As an oncologist, I’ve seen firsthand how the cost of cancer care can weigh heavily on patients and families. Beyond the emotional and physical challenges of a cancer diagnosis, the financial strain, often referred to as financial toxicity, can feel just as overwhelming. What was once a rarely discussed issue is now recognized as a critical part of the overall cancer care experience. And importantly, it can even shape the course of treatment.
What is financial toxicity?
Financial toxicity refers to the financial stress or hardship caused by the cost of cancer treatment. It includes more than medical bills—it’s also about missed work, travel expenses and the long-term financial uncertainty many families face. According to the National Cancer Institute, patients with cancer are more likely to experience significant financial challenges than those without cancer.
And the effects are real: Research shows that financial distress can impact whether patients stick to their treatment plans and can even affect health outcomes and quality of life.
When costs compromise care
Many cancer patients delay medications, stretch out appointments or decline recommended treatments—simply because they can’t afford them. Sadly, they are not alone. One study found that nearly half of cancer patients report some level of financial hardship, from using up savings to accumulating debt or being unable to pay for basic needs.
One of the biggest challenges is the lack of price transparency. It's often hard to know what something will cost until after you've received it. That’s why it’s so important to have open conversations with your care team. Even if those discussions don’t immediately lower your costs, they help your doctors understand what you’re going through. And, like any physical symptom, acknowledging financial stress is the first step toward finding relief.
How to talk to your healthcare team
Talking about your personal finances isn’t always easy, but it’s an important part of your care. Here’s how you can start the conversation:
- Speak up early. Don’t wait until bills are piling up or you're overwhelmed. If you’re worried about the cost of care—even before treatment begins—let your doctor or care team know. They can often connect you with the right support early in the process, which may help you avoid financial stress later.
- Ask about resources. Many cancer centers and hospitals have dedicated staff, such as financial counselors, social workers or patient navigators, who are there to help patients manage the cost of care. These professionals can guide you through assistance programs, help with grant applications and even negotiate payment plans on your behalf.
- Review your coverage. Ask someone on your care team to help you understand what your insurance covers, what your out-of-pocket costs might be, and whether prior authorizations for care are needed. Knowing this upfront can help you plan and avoid surprise bills.
- Explore alternatives. If a recommended treatment or medication is too expensive, don’t hesitate to ask your doctor if there are lower-cost options that are equally as effective. In some cases, there may be alternative drugs, generic versions, or different scheduling options that reduce the cost without compromising your care.
A shared commitment to your care
As oncologists, our job isn’t only to treat cancer; it’s to support you through the full experience of care. That includes helping you navigate the cost. Financial toxicity should never be a barrier to the care you deserve. And while we may not be able to fix every system-level issue overnight, we can start with something powerful: a conversation.
