Cancer Management

Among the general population, the greatest concerns about being diagnosed with cancer are suffering/pain (59%), dying from the disease (58%), becoming a physical or emotional burden on family/friends (53%), the side effects of treatment (53%), and losing control over their lives (53%). Other concerns included the financial effect and paying for treatment.

Individuals with or who have had cancer reported that the most important things that their oncology provider should do is prescribe the right treatment (67%), be upfront and straightforward about their chances of survival (57%), and take the time to listen to the patient (56%).

The most common treatment among individuals with or who have had cancer were surgery (31%), radiation (24%), and drug-based therapies (24%). Interestingly, 26% of individuals with or who have had cancer and 37% of individuals with no experience with cancer thought that alternative treatments alone can be used to cure treatment. However, 8% of individuals with or who have had cancer report using complementary or alternative therapies.

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Cancer-related pain, currently or in the past, was experienced by 60% of respondents. Patients discussed symptom management with their doctors and most commonly discussed use of over-the-counter pain medication (30%), prescription opioids (29%), vitamins/minerals/herbs (17%), and medical marijuana (13%).  Over-the-counter pain relievers were most commonly used to manage symptoms (24%), followed by vitamins/minerals/herbs (18%) and prescription opioids (17%).  Medical marijuana use for symptom management (use in the past 12 months since when the survey was conducted) was reported by 10% of individuals with or who have had cancer; 18% of those who had active cancer reported use of marijuana during this time. Meanwhile, 13% of respondents who identified as caregivers to individuals with cancer reported the use of medical marijuana.

Among those with or who have had cancer, 37% reported difficulty accessing prescription opioids and 56% had difficulty accessing medical marijuana to manage cancer-related symptoms. Among those who used medical marijuana, 51% reported that it managed their symptoms very well and 47% said it managed them somewhat well.

End-of-Life Care

Only 53% of adults in the general population have thought about end-of-life care, and among those who have thought about it, 25% have not communicated their wishes with anyone. In addition, among individuals who have had or who currently have cancer, only 51% have an end-of-life care plan in place and just 26% have discussed their end-of-life care with their doctor.

Most caregivers of family members or loved ones with cancer wish they had more information to help them and their loved one with cancer prepare for end-of-life care (70%), and many felt that managing end-of-life care was more difficult than they expected (66%).

Access and Affordability of Care

Many individuals who have had or who currently have cancer (and their caregivers) feel that they are receiving or have received the best possible cancer care. However, 26% of individuals with or who had cancer and 38% of caregivers reported that they had to travel too far to see their oncologist. For individuals with or who have had cancer, the median time traveled one way to see their oncologist was 30 min for those living in urban or suburban areas, and 45 min for those living in a rural area.

Among those who felt that they or loved ones were not receiving the best possible cancer care, the most common reasons for this perception focused on access to quality care; they did not know where or how to find the best quality care, oncology providers were not available where they lived, treatment delays occurred due to appointment scheduling, and there was a lack of affordable quality care.

Almost half (44%) of individuals with or who have had cancer reported that at least some aspects of their health insurance served as barriers to obtaining the best care. The most common barriers were copays (20%), preauthorization requirements (19%), and deductibles (18%). Individuals who were uninsured or who had Healthcare.gov or state health insurance were much more likely to refuse treatment (26% or 19%, respectively) or engage in other cost-reducing measures, such as not filling prescriptions, skipping doctor appointments, or delaying imaging.

At least some financial anxiety surrounding a cancer diagnosis was present among 65% of individuals with or who have had cancer, and their caregivers. Almost half as many individuals who have a loved one with cancer — but who are not involved in their care —  reported anxiety about their financial situation as a result of cancer. Although most individuals with or who have had cancer reported that they have done nothing to reduce cancer treatment costs (74%), the most common practices to reduce costs were cutting pain or antinausea pills in half (9%), postponing or not filling prescriptions (8%), and skipping or postponing doctor appointments (8%). However, 51% of caregivers reported engaging in these practices more frequently to reduce treatment costs, including 14% skipping or postponing doctor appointments, 12% postponing or not filling prescriptions, 12% skipping doses of prescribed medication, 12% refusing treatment, and 11% cutting pain or antinausea pills in half.

Reference

The Harris Poll. American Society of Clinical Oncology (ASCO) 2019 Cancer Opinions Survey. Harris Insights & Analytics, LLC; September 2019. https://www.asco.org/sites/new-www.asco.org/files/content-files/blog-release/pdf/2019-ASCO-Cancer-Opinion-Survey-Final-Report.pdf. Published September 2019. Accessed November 6, 2019.