The global economic burden of cancer is staggering. In 2010, the World Health Organization (WHO) estimated that cancer imposes $1.16 trillion in economic burden worldwide. This number could be even higher today – the year 2020 saw an estimated 10 million cancer deaths and 19.3 new cancer cases across the globe.

At the same time, thanks to advanced technologies, more and more people are surviving their cancer diagnosis. In 2019, the United States had an estimated 16.9 million cancer survivors.

However, the economic impact of cancer survival isn’t only positive. The issues to consider when looking at the economics of cancer survival include:

• The economic impact that surviving cancer has in a positive way (i.e., returning back to work)
• The economic impact that surviving cancer has in a negative way (i.e., productivity loss, medical debt)
• The economic impact that surviving cancer has on society (i.e., the cost of healthcare, social welfare programs), and more

Cancer survivors often face a difficult life after cancer, where they are forced to cope with the long-term side effects of treatments such as surgery, radiation, chemotherapy, and immunotherapy.

This blog post will discuss the mechanics of cancer survival, how it impacts global economies, and how best to cope with the “new normal”.

Positive Economic Impact of Cancer Survival

The positive economic impact of cancer survival may be relatively obvious: cancer survivors can continue working and contributing to society in ways that they couldn’t before or during treatment.

The economic benefits of this are twofold: cancer patients may become more productive and healthier at work, especially in regards to their mental health. These contributions benefit all stakeholders in the workplace through increased productivity and decreased absenteeism.

Cancer survivors support economic growth by contributing to the workforce and seeking higher education. Additionally, adult cancer survivors may also spend more money on consumer goods or hire out services.

They can also become a source of social capital through volunteering or donating to organizations.

On a large scale economic level, the payoff for cancer survival can add up: an estimated five million jobs could exist today because of effective cancer treatments that have been developed in the last five decades.

The economic benefits of cancer survival extend beyond just those directly affected by treatment, to society as a whole. Life expectancy is a key indicator of the economic development of a country. A country with a higher life expectancy for its citizens can be more productive and competitive in the global marketplace.

Negative Economic Impact of Cancer Survival

One would assume that surviving cancer only has a positive economic impact. Unfortunately, this is not always the case.  Some negative economic impacts of cancer survival stem directly from treatment, and others result from productivity loss in survivors. Cancer survivors may experience side effects of their treatment that impact work efficiency, potentially resulting in long-term unemployment and financial insecurity.

For those who are unemployed for a long time, it can be challenging to find and secure employment due to age discrimination or other factors that may have accumulated over their period of unemployment.

Then there is the issue with medical debt; without life insurance, cancer survivors will likely carry significant amounts of unpaid bills in some way, shape, or form.

A report compiled by the CDC stated that one in four cancer survivors in the United States struggles to pay off their medical debt. Average out-of-pocket medical expenses for a cancer survivor amount to approximately $1000 a year – higher than the average $622 a year for those without a history of cancer.

These financial troubles can also cause psychological distress. For example, a cancer survivor may feel deep guilt over their inability to repay the medical debt owed. The National Cancer Institute declares that cancer survivors are highly likely to experience depression, anxiety, and other mental health issues after treatment. At least some of these problems are exacerbated by the burden of medical bills.

How to Mitigate the Economic Burden of Cancer Survival

Fully addressing the economic cancer burden would require a concerted, global effort. It could be achieved through improved cancer control, such as funding cancer research and making sure all countries screen and diagnose cancers early with high-quality healthcare systems that can provide assistance for cancer patients and survivors.

Cancer survivors could also benefit from support structures and resources that enable them to work or care for their families. Their transition back to “everyday daily life” should be eased with the help of social services and cancer-specific programs.

Financial burdens could be lessened by social security or financial assistance to cancer patients and their families. Tax incentives or insurance reimbursement policies could also allow cancer survivors to pay off their medical bills faster.

An essential step in mitigating the economic burden of cancer is to assess and address some of the known treatment side effects, especially long-term side effects.

Cancer Surgery Side Effects

Surgery is a type of cancer treatment typically used in one of three ways:

• For removing an entire tumor
• For removing only a part of a tumor (debulking a tumor)
• For easing the symptoms of cancer, such as pain or pressure

Short-term side effects of cancer surgery can include a wide range of unpleasant symptoms, such as nausea, vomiting, dizziness, fatigue, and pain at the surgery area.

However, there can also be long-term side effects, depending on the type of surgery performed, the methods used during the operation, and the cancer type and stage.

Surgeries for advanced cancer stages often involve removing organs or limbs that have been heavily affected by cancer. These surgeries may result in life-long disabilities like paralysis or amputation. Those recovering from colorectal cancer may require a colostomy – an opening in their colon or large intestine that replaces the function of the anus.

Patients that undergo prostate removal or a hysterectomy could experience changes in their urinary and sexual functioning. Urinary incontinence, reduced fertility, and erectile dysfunction are possible side effects in these cases.

Finally, the long-term effects of cancer surgery don’t have to be only physical; they could also be psychological. Studies found that some patients experienced post-traumatic stress disorder following surgery for cancer, and others even reported emotional distress severe enough to warrant clinical attention.

Chemotherapy Side Effects

Chemotherapy is a common cancer treatment. It includes administering drugs that are toxic to all cells – cancer and normal body cells alike. The side effects of chemo can be very varied, depending on what type of chemotherapy drug is administered and how it interacts with the body’s chemistry – but nausea is what most patients with cancer experience as an almost universal issue during chemotherapy. Other problems can include vomiting, fatigue, loss of hair or eyebrows (alopecia), mouth sores (stomatitis), decreased appetite, weight loss, and similar.

Most of these chemo side effects fade away once treatment is complete. However, some late effects of chemo can remain.

One of the most common long-term side effects of chemotherapy is “chemo brain” or “chemo fog.” This is a mental fog that is hard to shake, and some patients are left with chronic cognitive dysfunction such as difficulties with memory, concentration, and multitasking.

Chemo drugs cisplatin and carboplatin could lead to hearing loss. One research study found that cisplatin can cause tinnitus (ringing in the ears) because it accumulates in the inner ear even after treatment.

Because some chemotherapy drugs affect healthy blood cells, they could trigger anemia, fatigue, a higher risk of infectious diseases, and even myelodysplasia or leukemia.

Chemotherapy might also cause heart damage. The risk of heart disease is higher in cancer survivors who are over 65 years of age. Some chemo drugs could cause late side effects such as congestive heart failure, cardiomyopathy, coronary artery disease, and similar.

Radiation Side Effects

Radiation therapy uses large doses of high-energy X-rays, gamma rays, or other types of radiation beams to kill cancer cells and shrink tumors.

Radiation might lead to long-term side effects such as fatigue from the prolonged exposure in addition to skin burning and peeling for one month after treatment.

A significant potential side effect of radiation is the possibility of developing secondary cancer. Much like chemotherapy, radiation also affects the normal body cells. This could lead to the development of new cancer cells, even years after treatment.

Radiation treatment can lead to infertility and impotence in men as well. Issues with thyroid or adrenal glands could also occur, as well as permanent hair loss.

Immunotherapy  Side Effects

Immunotherapy can be used on its own or in combination with other cancer treatment options. It is a treatment option with a lower toxicity profile than chemotherapy and is less likely to result in permanent side effects. Immunotherapy drugs primarily affect the body’s immune system. They contain substances that mimic the body’s natural defense mechanisms to help it fight cancer cells.

However, some immunotherapy drugs can still cause long-term side effects.

An example of these is monoclonal antibodies (Moabs or mAbs). Bevacizumab could cause damage to the blood vessels, resulting in increased blood pressure, kidney damage, and blood clots. It could also lead to the hand-foot syndrome, limiting a patient’s mobility and preventing them from performing their daily activities.

Cytokines are another type of substance used in immunotherapy. They are known to cause long-term nerve damage, albeit rarely.

CAR T cells are often called “a living drug.” This form of immunotherapy consists of the patient’s T cells that have been separated from their blood sample and genetically engineered. CAR T cells are successfully used in treating children and adolescents with difficult forms of leukemia.

However, CAR T cells can cause severe and even fatal long-term side effects such as tremors, seizures, delirium, and speech problems. These side effects could be mitigated with newer, remodeled forms of CAR T cells.

Life After Cancer

People with cancer face a long, difficult road. If they complete their treatment and become free of the disease, they still need to tackle the long-term side effects. They also need to adapt their lives following the traumatic experience of cancer diagnosis and treatment.

While it should be a moment of relief and celebration, becoming a cancer survivor also brings with it a wide range of new challenges. Having feelings of fear, stress, anxiety, and depression is entirely normal when one is expected to adjust to a new life.

Life after cancer can be just as difficult, if not more so, than the struggle with the disease itself.

Fear of Cancer Recurrence

The fear of their disease returning is one that cancer survivors carry with them for the rest of their lives.

There is never a guarantee that cancer will not come back, so it can be difficult to live without fear. Fear of recurrence contributes to living in constant worry about what might happen down the line. Some cancer survivors get so consumed by their fear that they cannot eat, sleep, or even attend their regular screening and follow-up appointments.

If you feel that this is happening to you, take a moment to breathe. Remember that you cannot let this fear hold you back from leading the life you’ve always wanted to.

Here is what you can do to fight these feelings:

• Stay informed. The more you know about your cancer and the ways in which it can recur, the easier this will be. Talk to your health care team about the medication you were given during treatment, the steps to take should the disease return, and the follow-up care schedule.
• Take care of your mental and physical health. Getting enough sleep, eating a healthy diet, and exercising can help you deal with the side effects of cancer treatment. These activities will also contribute to a better mental state.
• Express your emotions. Everything that you are feeling at any stage after cancer treatment is normal. It is crucial that you do not keep these emotions bottled up. Find someone who can listen to what you are going through and help you work through your feelings. It can be a person close to you or even a therapist.

Stress

When cancer treatment comes to an end, and the cancer survivor is expected to resume their old way of life, stress can be at an all-time high.

After diagnosis and during treatment, many other aspects of their lives were dropped to focus on beating the disease. People can easily feel like cancer is the only thing in their life. When they are finished with treatment, the stress of work, family, house projects and chores, finances, and other obligations can overwhelm them.

It could take a while before cancer survivors can adapt to a new type of lifestyle after cancer.

Here are some activities that could help reduce stress levels:

• Exercise – Exercise is a proven stress reducer and mood elevator. Make sure that you consult with your healthcare provider before starting any new exercise plans.
• Relaxation techniques – Yoga, imagery, meditation, and breathing exercises are all ways to reduce stress.
• Creative hobbies – Outlets such as painting, singing, playing music, or writing can be great ways to express your feelings and thoughts and let them go more easily.
• Support groups – Support groups offer an opportunity for cancer survivors to share their experiences, ask questions, or just listen.
• Socializing – Socialization can help improve mood and make you feel like your old self again.

Anxiety and Depression

Feelings of anxiety, sadness, guilt, anger and depression are common after cancer. It is important to talk about your feelings and get professional help if you need it.

If you notice any of these symptoms becoming a constant in your life (for more than two weeks), it is time to consult a doctor or a therapist:

• Inability to concentrate
• Inability to prevent specific thoughts from intruding
• Moodiness
• Short temper
• Helplessness or hopelessness
• Emotional numbness
• Feeling shaky or overwhelmed
• A strong sense of guilt or feeling unworthy
• Crying for prolonged periods or many times a day
• Considering ending your life

There is nothing shameful about feeling this way. Mental health is just as important as physical health, and any issues with it should be addressed as soon as possible.

Find New Meaning in Life After Cancer

Discovering the meaning of your cancer journey is one of the most challenging parts of life after cancer.

The good news is that there are many ways to find a sense of purpose in your new post-cancer life:

• Get involved with cancer support groups – Social support may be one of the most important components for living well after cancer. Connecting with others who have shared similar experiences and swapping stories about what you’ve been through can help put life into perspective.
• Volunteer at a cancer-related organization – Volunteering can be an excellent way to find meaning in your cancer journey because it contributes back to society and gives you the chance to make a significant difference for someone else in need.
• Get involved with political advocacy efforts – Engaging yourself in policy reform that helps cancer patients and survivors alike is a great way to continue making a difference.
• Donate money or time – If you’re financially able, donating money is an excellent option for those who may need help getting the care they deserve and find it hard to afford.

Conclusion

Even though cancer survival is a wonderful thing, it comes with a fair share of trials. Throughout this journey, keep in mind that you are not alone. Whenever you feel stressed, worried, depressed, or overwhelmed, there are people who can and want to help. Turn to your loved ones and your cancer care team if it feels like you are having trouble handling your new normal.

Take care of your body and your mind. Find a new purpose in life, one that will make you feel fulfilled and happy. The support you need is out there, but it can only come if you reach for it first.

Consider donating to our active cancer research campaigns that will significantly impact the future of cancer treatment.