S16 Ep41: The Price of Survival: Addressing Financial Toxicity in Gynecologic Oncology With Ursula A. Matulonis, MD; and Katharine M. Esselen, MD, MBA

From Discovery to Delivery: Charting Progress in Gynecologic Oncology, hosted by Ursula A. Matulonis, MD, brings expert insights into the most recent breakthroughs, evolving standards, and emerging therapies across gynecologic cancers. Dr Matulonis is chief of the Division of Gynecologic Oncology and the Brock-Wilcon Family Chair at the Dana-Farber Cancer Institute, as well as a professor of medicine at Harvard Medical School, both in Boston, Massachusetts.

In this episode, Dr Matulonis sat down with guest Katharine M. Esselen, MD, MBA. Dr Esselen is an attending gynecologic oncologist at Beth Israel Deaconess Medical Center and an assistant professor of obstetrics, gynecology, and reproductive biology at Harvard Medical School in Boston. 

Drs Matulonis and Esselen explored the growing effect of financial toxicity in gynecologic oncology, emphasizing how economic burden can influence access to care, treatment adherence, and patient outcomes. Dr Esselen, whose research focuses on patient-centered outcomes and value-based care, highlighted that financial toxicity extends beyond direct medical costs to include indirect burdens such as lost wages, childcare needs, transportation, and basic living expenses. 

To address these challenges, Dr Esselen and her colleagues developed a financial navigation program at Beth Israel Deaconess Medical Center. This initiative includes systematic screening for financial concerns and dedicated support from a financial navigator who connects patients with resources such as insurance optimization, transportation assistance, and financial aid programs. Implementation of this program significantly increased identification of at-risk patients and improved access to supportive services.

Importantly, Drs Matulonis and Esselen emphasized that financial toxicity is not only a quality-of-life issue but also a clinical one. Studies show that patients experiencing high financial burden are more likely to delay or forgo care and less likely to adhere to prescribed treatments, which may ultimately affect survival outcomes. Drs Matulonis and Esselen concluded the discussion by outlining the steps that can be taken to reduce financial burden on patients, underscoring the need for proactive screening, multidisciplinary support, and systemic change.