Navigating healthcare costs and family support: Coping strategies adopted by breast cancer patients in a tertiary cancer care center—A qualitative phenomenological analysis.

Abstract

e21022 Background: Economic distress caused by high costs of cancer treatment poses a significant challenge to patients and their caregivers. It affects treatment adherence, quality of life, and emotional well-being, often necessitating adoption of coping strategies that vary based on sociocultural contexts. Existing literature highlights that up to 22% of cancer patients delay or forgo necessary treatment due to financial constraints, and 51% resort to depleting personal savings. However, there is a paucity of research exploring coping strategies used by patients to navigate these costs within diverse cultural and economic contexts, particularly in low- and middle-income countries like India. Methods: This qualitative study employs a phenomenological design to explore experiences of breast cancer patients navigating financial toxicity. Semi-structured, in-depth interviews were conducted with a purposive sample of 12 breast cancer patients receiving treatment at PSG Institute of Oncology, Coimbatore, India. Eligible participants included patients aged 18 years or older who are undergoing active treatment for at least three months. Patients in terminal stages or palliative care, or those who completed treatment over six months ago, were excluded. Interviews were conducted using an open-ended guide, transcribed verbatim, and thematic analysis was performed to identify recurring patterns and unique strategies employed to address financial burdens. Results: Patients and their families adopt various coping strategies including relying on government schemes for medical and non-medical expenses, depleting savings, and seeking financial aid through scholarships, grants or philanthropic contributions. To avoid debt, many families adhere to tight budgets, while others take loans from friends, family, or use gold loans. Sacrifices are made, with families prioritizing treatment expenses over leisure, travel, and social activities. Relocation closer to treatment centers or cutting back on ration expenses, reducing clothing purchases, along with taking on extra jobs are common measures to navigate costs. In some instances, families move to more affordable housing or benefit from rent flexibility provided by landlords. Emotional and spiritual coping also play an important role, with some individuals turning to new religious practices for support. Government programs like the Chief Minister’s scheme, life insurance benefits, and free lab services provide additional financial relief. Conclusions: Oncology patients employ diverse, personalized coping strategies to navigate these challenges. This study highlights the complexity of financial toxicity in cancer care, with findings aimed at strengthening patient support systems, and influencing policies to address these economic barriers.