As if the disease was not enough: coping with the financial consequences of cancer.

PURPOSE: The goal of this research was to understand how cancer survivors cope with the financial consequences of their disease.

METHODS: Twenty-six cancer survivors who self-identified as having experienced financial hardship related to their disease were interviewed. Transcripts of these interviews were analyzed using constructivist grounded theory approach. An analysis of codes related to coping strategies was conducted, and findings were stratified based on established coping theories (Lazarus and Folkman and Moos and Holahan) previously applied to coping with serious/chronic illnesses.

RESULTS: Participants used both person-oriented/emotion-focused and task/problem-focused coping skills to confront the financial consequences of their disease trajectory. Problem-focused skills included dealing with debt, accessing financial assistance, making lifestyle changes, seeking information and education, altering treatment protocols, being proactive, and negotiating insurance. Emotion-focused tasks included using personal strengths, expressing emotion, accessing social support, being determined, and taking care of oneself. Results were further analyzed using Moos and Holahan's framework of coping skills; examples of each of these coping skills were identified in the interview data.

CONCLUSIONS: Facing serious financial ramifications due to a cancer diagnosis calls forth coping skills and tasks that can be categorized using coping theories traditionally applied to coping with the illness itself. Cancer patients are often confronted with dual threats: the physical and emotional impact of the illness and the loss of financial security and the lifestyle that they have worked to maintain. Interventions with cancer survivors should include facilitating effective coping with the financial implications of the disease.