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Is Time Really on Our Side?

breast cancer-cancer-pink fund-time toxicity
breast cancer-cancer-pink fund-time toxicity

A breast cancer diagnosis can bring burdens far beyond the physical wellbeing of patients.

Molly MacDonald

Co-Founder, Pink Fund

“Ultimately, the goal in addressing time and financial toxicity is to ensure the patient’s quality of life is preserved as much as possible during and after cancer treatment.”

Recently, I learned of a new-to-me term around cancer treatment and the challenges it presents for patients: Time Toxicity. And I began to wonder about that term with respect to Pink Fund’s mission addressing the challenge of financial toxicity. At Pink Fund, we provide 90 days of non-medical financial aid to breast cancer survivors in active treatment. These funds help cover the basic costs of living expenses, such as health insurance, housing, transportation, and utilities.

Now, along with financial toxicity, “time toxicity” as a concept is gaining traction. “Patients spend hours, days, weeks, or even months receiving treatment. Driving to appointments, waiting in waiting rooms, undergoing tests, recovering — the time all adds up, but it’s rarely acknowledged,” said Elsa Pearson Sites, policy director of the Partnered Evidence-based Policy Resource Center, Veteran’s Health Administration.

Quality of life

Sites is clear about the patient burden.

“Patients are the only participants in the healthcare system without any formal expertise,” she said. “Yet they’re the ones rearranging their work and childcare schedules to make the only appointment slot they were offered. They’re the ones spending hours on the phone fighting with insurance companies to get their care covered.”

“Time toxicity” and “financial toxicity” are two concepts associated with cancer treatment, emphasizing the multi-faceted challenges patients face during their journey with the disease. Both highlight the indirect ways cancer affects patients beyond the direct physical impact of the illness and its treatments.

Financial toxicity addresses the economic burden of cancer treatment on patients. It encompasses more than just high out-of-pocket costs for treatment. Time spent during treatment in waiting rooms and during recovery can equate to hours off work and missed paychecks. Frequent trips to healthcare facilities can lead to additional costs for childcare, transportation, and lodging.

Ultimately, the goal in addressing time and financial toxicity is to ensure the patient’s quality of life is preserved as much as possible during and after cancer treatment.

Reducing time burden

Since launching Pink Fund in 2006, I have always wondered why treatment protocols in the provider setting are not more sensitive to patient’s work and family schedules, allowing for evening and weekend infusions and radiotherapy.

After all, imagine if patients did not have to take unpaid time off from work for treatment. Would that reduce the economic burden they face, impact treatment adherence, reduce medically related bankruptcies, and improve survivorship outcomes?

Hospitals operate 24/7 and I get it — most services rendered after “normal” business hours are reserved for emergencies, like gunshot wounds (and when your 4-year-old runs into a door jam on Christmas Eve gushing blood and requiring stitches). And you certainly cannot ask a woman who’s about to deliver to come back at 8 a.m. Monday morning.

The overall “time burden” can be mentally, emotionally, physically, and financially draining for patients.

So, let me ask you this, dear readers: Would we be able to mitigate both time and financial toxicity by offering healthcare services during hours that are friendlier, or providing clearer communication on wait times, even expanding telehealth services to reduce trips to and from healthcare facilities?

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