Report highlights inequalities and hidden suffering among people living with breast cancer

The hidden costs of breast cancer

The associated costs of breast cancer - including physical, psychological, social, and financial costs - are immense but under-recognised. Many of these costs are not captured by current global health metrics.

In response, the Commission established a UK-based pilot study that provides a snapshot of the economic burden and supportive care needs for people affected by breast cancer. Nearly all of the 606 people living with breast cancer and carers surveyed by the Commission stated physical or well-being issues related to breast cancer. One participant described losing their job as as result of being unable to cope during chemotherapy, while another experienced sexual dysfunction but found it difficult to ask for help.

Additionally, a fifth of participants with early breast cancer and a quarter of those with metastatic breast cancer reported difficulty in covering the costs of travel for treatment. 27% with early breast cancer and 35% with metastatic breast cancer said they had financial problems.

This pilot research suggests that, even in countries with a health care system free at the point of care, people with breast cancer can incur hidden costs.

Building on previous work, the Commission report also discusses serious health-related suffering, an indicator of the need for palliative care, with estimates provided by a small expert group. In 2020, an estimated 120 million days were spent with serious health-related suffering per year for people who died of their cancer. A further 520 million days were estimated for patients living with the disease. Behind these numbers are individuals experiencing pain, shortness of breath, fatigue, and other, often resolvable, distressing symptoms.

"Even in countries with well-developed health care systems, patients with breast cancer experience inadequate support and care. In countries lacking affordable health care facilities, patients experience these costs more commonly and intensely, too often leading to catastrophic spending and impoverishment."

^{Dr Carlos Barrios, Oncology Research Center, Hospital São Lucas, Brazil}

The Commission advocates the development of new tools and metrics that capture the many costs associated with the disease. This measurement should guide policymakers to invest in breast cancer prevention, early detection, cost-effective therapy, optimal management, financial protection, and other interventions that relieve suffering.

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