Cost-related challenges in bladder cancer surveillance, treatment, and management of complications

Although the physical and emotional implications of cancer are widely recognized, cancer patients and their families, face a less obvious burden: the financial impact of their diagnosis. Many cancer survivors find that the lingering side-effects of their treatment include dwindling savings and mounting debt.

Bladder cancer forms when the DNA inside normal bladder cells is damaged or mutated, disabling the function that controls cell division. Gene mutations can occur for many reasons. For example, the inhalation of asbestos fibers causes inflammation that leads to cellular mutations even after 20-40 years since first exposure.

Bladder cancer has the highest lifetime treatment cost per patient of all cancers with estimated expenditures of more than $186,000 per case

Early diagnosis and new treatment advances may help to improve survival rates, in patients with bladder cancer. New diagnostic tools such as urine markers may assist in more cost-effectively detecting bladder cancer at an earlier stage. However, these markers cannot replace cystoscopy, which is the key diagnostic procedure for bladder cancer. Typically, cystoscopy can cost anywhere from $350 to $3,000 out of pocket, but the total cost depends on the location of the procedure done. Regular cystoscopy exams can be repeated periodically to determine if the treatments are working or not.

Depending on the stage of cancer and other factors such as the patient's clinical status and prognosis upon being diagnosed, treatment options for bladder cancer can include surgery, urinary diversion, radiation therapy, chemotherapy, and/or immunotherapy.

Surgery is usually the first step in treating early-stage bladder cancer because tumors have likely not spread to other areas of the body. Surgical procedures used for bladder cancer include:

• Transurethral bladder tumor resection - According to MDsave, the cost of this procedure used for diagnosis and staging, as well as treatment ranges from $4,441 to $9,421
• Radical cystectomy - the removal of the entire bladder and any lymph nodes affected. The total cost of robotic-assisted surgery is $3,000 greater than traditional surgery - median $28,100 vs. $24,303

The costs of bladder cancer reflecting surveillance and treatment are substantial and expected to increase significantly with the onset of complications. The continuous phase of care as well as the severity of complications are major contributors to the increasing cancer costs. A retrospective cohort study found that the average cost of bladder cancer among patients surveyed was $65,158. On average, the study found that 60% of the costs were due to surveillance and treatment of recurrences and 30% of the costs due to complications from bladder cancer.

Cancer patients are more likely to delay care because of personal factors, such as inability to afford general expenses

While all physicians outline potential complications, side effects, expected courses of treatments, alternative approaches, and follow-up schedules, they often do not discuss costs related to care and treatment. Cancer costs are frequently a source of great concern and anxiety among patients and their families - a condition termed "financial toxicity". A recent survey found that more than 40% of cancer patients who had savings used at least some of them to cover the financial impact of their diagnosis. This is a worrying statistic given that a quarter of people with cancer said they had no savings at all to rely on. Ultimately, this leaves too many people at significant risk of facing spiraling debts and falling into serious financial hardship.

There are several different factors that influence the cost of bladder cancer for diagnosed patients, including:

• The type and the length of bladder cancer treatment - a patient may receive one type of systemic therapy at a time or a combination of systemic therapies given at the same time
• The length of bladder cancer treatment
• The location of treatment

We can help patients diagnosed with asbestos-related bladder cancer to avoid falling into financial hardship

A cancer diagnosis is typically sudden and unexpected, and people often don't realize the extent to which their finances are likely to be affected. Living with cancer can leave patients struggling to make ends meet and worrying as much about money as the disease itself.

Workers directly involved in manufacturing asbestos products and U.S. military veterans who have developed illnesses due to exposure to asbestos are eligible for significant financial compensation that could help them pay for their treatments.

Attorneys at Environmental Litigation Group P.C. believe action is needed to make sure everyone who experiences a financial impact of bladder cancer gets the help and support they need when they need it. We know that when people receive help early - in the form of legal guidance on all aspects of benefits and compensation they might be entitled - they are more able to access the right support and manage the financial impact of cancer, and they are less prone to a disastrous financial freefall.