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10 Steps to Cope with Financial Toxicity When Fighting Cancer

Many of us have stories about friends or loved ones who have been tragically impacted by cancer. What is not discussed as often is the financial impact of this terrible disease. 

Cancer is one of the most expensive medical conditions to treat in the United States, even when you have insurance. Some cancer survivors report spending more than 20% of their annual income on medical care. 

Worrying about the cost of treatment makes it harder for cancer survivors and their loved ones to focus on fighting cancer. The National Cancer Institute (NCI) coined a term for distress related to cancer’s economic burden: ‘financial toxicity‘.

Financial toxicity often leads to depression and anxiety because it impacts the emotional and physical health of patients and their caregivers, who experience a variety of its effects:

  • Physical stress, which makes it harder to stay healthy, impairs the immune system’s ability to fight off illness, and aggravates pre-existing medical conditions such as diabetes or high blood pressure.
  • Difficulty sleeping, which causes a variety of negative symptoms including fatigue, irritability, and low energy.
  • Reduced emotional resiliency, which means our coping mechanisms become overwhelmed and we are less able to process or adapt to setbacks.
  • Relationship difficulties, which arises when couples or families shy away from tough conversations in an attempt to protect each other from financial stress.

Why is it so expensive?

Health care professionals  examining medicine while writing on chart

Cancer care and treatment are complex. Successful cancer treatment may involve surgery, radiation therapy, and/or systemic treatment, and cancer patients frequently need to be hospitalized.

The costs associated with treating cancer fluctuate and can be unpredictable. Cancer treatment often needs to be extended or altered, complications can develop, or worst of all, the cancer can return.

One of the most financially devastating consequences of a cancer diagnosis is its impact on earnings and employment. Living with cancer may affect the patient’s and the caregiver’s ability to work. That means lost wages in addition to lost health insurance.

With the steep rise in healthcare costs, the cancer patients with health insurance are not only paying higher premiums, but they are also paying more for copayments, deductibles, and coinsurance. Plus there are other financial expenses associated with cancer treatment that may not come to mind until the bills show up:

  • Research-related costs and additional transportation, travel, lodging and childcare costs for treatment or participation in a clinical trial
  • Mental health counseling
  • Nutritional classes
  • Home care tools

On a positive note, we are getting better at treating cancer every day, which means people are living longer. This is promising for everyone involved, but places an additional strain on our budgets, because long-term medical costs only add to the monetary burden. 

With all of these challenges, it can be easy to lose hope. Fortunately, there are steps you can take to ease cancer’s financial weight.

10 Ways to Fight Financial Toxicity

  1. Meet with a financial advisor.
  2. Share your financial concerns with your doctor soon after the diagnosis.
  3. Ask the hospital about financial assistance options like payment plans, reduced rates, patient assistance, patient care navigators or charitable help.
  4. Meet with an accountant to discuss which of your documented expenses can be credited towards your tax bill.
  5. Set up a meeting with your employer’s Human Resources Department. They can help you better understand access to paid time off, sick leave, or other benefits that could help you keep your job, despite your diagnosis.
  6. Develop a thorough understanding of your health insurance and benefits. (Pointer: ask your health insurance company about a specific case manager, so that you can speak to the same person each time you call.)
  7. Plan and save for unexpected costs and non-medical expenses such as travel, accommodation, or childcare.
  8. Stick with your treatment plan to avoid costly unexpected hospital or emergency room visits. (Speak to your doctor or treatment nurse if you are unable to afford prescribed medications, rather than stopping them altogether.)
  9. Set up a system to track all bills and health insurance information. Decide whether you want to use paper files, electronic medical records, or one of the commercially available apps like Family Healthcare Manager. Medicare beneficiaries have access to a free online tool for organizing and storing medical financial information. ASCO and Cancer.net recommend keeping track of the following items during your cancer treatment:
    • Hospital, physician, and treatment bills
    • Insurance claims and explanations of benefits
    • Doctor’s letters prescribing needed treatments
    • Insurance notices that approve, deny or authorize treatment costs
    • Receipts for related expenses, such as pharmacy bills
    • Notes or recordings of conversations about finances
  1.  Ask for (and accept) help. Friends and family are always looking for ways to contribute. Let your loved ones bring you meals, clean your house, offer medical and financial expertise, help you organize bills, or just lend a sympathetic ear.


The American Society for Clinical Oncology (ASCO)’s free
Managing The Cost of Cancer Treatment lists excellent
questions to guide you through these difficult conversations.

Plan Ahead

Two men sitting and having a conversation

When you or a loved one is diagnosed with cancer, finances should be a key aspect of your treatment plan. Financial distress can make cancer treatments less effective and put everyone involved at risk for stress-induced health conditions. That’s why our doctor-led care treatment teams work with our patients to limit financial toxicity so that they can focus on what matters most, beating cancer.  

Prospero’s social workers have local knowledge of helpful resources such as community agencies and elder attorneys. They are available in person or over the phone to be a compassionate ear and an on-the-ground problem solver for patients and their families. Please give us a call any time (toll free) to find out how Prospero can help you or your loved one at 1-888-608-0499, TTY 711.


Managing the Costs of Cancer Care, ASCO Answers, American Society of Clinical Oncology, 2019. Available at: https://www.cancer.net/sites/cancer.net/files/cost_of_care_booklet.pdf