethics approval

All study materials and procedures were approved by the University of Illinois at Chicago Institutional Review Board (IRB#2016–0803) and the University of Illinois Cancer Center Protocol Review Committee.

Consent to participate

All participants were provided a copy of consent documents and study information prior to data collection. Signed consent was obtained from all participants.

Consent for publication

The authors affirm that human research participants provided informed consent for publication of deidentified data.

Conflict of interest

The authors declare no competing interests.

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Hallgren, E., Moore, R., Ayers, B.L. et al. “It was kind of a nightmare, it really was:” financial toxicity among rural women cancer survivors. J Cancer Surviv 18, 1006–1015 (2024). https://doi.org/10.1007/s11764-023-01344-x

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  • DOI: https://doi.org/10.1007/s11764-023-01344-x

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