Assessing the personal financial impact of vestibular schwannoma management.

PURPOSE: To investigate the personal financial impact of vestibular schwannoma (VS) management through a survey hosted by the Acoustic Neuroma Association (ANA). METHODS: A cross-sectional survey was created to ask participants with a VS questions relating to their personal finances and employment with a specific emphasis on financial toxicity, with this toxicity being measured through the COmprehensive Score for financial Toxicity (COST) assessment and the Financial Distress Questionnaire (FDQ). RESULTS: At the time of study completion, 41 respondents had fully completed the provided survey, with the majority being > 50-years-old at the time of intervention (24 participants, 59%) and female (33 participants, 80%). Twenty-nine participants (71%) reported undergoing microsurgical resection of their VS, 9 (22%) documented undergoing radiation therapy, and 3 (7%) described undergoing a combination of both modalities. After initiation of management, 11 respondents (27%) experienced a change in employment and 17 (41%) experienced a change in their duties at work, including change in hours, reduced activity, or new unemployment. The median score on the COST questionnaire was 32 (IQR 15-39). On the FDQ, only 4 respondents (10%) were noted to have moderate financial toxicity and 2 (5%) reported severe financial toxicity. CONCLUSIONS: Among surveyed VS patients after treatment, change in employment as well as job duties can be observed; however, the ultimate financial toxicity of these changes appears limited, with few patients experiencing substantial financial hardship. Further study of this point through prospective study could better identify risk factors associated with personal financial difficulty and improve generalizability.