Long-term impact of financial distress and mental well-being in early vs advanced oral cancer patients on the quality of life of informal caregivers: An exploratory study of a real-world cohort from LMIC
Year: 2025
Type: article
Study design: Observational Study
Abstract: PURPOSE: In low- to middle-income countries (LMICs) like India, oral cancer not only affects the patients but also imposes significant challenges on their informal caregivers. The objective of this study is to explore how the financial distress and mental well-being of early-stage compared to advanced-stage oral cancer patients impact the quality of life of their informal caregivers. METHODS: An exploratory prospective cohort study was conducted at a tertiary teaching hospital in India, enrolling 79 pairs of oral cancer patients and their informal caregivers from September 2019 to March 2022. Patients were categorized into two groups based on the clinical staging of oral cancer: Group A (early-stage, n = 21) and Group B (advanced-stage, n = 58). The study employed the Comprehensive Score for Financial Toxicity (COST FACIT), Depression Anxiety Stress Scales-21 (DASS-21), and the World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaires to assess financial distress, psychological well-being, and quality of life, respectively. Data collection occurred at least 6 months post-treatment. RESULTS: The study found no significant differences in the physical, psychological, or environmental quality of life domains between the two groups. However, caregivers of early-stage cancer patients (Group A) reported slightly higher scores in the social domain than caregivers of advanced-stage patients (Group B). However, this difference could not reach statistical significance. A trend towards significant financial toxicity was observed in Group B (P = 0.06), indicating increased financial distress among caregivers of advanced-stage oral cancer patients. Furthermore, depression in advanced-stage patients significantly impacted caregivers' psychological (P < 0.05) and environmental (P < 0.05) quality of life domains. CONCLUSION: This exploratory study highlights the impact of financial distress and mental well-being of oral cancer patients on the quality of life of their informal caregivers in an LMIC setting. While differences in caregivers' quality of life between early and advanced-stage patients were not statistically significant, a trend toward greater financial toxicity and psychological impact among caregivers of advanced-stage patients was observed. These findings underscore the need for targeted support interventions for caregivers, particularly focusing on financial and mental health assistance. As a preliminary investigation, this study emphasizes the importance of further research to develop comprehensive support strategies for caregivers in LMICs, aiming to enhance their overall quality of life.
Institutions: Basavatarakam Indo American Cancer Hospital and Research Institute, Kasturba Medical College, Manipal, Shri Guru Ram Rai Institute of Medical & Health Sciences, Mediciti Institute of Medical Sciences, Dr. Ram Manohar Lohia Institute of Medical Sciences, All India Institute of Medical Sciences Jodhpur
Language: English
Topic: Cancer survivorship and care
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4409133638