The Financial Burden of Cancer

In recent weeks, attention has been brought to the plight of cancer patients caught in the flooding and devastation left in the wake of historically unprecedented and destructive hurricanes. Patients have been forced from their homes and cut off from caregivers. In the short run, they may be missing chemotherapy and other necessary medical assistance, and in the long run, may end up jobless, displaced, homeless, and without transportation or resources to pay for care.

However, even without catastrophic natural disasters, and even for individuals with insurance, cancer care can be a hard hit financially. The costs of treatments including surgery and expensive drugs, as well as non-medical supportive needs, such as child care, can be crippling. About 29 percent of cancer patients in the U.S. report some financial burden, whether this is declaring bankruptcy, difficulty paying medical bills, or making other financial sacrifices.¹ In addition to not filling needed prescriptions or taking less medication than is prescribed, patients engage in cost-saving measures such as reducing spending on leisure activities, food, and clothing, borrowing money, or spending savings.² In a sample of adults in Washington, those with cancer were 2.65 times more likely to file for bankruptcy than those without cancer.³ Those who were younger, as opposed to older than 65, were more likely to go bankrupt, prompting the authors to implicate the protective role of Medicare and Social Security in mitigating against financial insolvency. Financial burden is linked to psychological problems such as depressed mood, more worry about cancer recurrence, and lower quality of life.¹ Furthermore, financial difficulties, which may lead to foregoing or delaying care or medications, are connected to health-related outcomes, and importantly, mortality.⁴

Some cancer support organizations, in addition to offering resources for coping with emotional difficulties associated with cancer, provide financial assistance. For example, the Cancer Financial Assistance Coalition is a clearinghouse of helpful information and offers ways to connect with various types of support. Professional organizations such as the American Society of Clinical Oncology have information on managing the costs of cancer care. CancerCare can help to pay for transportation, home care, and child care, as well as medication, and medical supplies, and provides referrals to oncology social workers. However, direct financial assistance may be limited by the funds available and patients may need to meet eligibility requirements. Some have called for the necessity of cancer care professionals and institutions to consider the financial health of patients and advocated for policies to cap costs.³ Patients should also inquire about costs early and with each step of treatment to avoid being blindsided. Advocating for oneself can be complicated and involves collecting information, despite being a way to defend oneself against the financial strain.