November 1, 2018
ASCO’s second annual National Cancer Opinion Survey, supported by the Mission Endowment of ASCO’s Conquer Cancer Foundation, also shows caregivers and rural Americans struggle to afford and access cancer care
ALEXANDRIA, Va. – Nearly four in 10 Americans believe cancer can be cured solely through alternative therapies, according to the American Society of Clinical Oncology (ASCO)’s second annual National Cancer Opinion Survey. This is despite research showing that patients who use alternative therapies instead of standard cancer treatments have much higher mortality rates. The survey, funded by Mission Endowment, also found that amid the ongoing opioid crisis, nearly three in four Americans are opposed to limiting access to opioids for people with cancer, and many cancer patients report difficulty obtaining these medications. In addition, just as many Americans say they are worried about the financial impact of a cancer diagnosis as about dying of cancer, with caregivers and rural Americans bearing the weight of cancer’s financial and access challenges. The National Cancer Opinion Survey is a large, nationally representative survey conducted online by The Harris Poll.
“This survey serves as a barometer of the American people’s views on important cancer-related issues,” said ASCO President Monica Bertagnolli, MD, FACS, FASCO. “It’s revealed a number of critical areas we urgently need to address – from correcting widespread misinformation about cancer treatments, to ensuring patients have access to the pain medication they need, to alleviating the financial distress both patients and their loved ones experience too frequently.”
The national survey, commissioned by ASCO and released October 30, was conducted online by The Harris Poll from July 10 – August 10, 2018 among 4,887 U.S. adults ages 18 and older. Of these adults, 1,001 have or had cancer.
“Understanding the public’s perception is key to understanding and treating cancer,” says Nancy R. Daly, executive vice-president and chief philanthropic officer for Conquer Cancer. “We’re pleased the foundation’s Mission Endowment can bring to light information that begins important conversations about cancer care and guides oncology leaders toward the most efficient ways to treat and communicate with patients.”
Many Americans, Including Patients, Believe Cancer Can Be Cured Without Standard Treatments
Nearly four in 10 Americans (39%) believe cancer can be cured solely through alternative therapies such as enzyme and oxygen therapy, diet, vitamins, and minerals. However, according to a recent study published in the Journal of the National Cancer Institute, patients with common cancers who chose to treat them using only alternative medicine had a 2.5 times higher mortality rate than patients who received standard cancer treatments such as surgery, radiation, chemotherapy, immunotherapy, and hormone-based therapies.
Even many of those with direct cancer experience – people who have or had cancer and family caregivers – believe cancer can be cured solely through alternative medicine (22% and 38% respectively). The survey also found that younger people – 47% of people ages 18-37 and 44% of people ages 38-53 – are the most likely to hold these views.
“There’s no question that evidence-based cancer therapy is necessary to effectively treat the disease,” said ASCO Chief Medical Officer Richard L. Schilsky, MD, FACP, FASCO. “The vast majority of alternative therapies either haven’t been rigorously studied or haven’t been found to benefit patients. When patients are making critical decisions about which cancer treatments to undergo, it is always best to follow the evidence from well-designed research studies.”
Caregivers and Rural Patients Bear the Weight of Cancer’s Financial and Access Challenges
If faced with a cancer diagnosis, 57% of Americans say they would be most concerned about either the financial impact on their families or about paying for treatment, compared to 54%, each, who say they would be most concerned about dying or about cancer-related pain and suffering.
Even more than patients, family caregivers bear the brunt of the high cost of cancer treatment:
• Among caregivers responsible for paying for cancer care, nearly three in four (74%) say they’re concerned about affording it.
• More than six in 10 caregivers (61%) say they or another relative have taken an extreme step to help pay for their loved one’s care, including dipping into savings accounts (35%), working extra hours (23%), taking an early withdrawal from a retirement account or college fund (14%), postponing retirement (14%), taking out a second mortgage or other type of loan (13%), taking on an additional job (13%), or selling family heirlooms (9%).
“Patients are right to be concerned about the financial impact of a cancer diagnosis on their families. It’s clear that high treatment costs are taking a serious toll not only on patients, but also on the people who care for them,” said Dr. Schilsky. “If a family member has been diagnosed with cancer, the sole focus should be helping them get well. Instead, Americans are worrying about affording treatment, and in many cases, they’re making serious personal sacrifices to help pay for their loved ones’ care.”
Rural Americans are the most likely to be concerned about the availability of cancer care near where they live:
• Four in 10 rural Americans who have or had cancer (40%) say there aren’t enough doctors specializing in cancer care near their home, compared to 22% of urban and suburban patients.
• Rural patients typically spend 50 minutes traveling one way to see their cancer doctor, versus 30 minutes for non-rural patients.
“The unfortunate reality is that rural Americans routinely have to travel long distances for cancer care, which can lead to dangerous delays in their diagnosis and treatment,” said Dr. Bertagnolli. “As a result, rural counties have higher death rates from many common cancers than urban areas. Our healthcare system needs to address these disparities so that every patient, no matter where they live, can access high-quality cancer care.”
Americans Support Cancer Patients’ Use of Opioids and Medical Marijuana, But Many Have Difficulty Accessing Them
Most Americans believe that cancer patients should not have their access to opioids curtailed amid efforts to curb the opioid epidemic: 73% say any new rules and regulations that make prescription opioids harder to obtain should not apply to cancer patients.
Yet, the survey shows that accessing opioids for cancer pain is already difficult for many people with cancer. In a small sample, 40% of cancer patients who have used opioids in the past 12 months to manage pain or other symptoms have had trouble accessing them.
“People with cancer frequently experience severe pain, and many of them require opioids to treat it,” said Dr. Bertagnolli. “Americans seem to recognize that cancer patients’ access to needed pain medication should not be restricted, even as our country grapples with how to tackle the opioid crisis.”
According to the survey, the vast majority of Americans (83%) support the use of medical marijuana among people with cancer. However, 48% of a small sample of patients who have used medical marijuana in the past 12 months say they have had difficulty obtaining it.* In addition, 58% of people who have or had cancer say they wish more information were available about the benefits of medical marijuana for symptom relief.
Americans Demand More Action from Washington on Several Fronts
Regardless of political affiliation, Americans want the U.S. government to take action in several key areas, including lowering the cost of prescription drugs. For example:
• 88% say Medicare should be allowed to directly negotiate prescription drug prices with drug makers.
• 86% say the government should regulate the price of cancer drugs to help lower their cost.
• 77% say it should be legal for U.S. residents to buy cancer drugs from pharmacies in other countries.
In addition, Americans are calling for greater investment in cancer research, screenings and care, even if it means higher taxes or adding to the deficit:
• Two in three Americans (67%) say the government should spend more money to develop cancer treatments and cures.
• Over half of Americans (58%) think the government should spend more money to help Americans afford cancer screenings and care.
Still, the overwhelming majority of cancer patients are happy with the cancer care they have received: nearly 9 in 10 people with cancer believe they are receiving/have received the best possible cancer care (89%) and are satisfied with the quality of the doctors who specialize in cancer care near where they live (88%).
*Small base (<100). Results are suggestive but not definitive.
About The National Cancer Opinion Survey
ASCO's National Cancer Opinion Survey was established by the American Society of Clinical Oncology (ASCO), in collaboration with The Harris Poll, to track the U.S. public’s views on cancer research and care. As the world’s leading organization of oncology professionals who care for people with cancer, ASCO believes it is critical to understand what the public, including patients, think of, expect, and need from the nation’s cancer care system. The poll, supported by the Mission Endowment of ASCO’s Conquer Cancer Foundation, is designed to be conducted annually to measure shifts in the public’s perceptions of a range of cancer-related issues over time.
This survey was conducted online in the U.S. by The Harris Poll on behalf of ASCO between July 10 – August 10, 2018 among 4,038 U.S. adults ages 18+, including 152 people who have or had cancer. An oversample of 849 adults with cancer was added to have a large enough sample size to draw conclusions about the population of people with cancer, bringing the total number of adults with cancer surveyed to 1,001. Figures for age, sex, race/ethnicity, education, region, household income, household size, employment status and marital status were weighted where necessary to bring them into line with their actual proportions in the population. Propensity score weighting was also used to adjust for respondents’ propensity to be online. The adults with cancer were weighted separately, as needed, using population distributions from the CDC’s NHIS for those diagnosed with cancer, using the same demographic variables as above.
Founded in 1964, the American Society of Clinical Oncology (ASCO) is committed to making a world of difference in cancer care. As the world's leading organization of its kind, ASCO represents more than 40,000 oncology professionals who care for people living with cancer. Through research, education, and promotion of the highest-quality patient care, ASCO works to conquer cancer and create a world where cancer is prevented or cured, and every survivor is healthy. ASCO is supported by its affiliate organization, the Conquer Cancer Foundation. Learn more at www.ASCO.org
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About Conquer Cancer
Conquer Cancer Foundation funds research into every facet of cancer to benefit very patient, everywhere. In 1964, seven oncologists created the American Society ofClinical Oncology (ASCO), now a global network of nearly 45,000 cancer professionals.
As ASCO’s foundation, Conquer Cancer helps turn science into a sigh of relief for patients around the world by supporting groundbreaking research and education across cancer’s full continuum. For more information, visit CONQUER.ORG.