Here’s a useful term: time toxicity. Oncologist Dr. Arjun Gupta and colleagues defined it as”time spent in pursuing, receiving, and recovering from cancer treatments.”
Time toxicity matters when deciding on treatment, especially if dealing with advanced, incurable disease and hoping to buy a bit more time.
In an interview shared in cancertoday magazine, Gupta offers a metric:
Contact days: days in contact with the healthcare system, whether for a blood draw or an all-day infusion.
Home days: days free of contact with the healthcare system.
Calculating how many “home days” patients can expect (instead of how many weeks or months of life) helps patients assess whether pursuing treatment is worth it to them.
Gupta wisely mentions the importance of considering both:
Planned contact days: regularly scheduled tests, doctor visits, treatments.
Unplanned contact days: dealing with side effects necessitating doctor visits, ER visits or hospitalizations.
Note that this calculation of “contact days” does not include time toxicity due to:
Feeling too sick to do anything enjoyable.
Debating whether and when to call about a new symptom.
Discussing test results and doctor visits with loved ones.
Labels matter. Introducing the term “financial toxicity” in 2008 brought attention to a serious issue, which led to studies and policy changes. I have great hope that widespread use of the concept of “time toxicity” will lead to more informed decisions by patients now and to studies and policy changes that help decrease time toxicity whenever possible.
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