Veering Off Course: Addressing Challenges in Chemotherapy and Radiation Adherence

Patients often face challenges in adhering to infused chemotherapy or radiation, but many obstacles can be resolved.
DARA CHADWICK
PUBLISHED: NOVEMBER 17, 2016
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Puzo adds that the cost of co-payments can be a particular challenge for patients receiving radiation therapy. “There are a lot of chemo-related co-pay assistance programs out there. But help is not as frequent for people having radiation,” she says.

Some hospitals and treatment centers offer financial assistance — or aid in connecting with organizations or pharmaceutical companies that can help with costs — so it’s important to be up-front with your doctor or nurse about any issues that might keep you from getting your treatment. “We can’t help you if you don’t tell us,” says Shanika Eberhardt, R.N., clinical coordinator for GYN/oncology for Northside Hospital Cancer Institute in Atlanta. Beyond programs that help with co-payments, Eberhardt says that assistance such as validated parking for patients who come in for appointments also helps ease the collective financial burden that treatment places on patients.

Location can also make it difficult for patients to adhere. “As smaller oncology practices consolidate into larger treatment centers, patients in rural areas may find themselves having to travel a long distance for treatment — leading to increased transportation and lodging costs, additional missed work time and difficulty finding a caregiver who can accompany them,” explains Puzo.

If treatment can’t be arranged closer to home, patients can check with nonprofit organizations that offer financial help to people with cancer, asking if any can provide funding for treatment-related travel.

FEAR AND CONTROL

According to Eberhardt, there is often fear at the beginning of treatment that can present a hurdle. “When I call someone and say, ‘I can get you started in a week,’ they sometimes say, ‘Oh, I’m not ready. Let’s wait until the end of the month,’” she says.

To help allay patient fears that lead to putting off treatment, Eberhardt holds education classes before treatment begins. She typically schedules classes for three to four patients and their caregivers or family members at a time, and covers everything from the basics of cancer cells and chemotherapy to exercise, nutrition, the management of stress and side effects, and the use of wigs and laboratory tests. Knowing what to expect and how to deal with it helps patients feel a greater sense of control, which can boost the likelihood that they’ll adhere to their treatment plans, she says. While not all hospitals offer classes like the one Eberhardt teaches, some do — and those that don’t often have other educational and support services for patients, such as workshops, support groups and helplines. Patients looking for more information should start by asking their social workers, nurse navigators or oncology nurses for recommendations. Patients can also find classes and patient education through advocacy organizations like the American Cancer Society, CancerCare and SHARE Cancer Support. Additionally, an Internet search for cancer education for patients in a particular city and state may help identify nearby classes and support services.

A need for control can also become an issue when patients aren’t convinced they need the treatment in the first place, says Ben Smith, M.D., a radiation oncologist with the University of Texas MD Anderson Cancer Center in Houston.

“Some patients feel conflicted about the potential benefit of treatment,” he says. “I’m a huge believer in the concept of shared decision making, and it’s important for me to understand all the parameters of the patient’s situation. If we’re proactive about trying to pair the right course of treatment with the patient’s schedule, that sets us up for success.”



Talk about this article with other patients, caregivers, and advocates in the General Discussions CURE discussion group.
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