COVID-19’s Effects on Anxiety and Financial Distress in Patients with Renal Cell Carcinoma

COVID-19 has had serious consequences on financial stability and anxiety for patients with renal cell carcinoma (RCC), according to survey results published in a recent article in the World Journal of Urology. The article also identified patients with RCC who are at higher risk of experiencing financial distress.

Advances in care for patients with RCC have dramatically changed over the last decade, improving outcomes and increasing overall survival for patients,” wrote the authors, led by Michael D. Staehler of the Department of Urology, Ludwig-Maximilians University of Munich. “But advances in cancer care become meaningless if patients cannot afford them or if the patients’ prognoses continue to be determined by where they live or how good their insurance is.”

The online survey, conducted in March 2020, explored the pandemic’s effects on patient anxiety levels regarding COVID-19, its impact on their attempts to get treatment, and any financial toxicity caused by the pandemic. The Kidney Cancer Research Alliance (KCCure) developed the survey with input from two surgeons, a medical oncologist, a psychologist, and a patient advocate. The survey also was evaluated by a group of patient advocates.

The survey included 45 items to collect data on demographics, clinical information, treatment-related information, and anxiety levels related to COVID-19. It also included several items from the 11-item Comprehensive Score for Financial Toxicity (COST) tool, a validated scale that measures financial distress and cost concerns.

The team sent the survey via email to the KCCure subscriber list (N = 1,532) and also posted it on Facebook and Twitter. The survey garnered 539 individual responses from patients in 14 countries, for a response rate of 35%.

Respondents were mostly women (58%), and the median age was 55 years (range = 24–87). Most patients were white (88%) and lived in the United States (87%). Most had college or graduate degrees (58%) and a household income higher than $50,000 (68%). Approximately half of the patients had metastatic disease.

Analysis revealed that 23% of the respondents did not feel like they were in control of their financial situations. Female and younger patients were more likely to feel this way, as well as patients with:

  • higher anxiety about getting COVID-19
  • higher distress about the possibility of cancer progression
  • homes in urban areas
  • lower incomes
  • lower educational levels
  • metastatic disease

Acknowledging financial hardship and uncertainty related to future costs and providing thorough counseling of cancer patients should be part of the conversation during the pandemic,” the authors concluded. “Treatment and surveillance of RCC patients might have to be adjusted to contemplate financial and medical needs.”