“My Cancer Is Worth Only Fifteen Weeks?” A Critical Analysis of the Lived Experiences of Financial Toxicity and Cancer in Canada

Document Type : Original Article

Authors

1 Women’s College Research Institute, Women’s College Hospital, Toronto, ON, Canada

2 Nova Scotia Health Authority, Cape Breton Regional Hospital, Sydney, NS, Canada

3 School of Professional Studies, Cape Breton University, Sydney, NS, Canada

4 Cape Breton Cancer Centre, Sydney, NS, Canada

Abstract

Background 
Cancer patients experience financial hardship due to rising expenses related to cancer treatment and declining income levels associated with reduced employability. Employment Insurance Sick Benefits (EI-SB) is a social income support program which provides temporary income replacement to Canadians when they fall ill. Although EI-SB is designed to maintain continuity of income during an illness, little is known about the perspectives of cancer patients who receive EI-SB. This knowledge can inform the development of public policies which are responsive to the needs and priorities of cancer patients.
 

Methods 
We conducted a theory-informed thematic analysis of data collected from twenty semi- structured interviews with participants who were receiving care in a cancer centre in Cape Breton, Nova Scotia and had received EI-SB. A coding framework was developed using Taplin and colleagues’ intermediate outcomes of patient care across the cancer care continuum. Interpretation of findings was guided by the synergies of oppression theoretical lens.
 

Results 
Three overarching themes describe the experiences of cancer patients receiving social income support: Economic exclusion, in which the structure of the labour market and social welfare system determine access to workplace benefits and continuity of reasonable income; financial toxicity, a vicious cycle of financial burden and increasing financial distress; and constrained choices, where cancer influences employability and lowered income influences the need to be employed.
 

Conclusion 
Cancer patients need income support programs that are tailored to match their healthcare priorities. In addition, policies which strengthen working conditions and facilitate a reintegration to work when possible will be important in addressing the structural drivers of income insecurity experienced by cancer patients.

Keywords


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Articles in Press, Corrected Proof
Available Online from 15 August 2021
  • Receive Date: 15 October 2020
  • Revise Date: 11 June 2021
  • Accept Date: 12 July 2021