FINANCIAL HARDSHIP IN OLDER CHINESE CANCER SURVIVORS

Purpose: To estimate the proportion of Chinese cancer survivors experienced financial hardship and then examine whether older age was associated with financial hardship. Methods: We surveyed 965 cancer survivors 30 to 64 years of age and 643 cancer survivors age >=65 years in China. Cancer survivors were asked whether (1) they have borrowed money because of cancer, its treatment, and lasting effects of treatment and (2) they have forgone some cancer-related medical care because of cost. Multi-variable logistic regression models were used to examine factors associated with financial hardship. Results: About 44% of cancer survivors older than 65 borrowed money because of cancer, and 18% had borrowed more than 20,000 CNY (about 2,900USD, the disposable personal income in China in 2015 was about 22,000 CNY). In contrast, 54% of younger patients (P<0.01) had cancer-related debts, and 32% had to borrow more than 20,000 CNY. About 11% of cancer survivors have forgone cancer care in both age groups. The logistic regression analyses show that being 65 or older was 43% less likely to report cancer-related debts than younger patients (OR=0.57, 95% CI: 0.44-0.73). Among older cancer survivors, those who were older than 75, female, and had Urban Employee Medical Insurance and higher family income were less likely to report financial hardship. Conclusion: Older cancer survivors in China experience significant financial hardship, but not as striking as younger patients. Additional research is needed to analyze whether the finding is associated with the Chinese family structure and traditional filial piety culture.

Why Don’t Cancer Survivors Attend Cancer Support Groups in Toronto

Background: Cancer is the leading cause of death for both men and women in Canada. Professionally or nonprofessionally led support groups have been recognized as a significant source of psychosocial support for cancer survivors. However, the participation rate was low and reasons for leaving a support group were not explored fully. Purpose: To explore the reasons why Chinese cancer survivors left or did not attend a cancer support group in Toronto. Methods: In-depth individual qualitative interviews were conducted. Five Chinese cancer survivors participated in in-depth interviews. Colaizzi’s phenomenological method was used to analyze the interview data. Results: Four themes were extracted from the in-depth interviews: “not fit in”, “not satisfied with the information provided”, “tried to be a normal person”, and “lack reliable transportation and convenient scheduling”. Conclusion: Cancer support groups can improve cancer survivors’ physical and psychosocial outcomes. The services can also help cancer survivors to obtain health related information and connect with professionals and peers. In recognizing the reasons why cancer survivors left support groups, health-care providers need to evaluate and be aware of the needs and difficulties for cancer survivors to attend support groups. They should match cancer survivors with appropriate groups. More language-friendly groups need to be launched, so cancer patients can easily find a suitable one from their neighborhood.

Consequences of Cervical Cancer Treatment on Sexual Health in Chinese Cancer Survivors: A Qualitative Study

Background: The attitudes and perceptions of cervical cancer survivors (CCS) toward sexual activity after a diagnosis of cervical cancer and its treatment are unknown. This study describes the experience of CCS in Hunan Chinese about sexuality and sexual function after cervical cancer treatment. Methods: We used descriptive phenomenology to qualitatively assess these experiences. Purposive sampling was used to recruit 20 CCS. Data were collected through in-depth interviews and analyzed according to Colaizzi’s method to explore the essence of the experience in sexuality among CCS after cancer treatment. Results: Uncertainty, fear, and worry dominated the attitudes and behaviors of CCS-related to sexual activity after treatment. Four themes explain these complex emotional responses: 1) needing information; 2) dealing with sexual changes physically and emotionally; 3) communicating with a partner; 4) attribution of fault to her one-lifetime sexual partner. Conclusion: Sexual life was influenced by the physical changes associated with cervical cancer treatment. These changes in combination with inadequate information and limited communication led to uncertainty, fear and worry about engaging in sexual activity and relationship distress. Chinese CCS need targeted and patient-centered information on the change in sexual life caused by treatment, anticipatory guidance, and support in communication with providers and partners, and strategies to cope with the physical and psychosexual sequelae of treatment, all of which must be congruent with their cultural norms.