Killing time

Cancer's unrecognized toll: Time by LAURAN NEERGAARD

The hours spent sitting in doctors' waiting rooms, in line for the CT scan, watching chemotherapy drip into veins: Battling cancer steals a lot of time - the tallies, by government researchers, of the sheer hours lost to cancer care: 368 hours in that first year after diagnosis with ovarian cancer; 272 hours being treated for lung cancer, 193 hours for kidney cancer.

Battling cancer steals a lot of time - at least $2.3 billion worth for patients in the first year of treatment alone.

That doesn't count the days spent home in bed recovering from surgery or weak from chemo, just time spent actively getting care - chemo or radiation therapy, blood tests or cancer scans, surgery or checkups, driving to medical appointments and waiting your turn.

"What we see here is a measure of the patient's burden of commitment," wrote Drs. Larry Kessler of the Food and Drug Administration and Scott Ramsey of the Fred Hutchinson Cancer Center, in an accompanying editorial.

NCI epidemiologist Robin Yabroff and colleagues culled the records of 763,000 cancer patients covered by Medicare, the government's insurance program for those 65 and older, and estimated the time involved in traveling to, waiting for and receiving both in-hospital and outpatient care. They compared the results to time spent in medical care by 1 million other Medicare recipients without cancer.

Although most of these patients were retired, the researchers assigned a monetary value to their time - $15.23 an hour, the median U.S. wage rate in 2002. Then they estimated the national toll by including the number of patients diagnosed with cancer in 2005.

It is almost certainly an underestimate, the researchers said, noting that younger cancer patients often receive more intensive treatment.

Whatever the dollar figure, the study showed something important to patients' day-to-day lives, Lichtenfeld noted: Cancers that often are diagnosed early, when they're more curable, require less treatment time.

The difference shows that investing in research for better early detection of cancer "has real benefits," Lichtenfeld stressed.

The study also highlights the importance of newer "targeted" cancer treatments that promise fewer severe side effects and often allow patients to be treated with pills at home instead of in a clinic, added Kessler and Ramsey. The pair called on manufacturers to do research on patients' time toll, and for insurers to better cover new drugs that reduce it.