Financial Burden among Black Men Making Prostate Cancer Treatment Choices: A Mixed Methods Study

Project Dates: 2022-2024

In the U.S., Black men have higher prostate cancer incidence and mortality when compared to other racial/ethnic groups. Prostate cancer treatment options have high upfront costs and patients often experience a multitude of unanticipated indirect costs. Financial hardships, like financial toxicity (FT), are the harmful financial circumstances those undergoing cancer treatment may experience. FT is associated with diminished health-related outcomes and reduced quality of life among cancer survivors. Clinicians often want to discuss and address care costs with their patients; however, the complexity and unknowns associated with treatment costs make these conversations difficult. The impact of FT is an urgent concern for those undergoing prostate cancer treatment, particularly in the context of disparate health outcomes among Black men. The aim of this study is to quantify and explore the impact of direct and indirect costs associated with different prostate cancer treatment options among Black men.

Project Goals:

• Quantitatively estimate the cost across options for prostate cancer (i.e., radiation, surgery, active surveillance) using MarketScan data. This aim will allow us to quantify the multilevel costs (i.e., patient, provider, system/facility) of implementation for the varying treatment options.
• Characterize the burden of direct and indirect costs of prostate cancer care using qualitative interviews with patients and caregivers from The Empowerment Network and Siteman Cancer Center.

Implications for Research and Practice:

This project will incorporate direct and indirect cost information in a decision support tool to improve shared decision making, particularly when weighing tradeoffs between multiple efficacious treatments among Black men who are disproportionally negatively impacted by prostate cancer. The expected outcomes will build shared decision making capacity by translating cost information and the impact of those costs on patients’ lives to improve the implementation of cost conversations in shared decision making.

Project Contact: Ashley Housten

Project Team: Su-Hsin Chang, Mary Politi, Bettina Drake, Eric Kim, Robin Wright-Jones, Michelle Eggers