Aims: Individuals with metastatic breast cancer (MBC) are living longer due to treatment advances, however, experience unique challenges associated with ongoing therapy, disease progression, and prognostic uncertainty. In contrast to early-stage breast cancer treated with curative intent, where financial pressures typically diminish as treatment concludes – and focus shifts to recovery and living beyond cancer – the financial burden in MBC is ongoing. This study aimed to address this research gap by exploring the financial impact experienced by Australian women with MBC.
Methods: A national sample of women with MBC, recruited through community organisations and clinicians, took part in multiple semi-structed interviews conducted via phone or face-to-face over a 12-month period. Interviews were transcribed and analysed using a constructivist approach to thematic analysis.
Results: Thirty-eight women (aged 36-74, living with MBC for 1-23 years) were interviewed. Three themes were identified: (1) complexities and costs associated with healthcare and treatment; (2) workforce participation as protective against financial strain; and (3) systemic barriers to timely and affordable access to cancer drugs and financial support services. Although all participants reported ongoing financial impacts associated with living with MBC, these were not uniformly experienced. Women who were poorly connected to holistic supportive care including peer support, those who were not supported by their employers to continue working with flexible arrangements, and those who struggled to navigate government schemes in a timely manner were at greater risk of experiencing financial toxicity.
Conclusions: Metastatic breast cancer can invoke considerable downward force on the financial security of those diagnosed. Policy makers, employers, health service providers and clinicians are encouraged to work together and explore mechanisms to provide specialised support. This support should be attuned to the realities of lifelong cancer treatment that accounts for the multidimensional complexities of MBC and financial toxicity.