Families of 90% of cancer patients face financial distress

After meeting cancer treatment expenses for four years, Hamida Begum's family is now on the cusp of bankruptcy. Selling land and farm animals, her family spent about Tk10 lakh on treatment at several private hospitals in Rangpur and Dhaka.

Now running out of assets to sell, her further treatment and the family's livelihood now mostly depend on the mercy of their relatives.

Like Hamida, a vast majority of households in Bangladesh face financial distress when a family member is diagnosed with cancer, most of whom resort to borrowing money or sell valuable assets, according to a recent study.

A staggering 90% of families with cancer patients face financial hardship to meet treatment expenses, according to a recent study conducted by the Bangladesh Institute of Development Studies (BIDS).

The study titled "Out-of-pocket cost of cancer among Bangladeshi households: A field study", revealed recently, finds that for treatment purposes, 77.78% of families end up borrowing money, while 64.67% pay with regular income, 56% from savings, 39.56% from selling assets and 27.11% from assistance of relatives, friends and others.

During the treatment period, 88% of families face food deficiencies, the study finds. 

The study found the average annual out-of-pocket cost of cancer is Tk5.48 lakh. It is at Tk3.31 lakh if diagnosed in the first stage of the disease and Tk7 lakh for stage 4 patients. 

Drugs and diagnosis account for the highest share of the cost. 

The National Cancer Research Institute reported that a single cancer patient often spent approximately Tk4.92 lakh to Tk8.10 lakh for treatment purposes. 

The costs vary with the age of the patient, type of cancer, severity of the disease, mean length of stay in the hospital, mean length of stay in the ICU, and other various factors.

The study was conducted on 450 cancer patients treated at the National Institute of Cancer Research and Hospital, Bangladesh Medical College Hospital and Ahsania Mission Cancer and General Hospital. 

The study analysed the one-year out-of-pocket cost of cancer patients, including direct medical costs (medicine, diagnosis, chemotherapy, physician cost) and direct non-medical costs (transportation, food, informal payment). 

Researcher of the study Abdur Razzaque Sarker, PhD research fellow, BIDS told the Business Standard that chances of recovery are higher and expenses are less if cancer is detected in the early stage.

Therefore, emphasis should be placed on cancer prevention with hospitals having necessary diagnostic facilities, he said, adding that there should be nationwide screening programmes. 

Besides, expensive cancer medications should be produced by state-owned pharmaceuticals to reduce their cost and cancer treatment should be brought under an insurance mechanism, the researcher suggested. 

Cancer Epidemiologist Dr Habibullah Talukder Ruskin stressed the need for an expansive network of government cancer services. 

He told TBS that the government's initiative to set up cancer hospitals in eight divisional towns should be implemented more quickly.

Currently, the BSMMU is running a cancer screening programme, which is  incomplete, inadequate, and must be revised, Dr Habibullah added.

Cancer in Bangladesh

There are about 15 lakh cancer patients in Bangladesh, with about 2 lakh patients newly diagnosed with cancer each year. 

Cancer accounts for 12% of all deaths in Bangladesh. Male and female exposure was about 56% and 43% respectively. 

The most common cancers in Bangladesh are oesophagus (13.9%), lip, oral cavity (8.9%), breast (8.3%), lung (8.3%) and cervix uteri (5.3%).