Waldenström Macroglobulinemia

Blood Cancers

Brain Cancer

Metastatic Breast Cancer

Breast Cancer

Childhood Cancers

Anal Cancer

Colorectal Cancer

Esophageal Cancer

Gallbladder Cancer

Gastrointestinal stromal tumor

Liver Cancer

Pancreatic Cancer

Gastrointestinal Cancers

Bladder Cancer

Kidney Cancer

Prostate Cancer

Testicular Cancer

Genitourinary Cancers

Cervical Cancer

Ovarian Cancer

Uterine Cancer

Vulvar Cancer

Gynecologic Cancer

Head & Neck Cancer

Immunotherapy

Acute Myeloid Leukemia

Leukemia

Mesothelioma

Lung Cancer

Follicular Lymphoma

Mantle Cell Lymphoma

Non-Hodgkin Lymphoma

Small Lymphocytic Lymphoma (SLL)

Lymphoma

Myeloma

Cancer of Unknown Primary

Carcinoid Cancer

Neuroendocrine Cancer

Rare Cancers

Sarcoma

Melanoma

Skin Cancer

Thyroid Cancer

News

Cancer Horizons

All News

Blogs

Caregiving

Diet and Exercise

Financial

Psychosocial

Recipes

Sexual Health

Side Effect

Survivorship

Videos

All Videos

CURE Connections

CURE Expert Connections®

CURE Speaking Out

CURE TV

Educated Patient Sound Bites

On Demand: Webinars

Conferences

Conference Coverage 

Conference Listing 

Events

CURE Adventures

CURE Awards

Educated Patient In Person Education

Educated Patient Virtual Education

Resources

Advocacy Groups

Art Gallery

Clinical Trial Corner

Heal®

Partners

Podcasts

Publications

Share Your Story

Subscribe

CURE provides access to the cancer news, latest oncology research & expert insights that serve as a guide to every stage of the cancer experience.

About

Advertise / Support

Contact

CancerNetwork.com

TargetedOnc.com

OncLive.com

OncNursingNews.com

Terms & Conditions

Privacy

Do Not Sell My Information

CURE - Oncology & Cancer News for Patients & Caregivers

Facebook

Youtube

Instagram

Spotlight

Breast Cancer Webinar Series

Cancer Type

Bladder

Breast

Kidney

Lung

Ovarian

Prostate

Skin

About CURE

Press Releases

Write for CURE

1rem

Authors

Emily Armstrong, Rose Sawyer and Ruth Cummings, oncology nurses, are recognized for their dedication, expertise and patient advocacy at Denver Health.

Nurses Leading the Way in Cancer Care

An expert spoke with CURE® about the emotional bonds that can develop while treating patients with cancer.

Kate, Princess of Wales, ‘Got So Attached’ to Her Port During Cancer Treatment

Kate, the Princess of Wales, has announced that her cancer is in remission, but revealed in a candid moment that she felt connected to her port mechanism through which drugs were administered.

During a Jan. 14 visit to Royal Marsden Hospital in London, where she’d received treatment, the princess said of her port, “I got so attached to it,” with the Associated Pres noting that she joked that she had been almost reluctant to have hers removed when told she no longer needed it.

Dr. Frank J. Penedo of Sylvester Comprehensive Cancer Center, in an interview CURE®, said that he doesn’t often hear of patients becoming attached to their port, but he is familiar with patients developing an emotional connection with their care teams.

“It's not uncommon… for the patient to have a sense of loss and disconnection from their care team, because they become such a critical part of their lives and such an emotional connection occurs with them,” said Penedo, Associate Director, Cancer Survivorship and Translational Behavioral Sciences; Director, Cancer Survivorship and Supportive Care; and Director, Biopsychosocial Mechanisms and Health Outcomes (BMHO) Lab, at Sylvester Comprehensive Cancer Center, in Miami, Florida .

While at the Royal Marsden, Kate thanked the medical team for their support and spoke with other patients, the Associated Press reported.

“I wanted to come and show my support for the amazing work that’s going on here, and for those who are going through treatment and having such a hard time,” she said.

Kate announced in March 2024 that she had received a 

. The type of cancer has never been disclosed.

Penedo spoke with CURE® about the emotional bond that can form between patients with cancer and their care teams.

I do hear [about] a lot of emotional attachment to the care teams. It's not uncommon, even when it's good news and the patient is told, ‘You're in remission, the treatment has worked, we'll see you in months,’ for the patient to have a sense of loss and disconnection from their care team, because they become such a critical part of their lives and such an emotional connection occurs with them.

These are individuals — and I have to really give credit to not only the physicians, but the nursing teams, the social workers, the psychologists — the entire care team that works with these patients really are invested in not only making sure that the treatments are set up so that the patient can develop an optimal response, but also that they can live their best possible lives.

So it's [about] adjusting to the new normal, and of course, these patients are going to develop a connection to those individuals that are helping them navigate the challenges of living with cancer.

Transcript has been edited for clarity and conciseness.

For more news on cancer updates, research and education,

don’t forget to subscribe to CURE®’s newsletters here.

Heal

An expert explains the new phase of Princess Kate’s cancer journey as she enters remission.

Kate, Princess of Wales, Enters ‘Survivorship Care Period’ of Cancer Journey

Kate, the Princess of Wales, has announced that her cancer is in remission.

“It is a relief to now be in remission and I remain focused on recovery,” the princess, born Kate Middleton, 43, wrote on Instagram on Jan. 14. “As anyone who has experienced a cancer diagnosis will know, it takes time to adjust to a new normal.”

“What Kate is moving into is what we refer to commonly as the ‘survivorship care period,’” Dr. Frank J. Penedo of Sylvester Comprehensive Cancer Center, Miami, Florida, explained in an interview with CURE®.

Penedo, Center Associate Director, Cancer Survivorship and Translational Behavioral Sciences; Director, Cancer Survivorship and Supportive Care; and Director, Biopsychosocial Mechanisms and Health Outcomes (BMHO) Lab, at Sylvester, spoke with CURE® about cancer survivorship and the importance of patients maintaining a long-term relationship with their care team. Penedo also serves as a Professor of Psychology and Medicine, at the University of Miami.

What Kate is moving into is what we refer to commonly as the survivorship care period. The [National Cancer Institute] defines a cancer survivor as somebody from the day of diagnosis through the balance of their life. Survivorship care is the care that a person is receiving in addition to their medical treatment post-completion of their primary treatments. In that survivorship care, it's really critical that the patient remains very involved with their care team for a variety of reasons.

Patients with cancer, even if they go into full or partial remission, have a greater chance of developing secondary cancers, for example. There's the issue of recurrence as well, which is critical. There has to be ongoing monitoring, whether it's through blood test, through imaging and so forth.

There's also the issue of the treatment-related side effects, and those side effects can be persistent, they can be chronic and they can be debilitating. It's really important for an individual who's been treated for cancer, even if they're in remission, to have that engagement with the care team, so the care team can monitor their levels of fatigue, pain, sleep difficulties and other lifestyle factors that are impacted by cancer.

When Stacy Deems received a diagnosis of breast cancer in September 2019, her first concern wasn’t about her health, it was how she would afford treatment. The divorced mother of two teenaged boys worked for a nonprofit organization with a basic health plan.

“When I brought up (costs) to the oncology team, they were like, ‘You don’t have to worry about that. We’ll discuss it later,’ ” says Deems, 51, of Reisterstown, Maryland. “That’s not how my brain works. I need to know.”

In an initial conversation with the office manager, Deems discovered that although she likely didn’t earn enough to afford her medical bills, she made too much money to qualify for some grant programs. So, she got to work: Deems ensured her doctors all were in the network covered by her health plan and focused on her out-of-pocket maximum cost because she knew she would hit it.

She met with an insurance counselor at the hospital, who recommended a different plan to choose and advised her to get short-term disability insurance in case she needed it. She also used a flexible spending account to cover some bills and medications.

Deems also told family and friends about her plight. Over the past several years, as she underwent chemotherapy and radiation, a mastectomy and reconstructive surgery, she changed jobs and health plans, a family member covered her out-of-pocket maximum costs, and she found other sources of assistance, such as a copay card from her pharmacy. She followed up on any leads for organizations providing grant assistance.

“I just realized I can’t be shy or proud, and I need to just ask for everything and look for any free services that I could get because of what I’m fighting,” she says.

Deems’ financial concerns are common among patients with cancer, says Dr. Fumiko Chino, a radiation oncologist at Memorial Sloan Kettering Cancer Center in New York City whose research is focused on affordability and patient costs. Financial toxicity, a term used to describe financial problems and stress caused by medical costs, affects anywhere from 15% to 65% of patients, she says.

Each person’s financial impact will look unique from factors including the type of cancer they have, what their insurance will cover and the complexities of their treatment plan. 

“If you need chemotherapy and surgery and radiation, you’re going to generally be at a bigger risk for financial toxicity than if you just needed one of those treatments,” Chino says. Costs can add up both from medical and medication expenses as well as from lost income if people have to miss work.

Chino personally understands the patient and family perspective on cancer costs. Her late husband, Andrew, died from a neuroendocrine cancer in 2007. At the time, his insurance company would cover up to half a million dollars in expenses for a lifetime, which his treatment easily exceeded. At one point, he interviewed for and accepted a different job just to have a new health insurance plan, she said, yet she was still left with debt after he died. The experience inspired her to switch careers from art to medicine.

There are several ways to lessen financial costs, says Daniel Sherman, an oncology financial navigator at a Michigan hospital, and president of the NaVectis Group, an organization that trains health care providers on patient financial navigation services.

Ideally, discussions about cancer finances should begin on the day
of receiving a diagnosis, before any treatments occur, says Sherman: “The earlier that a well-trained financial navigator can get involved, the easier it is to mitigate not all but a lot of the financial distress that patient is going to experience.”

When Sherman sits down with patients, he first assesses the person’s insurance coverage to see if there are any opportunities for insurance optimization, or plan adjustments. Often this can happen outside of traditional open enrollment times, especially if there will be a decrease in income due to the diagnosis or if a patient falls below 150% of the federal poverty level.

Beyond that, there are several other resources where patients can receive assistance. Nonprofit hospitals all have charity programs where patients could qualify for free or reduced care. Pharmaceutical companies often have patient assistance programs to help cover drug costs. A variety of patient assistance foundations exist that help cover assorted medical costs, transportation to treatment and other items such as wigs for those who lose their hair.

Out-of-pocket costs for Health Insurance Marketplace plans, which are plans run by the federal government for individuals, families and small businesses, cannot exceed $9,100 in one calendar year, he says. For members of Medicare Advantage plans, those costs cannot exceed $8,300. For people covered by commercial insurance plans or Medicare Advantage plans, these out-of-pocket maximums are not uncommon.

Some people think they’re not going to qualify for assistance, so they don’t even ask. “That’s a mistake. There is no harm in asking. Most people qualify for something,” Sherman says.

Another myth is that patients who ask about financial assistance will receive substandard care. “Nothing can be further from the truth,” Sherman says. “Financial toxicity, left untouched, does more harm to people than asking for assistance.”

Apply for financial assistance as soon as it is necessary; don’t wait until bills have piled up and treatment is over, advises Joanna Doran, an attorney and the chief executive officer of Triage Cancer, a nonprofit organization that provides free education on practical and legal issues impacting people with cancer and their caregivers. “In some cases, you might lose out on eligibility for assistance, because some programs will only provide assistance while you’re in treatment.”

There aren’t specific federal laws that protect patients from medical bills, Doran says. However, the three major credit reporting agencies as of July 2022 have agreed not to include paid medical debt on people’s credit reports.

Always review medical bills carefully before paying them, Doran says: “It’s a human process, and a large percentage of medical bills have errors.” 

Individuals should compare their bills against the explanation of benefits (EOB), a statement from their health insurer that lists what medical services they had, how much the plan pays for them and what charges are not covered.

“Sometimes providers send bills too quickly, before they’ve actually gotten payment from the insurance company,” she says. If individuals pay before comparing to the explanation of benefits, they might pay more than they are actually responsible for.

Once individuals know for sure what they owe, and notice that the figure is too high, they should communicate with their provider, Doran says. See if they can set up a payment plan, or if the provider will accept a lump sum payment at a lower amount. Those scenarios are common, especially at larger hospitals. 

If individuals need additional assistance, then look into financial assistance through the hospital or other nonprofit organizations. “Most people jump to financial assistance, and the challenge with that is if you haven’t figured out what you actually owe, then you’re worrying about paying a bill you might not owe,” Doran says. “There’s only so much financial assistance to go around, so we want to make sure that people are maximizing their ability to get those funds.”

One big issue contributing to financial toxicity is denials, where an insurance company denies coverage for medical care or services. Only 0.1% of people with Marketplace plans appeal those denials, Doran says, but when they do, and it gets to an external medical review process where an independent party reviews the company’s decision, they are successful about 50% of the time.

Scott Matsuda, 69, of Mountlake Terrace, Washington, and his wife, Jennifer Matsuda, have become experts at navigating the finances of cancer treatment. Scott Matsuda was diagnosed approximately 16 years ago with thrombocytosis, a blood disorder in which the body produces too many platelets. But his doctor told him it could turn to leukemia, and a year later, it did.

The first thing Scott Matsuda did was review his family’s finances and contact his insurance company. As photographers who run their own business, the Matsudas purchased the best health plan they could afford to cover Scott Matsuda’s medical costs. For several years he took a cocktail of medications and had minimal copays. Then he started experiencing side effects and doctors switched him to a new, more expensive medication.

For the first three months, Scott Matsuda qualified for a clinical trial and received the drug for free. When the trial ended, he discovered the medication cost about $104 a pill, and he needed two pills a day. His health plan would only cover about 20% of the charges.

“We were floored with the cost and didn’t know how to pay for it,” Scott Matsuda recalls. “We’re solid, middle-class people. We pay our bills and have really high credit ratings, and suddenly, everything was going to blow up in our faces.”

“It was over $6,000 a month, and the options for us were don’t take it, knowing this might be a lifelong drug, or sell the house and drain your retirement account,” adds Jennifer Matsuda.

He stopped taking the drug, which sent his platelets skyrocketing. Then, his oncologist connected the Matsudas with the PAN Foundation, an independent nonprofit group that helps cover medication costs for people living with chronic and rare diseases. They qualified for a copay grant that covered the medication for a year at a time.

Three years ago, Scott Matsuda needed a bone marrow transplant, which he received from his sister. By then he was old enough to qualify for Medicare, which covered most of the cost. Now in remission, he is back on the expensive drug to combat graft-versus-host disease. But before he started taking it, Jennifer Matsuda contacted the pharmacy, which told her they had some grants available to cover the medication. Scott Matsuda is now receiving funds from his fourth grant foundation to help pay for the medication, leaving him with copays averaging $200 a month.

“There’s a whole community of organizations out there that provide different aspects of care and support and help,” Scott Matsuda says. “That’s a revelation when you start going down that avenue.”

As for Deems, she currently has no evidence of disease but is on a maintenance medication and receives mental health services for the trauma and post-traumatic stress disorder brought on by her diagnosis and surgeries. She covers those expenses with pretax dollars through a flexible spending account.

For more news on cancer updates, research and education, don’t forget to 

Financial toxicity is a significant concern for cancer patients, impacting 15% to 65% of them. Patients often face challenges in affording treatment due to high medical costs and lost income. Early financial navigation and assistance can mitigate these issues. Resources include insurance optimization, nonprofit hospital charity programs, pharmaceutical assistance, and patient assistance foundations. Patients should review medical bills carefully and seek financial aid proactively. Denials of insurance coverage are common, but appeals can be successful. Community organizations provide essential support for managing treatment costs.

Healing should be the primary focus of patients and survivors. But for many, the effects of high medical costs can become a burdensome challenge. Care providers, experts and family work to provide assistance.

Financial Issues

The Financial Toxicity of Cancer Treatment

In November 2019, Marlena Murphy completed treatment for triple-negative breast cancer and was fully ready to move on from this chapter of her life.

However, during a radiation session, Murphy told the radiation oncology nurse practitioner about the time she had heart palpitations from chemotherapy pills while trail walking with a friend. The conversation quickly turned into an emotional one for Murphy as she explained that she hadn’t been able to reach the halfway point of the trail. That’s when her nurse recommended speaking with a mental health professional.

“That was the first and only time during the journey that someone talked with me about mental health during treatment. But again, this was after treatment,” says Murphy, 46, of Atlanta. “It wasn’t until I had a break- down moment where someone — my nurse practitioner — saw I needed to speak with someone, and then a social worker, again, saw that I needed to speak with a therapist.

“I thought I was doing well. But I wasn’t.”

Although mental health is a crucial aspect of quality of life, it isn’t talked about enough before and after cancer treatment, experts say, which can be detrimental to survivors returning to their lives after treatment ends.

The revelation Murphy had with her nurse practitioner allowed her to consider how important it is to take mental health seriously. She met with a therapist and learned why she felt so emotional about not being able to climb and complete the trail. Through therapy, Murphy understood that feelings of sadness or anger regarding cancer were normal and that her experience with cancer was entirely out of her control.

In August 2020, Murphy went back to school for a master’s degree in clinical mental health counseling. Going to classes and talking with her classmates provided her time to deeply reflect, which she says was “a real breakthrough.”

Still, Murphy found that everyday tasks were not what they used to be after treatment, noting that her “chemo brain” — a term commonly used to describe the mental toll taken by chemotherapy — “really messes with the mind.” She says it makes her more forgetful, which causes her to mistakenly remember things that aren’t true and occasionally causes confusion when talking with others.

A little more than 2 years after the end of her treatment, Murphy experienced a recurrence and received a diagnosis of metastatic triple-negative breast cancer in March 2022. Nonetheless, this time around, she was in a healthier mental and emotional place compared with the time she received her initial diagnosis.

“Even though this diagnosis was metastatic, the fear was not there. I have strong faith [that] the fear was not there because I’ve recognized that I was on a path to follow my purpose: going back to school and completing my master’s degree,” Murphy says. Now Murphy is on the other side, counseling patients and survivors with cancer. Her role as a therapist grants her the opportunity to comfort and empathize with her patients as she helps them work through their thoughts and emotions. She continues to manage her mental health by completing jigsaw puzzles and “staying in the present moment,” and she still enjoys trail walking.

The issue of mental health during and after treatment isn’t widely discussed enough in the clinical setting, says Dr. Patricia Ganz, medical oncologist, distinguished professor and associate director of population science research at UCLA Jonsson Comprehensive Cancer Center in Los Angeles.

“What has happened is [patients], physicians and people on the care team underestimate the psychological impact of cancer,” Ganz says. “The patient is realizing ‘[Treatment] may be over, but my life is forever changed and I’m still a cancer patient/ survivor. I have to face the future; the disease could come back and I’m facing the side effects of treatment.

When will they go away? Can I go back to work?’ The weight of dealing with that kind of experience in the post-treatment period can be very difficult for many patients.”

Survivors and patients are typically more reluctant to introduce the topic of their mental health and feelings to medical professionals, Ganz says, but asking about their mental health history before cancer, at diagnosis or before treatment is important.

“[Medical professionals] don’t do a very good job of asking people about whether they had anxiety or depression before they had cancer, [which we know] because what we found in our own research is those are often the people who have more problems and more difficulties afterward,” Ganz explains.

Anxiety and depression are among the most common internalizing disorders associated with poorer mental health in survivors, agrees Daniel Hall, a licensed clinical psychologist at Massachusetts General Hospital and Harvard Medical School in Boston. He also notes that the long-term effects survivors experience may also contribute to their mental health.

“It’s very common after cancer treatments or even during cancer treatment, that there can be late or secondary effects of medications. Some of the most common concerns facing cancer survivors include pain, fatigue and insomnia,” Hall says. “We know that one in 10 adults in general has insomnia or chronic difficulties with poor sleep. But that rate triples after diagnosis of cancer. In other words, 30% of cancer survivors are estimated to have insomnia.”

Chris White, a 42-year-old Colorado native who now resides near Dallas, received a diagnosis of metastatic mucosal melanoma in 2018. This form of melanoma begins in the mucous membrane and is considered rare, accounting for approximately 1% of all melanomas, according to Memorial Sloan Kettering Cancer Center in New York.

At first, White thought he had a hemorrhoid, and left it alone until a different lump grew near his groin. White was referred to a surgeon, who strongly believed White had a rare type of hernia. Nevertheless, the pathology from the surgery confirmed that the lump was indeed cancerous.

In October 2019, when White was 37, his doctors suggested enrolling in a clinical trial, and by November, he was enrolled and ready to receive treatment. But in December, he was released from the trial due to a brain metastasis that was found during a scan.

Mental health is often overlooked in cancer treatment, impacting survivors' quality of life. Marlena Murphy's experience highlights the importance of addressing mental health during and after treatment. Despite initial neglect, therapy helped her manage emotions and pursue a career in mental health counseling. Chris White's story underscores the challenges of reintegrating into life post-treatment, emphasizing the need for support. Cognitive behavioral therapies, physical activity, and integrative practices can aid mental health management. Support groups and retreats offer additional resources for survivors seeking community and resilience.

Mental health after cancer treatment has not been talked about enough, experts say, so how should survivors effectively care for their minds?

Thelma Roach Serry

Articles

Latest Updated Articles