“I had to completely come to the realization that I wasn’t gonna have income, and yet the bills don’t stop.” Nicole Eggert said that to Fox News Digital, and the sentence says more about cancer care than most price lists do.
Eggert, 54, was diagnosed with stage 2 cribriform carcinoma breast cancer in December 2023. Two years later she can say her status is “NED,” no evidence of disease. The “Baywatch” actress calls herself a survivor of a club she “never wanted to be a part of.” The money side, she said, was a separate ordeal.
She is “a 100% single parent.” One daughter is an adult. A teenager still lives at home. Treatment kept her in and out of clinics “three-to-five at least days a week,” so taking any kind of production job was out. “It’s not like it’s work from home kind of work,” she said. The costs, she added, kept adding up until she feared she could not provide for her family.
A side effect with a name
Researchers call this financial toxicity. The term turned up in a 2009 article on the cancer drug industry, which listed it as a side effect of treatment, next to nausea and hair loss. It describes the damage medical bills do to a patient’s quality of life, and in some cases it ends in bankruptcy, lost work or homelessness.
A 2013 study in The Oncologist Journal found that the cost of treatment in the United States can cause suffering comparable to physical pain and can hurt a person’s chance of recovering. Some patients skip treatment. Others pick cheaper options.
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How common is it? In an Oregon study, almost 20% of older adults with advanced cancer were affected. The researchers used three questions: had the patient taken less medication than prescribed because of cost, was monthly income enough for food and housing, and was it enough for things like clothing, medicine, home repairs or transportation.
The National Cancer Institute, as of 2020, listed existing debt, conditions present before diagnosis, hourly versus salaried work and asset levels as areas needing more study. One link is already plain: treatments that need daily trips to a clinic raise the risk. That is Eggert’s schedule exactly.
Hardship in India
The problem is not American alone. A cross-sectional study in Cost Effectiveness and Resource Allocation looked at patients with advanced cancer in India. Median direct medical costs came to 145,200 Indian National Rupees, in a range from 17,800 to 1,384,000. Out-of-pocket spending made up 47.2 percent of total costs on average. The authors noted that out-of-pocket spending on cancer treatment in India has been described as more than half of all expenditure.
On the COST-FACIT scale, 21.9 percent of the patients had grade III, severe, financial toxicity. Another 17.7 percent each landed in grade II and grade I. The remaining 42.7 percent showed none, which leaves more than one in three with some degree of it. Government insurance schemes helped with treatment, the authors concluded, yet quality of life stayed poor and financial toxicity stayed high.
What helped in North Carolina
The Lessening the Impact of Financial Toxicity (LIFT) trial, reported by Wheeler and colleagues in the Journal of Clinical Oncology, tried a fix. It ran at eight oncology practices in North Carolina, four rural and four nonrural. Participants were adults with any cancer type, within 5 years of diagnosis or living with advanced disease, who scored 22 or lower on the FACIT-COST scale, which runs from 0 to 44. Lower means worse.
Trained navigators, among them social workers, financial counselors and oncology nurse navigators, assessed each person’s finances and then helped find resources, fill in applications and track progress. They met patients every 2 to 3 weeks, in person or remotely, for a median of 5 months.
Scores rose from 6.6 at baseline to 14.7 at follow-up, an average gain of 8.1 points (P < .001). A gain of 5 points counts as clinically meaningful. Rural sites improved by 6.3 points and nonrural sites by 9.3. Insured participants gained 5.6 points. Uninsured participants gained 15.9.
Navigators submitted 260 applications and referrals. Charitable foundations were involved for 50.0% of participants, Supplemental Security Income or Social Security Disability Insurance for 35.1%, and Medicaid enrollment help for 28.4%. Satisfaction ran high: 89.3% were satisfied, 86.6% understood the available assistance better, 83.9% found applying easier, 61.6% reported fewer financial worries and 93.6% would recommend the program. The authors wrote that such interventions “should be considered best practice.” The National Cancer Institute supported the study.
Eggert has made her peace with the money. “At least you are alive where you can go out and fix it,” she said. She is looking ahead to getting back into the workforce.
Sources
- 'Baywatch' star Nicole Eggert exposes financial toll of cancer battle: 'The bills don't stop'
- Financial toxicity
- Financial Navigation Program May Help Reduce Cancer-Related Financial Hardship
- Financial Toxicity and Poor Quality of Life Persist in Advanced Cancer Care
- 20 Heme-Onc Posts Not to Miss from October – OncoDaily
- Nicole Eggert says cancer treatment left her facing mounting medical bills and lost income | Tippah News
Photo: Centre for Ageing Better / Unsplash (Unsplash License)
