Authors’ Take: Consequences of Cancer Diagnosis in India

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This week, The Cancer News had the opportunity to connect with three authors (Dr. Aju Mathew, Sruti Ranganathan, and Dr. Edward Christopher Dee) of a recent article in the peer-reviewed Journal Supportive Care in Cancer.  In their article titled ‘A burden shared: the financial, psychological, and health-related consequences borne by family members and caregivers of people with cancer in India‘, the authors explore the socioeconomic, psychological, and health-related burdens placed on family members and caregivers of cancer patients in India.

What did this article highlight?

This article aimed to highlight the problems that family members and caregivers of cancer patients in India face, which include financial toxicity, physical strain, and mental stress. In India,  family members are likely to be heavily involved in the caregiving of a cancer patient. This is due to poor insurance coverage, excessive out-of-pocket expenditure for healthcare, and the strong sense of familial duties in India.


How will the results of this article impact patient care?

We believe that this article will aid in getting the conversation started on the problems that family caregivers for cancer patients face in India. Perhaps raising awareness about this issue will inspire numerous other efforts to highlight the problems that India’s family caregivers face.


Increased awareness of the problems the family caregivers face can potentially lead to local, regional, or national efforts to address these problems. These efforts can involve:

  • changes in healthcare delivery at the local or regional level to identify individuals who are serving as informal caregivers and are at a high risk of facing financial, mental, and physical strain; 
  • changes in policy at the national level to better support family caregivers.


In addition to these tangible efforts, highlighting these issues can potentially remove the stigma associated with family caregivers.


How will you change your practice based on these findings?

With a better understanding of the problems that family caregivers face in India, healthcare providers can also counsel or refer family caregivers to services to help manage the stress and lifestyle changes related to their caregiving role. 


It is important to underscore that in India, as with many other settings worldwide, policy-level initiatives are needed to address the financial toxicity of cancer. This is true for patients, their families, and caregivers. Our paper seeks to shed light on a real and very old issue for many patients worldwide. The drivers of the costs of cancer care are complex. Therefore, the solutions to the many manifestations of financial toxicity will necessitate interdisciplinary collaboration with stakeholders beyond the clinic.


What are the limitations of this article?

The article is limited to highlighting the problems that family caregivers in India face, with some proposed solutions at the local and national levels. There is a need to discuss further barriers to implementing these proposed solutions and research questions that should be addressed to direct the initiatives. Developing methods to identify family caregivers at the greatest financial, physical, and mental risk would further the understanding of this issue. Additionally, studying the socioeconomic and demographic variables associated with quantifiable financial, physical, and mental strain measures on family caregivers is essential.


Given the understanding of factors that predict strain in family caregivers in India, surveys can be developed to identify high-risk family caregivers. Breaking down each proposed initiative into smaller steps like this can aid in spearheading change.


How do these consequences compare to the challenges of cancer care in the US?

The challenges faced by the family caregivers of cancer patients are not unique to India.  But high-income countries like the United States have mechanisms to support family caregivers of cancer patients. Family caregivers’ financial toxicity burden is much lower in the US than in India. This is due to greater governmental assistance and insurance coverage in the United States.


Contributing Authors

Dr. Aju Mathew, Kerala Cancer Care Center, India.

Dr. Edward Christopher Dee, Memorial Sloan Kettering Cancer Center, New York, USA.

Sruthi Ranganathan, University of Cambridge, Cambridge, UK

Article Coordinator: Taylor Sageman, BTF Staff

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