WHILE cancer treatments have improved, not enough attention has been given to the devastating financial impact of the illness. This often goes hand in hand with the cancer and can remain long after the treatment is finished.
The Irish Cancer Society’s recent report,, stated that the average cost to someone dealing with cancer is €756 a month. Costs include wigs, medication, car parking and counselling.
There are also Government charges such as in-patient fees, prescription charges and medication not covered by the Drug Payment Scheme. Patients face a loss in income of over €1,500 a month on average (€18,000 per annum) because they have to leave their jobs, work reduced hours, or take significant time off work. 45% of carers’ employment was also affected.
Máiread O’Sullivan, of Adrigole, and Sarah Fitzgibbon, of Ballinlough are both living with terminal cancer. In light of the recent report by The Irish Cancer Society, both advocate for other cancer patients who are crushed by debt and struggle to make ends meet as a result of a diagnosis.
“People shouldn’t have to fight [financially] when they are fighting for their lives”, said Máiread.
She received her first cancer diagnosis in October, 2007, when her three sons were very young. She was diagnosed with breast cancer. After a mastectomy and removal of her auxillary nodes, she underwent a 20-month treatment plan, involving chemotherapy, radiotherapy and immunotherapy.
Complications following reconstructive surgery to her breast meant she was off work for a further six months. She returned to her job as a home help organiser for the HSE and remained cancer free for a further seven years.
In August, 2017, she started having problems with her shoulder.
She said: “Initially, it was thought it was a muscular issue but it continued to worsen. In December, 2017, it was confirmed that a tumour had been found in the muscle just under my shoulder.”
Máiread started another cancer treatment plan two weeks later which involved six months of aggressive chemotherapy, followed by 30 rounds of radiotherapy.
“Since January, 2018, I have gone to the chemo ward every three weeks and will continue to do so long into the future. I get two immunotherapy drugs that are given to me like chemo. I will stay on that for as long as that treatment continues to work for me.”
Máiread is no longer able to work as a home help organiser. She said: “I was in a fortunate position because I worked in the public service and there is a good sick leave policy. I also had private income protection policy. While in the last six months I have recovered a significant amount of my physical health, I am still not well enough to go back to work.”
Many people who receive a cancer diagnosis do not have income protection. They might have limited or no sick pay benefit from their employer and will need to rely on social welfare payments while undergoing cancer treatment.
Máiread said: “My income is more secure than a lot of cancer patients. But I feel I have to speak out because I want to help highlight the problems that cancer patients are facing.”
Additional costs occur as a result of a cancer diagnosis, such as travel and accommodation for those living in rural areas, managing side effects and increased day to day living costs.
Máiread travelled from West Cork to Cork city for her treatments.
She said: “There are a lot of hidden costs. My chemo affected my nails and I got infections in my nail beds. The growth of my nails is greatly impaired. I have to manage that with treatments and that cost isn’t covered.
“Not everything is covered under your hospital care. You might be told to take supplements to help boost your immune system or do things like juicing and the person pays for these themselves. All these hidden costs come out of a households weekly budget. None of your household expenses reduce because you are sick.
“Because you are sick and unwell, you’re at home more. You need to have the heating on. It is awful to think that there may be somebody who can’t afford to turn on their heating while dealing with cancer.”
Máiread thinks that more support and compassion should be offered to cancer patients, especially for patients who do not have income protection or sick leave benefits and must therefore rely entirely on social welfare payments while trying to battle cancer.
The Irish Cancer Society’s report calls for better access to medical cards for cancer patients.
Máiread experienced issues first hand when applying for a discretionary medical card. It took four months to receive a reply.
“I received a letter saying I was refused a medical card on financial, social and medical grounds You’re ringing to find out the status of your application while at the height of cancer treatment. It’s very stressful. No cancer patient has the physical strength to fight bureaucracy.”
Máiread contacted a local representative and asked for help after her discretionary medical card was refused.
“I went down the political route and went to a local representative. I didn’t understand why on social grounds I was refused. I don’t know how that was assessed. I couldn’t understand why I was refused on medical grounds.
“Two weeks later, after asking a political representative to help me, I was granted a discretionary medical card.”
GP and mum of three, Sarah Fitzgibbon, was diagnosed with Stage IV bowel cancer that spread to her liver in November, 2014. She finished radiotherapy treatment for cancer in June, 2018.
She said: “When you have Stage IV cancer, no-one will ever say that it’s cured. It is always deemed to be there. At the moment, there is no obvious cancer in my body according to scans.”
Like Máiread, Sarah had income protection insurance and was able to draw down income protection payments six months after her diagnosis.
She said: “For most people with cancer, your income goes down and your costs go up. Expenses in my experience related to parking on the days I went to chemo.
“Heating costs increase because you are at home more and you feel the cold more on chemo.”
Sarah also paid for private counselling sessions after her diagnosis.
She said: “People with cancer, especially Stage IV, have a lot of psychological needs around living while dying so counselling is important.
“ARC House provide a wonderful counselling service which is free. I used that but I also paid for private counselling sessions as well.”
She said, “I don’t know how some people manage, if they are just about managing to pay bills and a mortgage and are then diagnosed with cancer and their income is taken away.
“Some patients find themselves in severe financial difficulty.
“People have to return to work when they aren’t fit enough to do so.
“Dealing with cancer is stressful enough and the added financial stress attached is awful.”
Sarah set up an organisation called The Women In Ireland In Medicine Network which supports female doctors and addresses the challenges and inequalities they face in the medical profession.
When she returned to work as a GP, she planned to travel to the U.S to attend a conference as part of the organisation she set up.
She said: “Because I have Stage IV cancer, no insurance provider in Ireland would provide travel insurance.
“Everyone knows that is you are unwell in the States, seeing a doctor can cost an arm and a leg.”
Because Sarah couldn’t get insurance from an Irish company, she contacted insurance companies in the UK and was quoted up to €700 to cover five days of travel.
She said: “When you fill in the forms for insurance, you’re asked when your last treatment was and whether or not you have a terminal diagnosis.
“Even though I explained that I haven’t had treatment since 2018 and my oncologist has not said that I am dying, once they see you have a cancer that has spread, they [insurers] just say no.
“The whole time I was away, I kept thinking that I really didn’t want to get sick. Even if I got sick and it has nothing to do with my cancer, I still wouldn’t have been covered.”
The Irish Cancer Society is calling for action so that no-one battling cancer is more worried about bills mounting up than they are about getting better.
Averil Power, Chief Executive of the Society, concluded in the report: “We need the Government to stop the endless charges it levies on cancer patients.
“We need better access to medical cards and a greater appreciation of the huge financial strain of having cancer. The double whammy of increased costs and loss of income needs to be taken into account when considering what cancer patients can reasonably bear.
“The Irish Cancer Society will continue to push Government so that a more compassionate and understanding approach is taken.”
For the full report, visit www.cancer.ie/realcostreport
For those concerned about cancer, contact the Cancer Nurseline on 1800 200 700 or email firstname.lastname@example.org