For more than one quarter of cancer survivors, life after defeating cancer includes many financial burdens.

Researchers at Virginia Commonwealth University School of Pharmacy set out to examine how financial burdens affect quality of life for cancer survivors. They analyzed data on 19.6 million cancer patients from the 2011 Medical Expenditure Panel Survey to look for any signs of burden, which could include borrowing money, declaring bankruptcy, expressing concern about paying off medical bills and actually being unable to pay for medical care visits.

The researchers found that 29 percent of the survivors had at least one financial problem. The problem that was reported the most was worrying about large medical bills at 21 percent. The breakdown for the remaining burdens was: 11.5 percent said they could not pay for a medical visit, 7.6 percent had borrowed money, 1.5 percent declared bankruptcy and 8.6 percent listed other financial sacrifices.

The researchers added that the survivors' quality of life was affected differently depending on the type of burden they reported. For example, those who declared bankruptcy experienced a 20 to 25 percent reduction in their life quality. People who worried about paying off large medical bills had a reduction in their quality of life by six to eight percent.

Patients with financial burdens were less likely to go to follow-up visits, less likely to take their medications and more likely to delay or skip medical care. The researchers pointed out that people who have financial burdens, in general, tend to have lower physical and mental health quality.

"Our results suggest that policies and practices that minimize cancer patients' out-of-pocket costs can improve survivors' health-related quality of life and psychological health," researcher Norman Carroll said. "Reducing the financial burden of cancer care requires integrated efforts, and the study findings are useful for survivorship care programs, oncologists, payers, pharmaceutical companies, and patients and their family members."

Study co-author Hrishikesh Kale added that patients and their loved ones could benefit from being educated about programs that provide support, whether it is financial or emotional.

"Cancer patients and family members should educate themselves regarding survivorship issues, coverage and benefit design of their health plans, and organizations that provide financial assistance," Kale said. "Cancer survivorship care programs can identify survivors with the greatest financial burden and focus on helping them cope with psychological stress, anxiety, and depression throughout their journey with cancer."

The study was published in the American Cancer Society's journal, Cancer.