What Is Financial Toxicity, and How Does It Impact Cancer Patients?

Receiving a cancer diagnosis can be devastating and scary.  You and your loved ones suddenly have to rearrange your life plans. And you don’t know whether treatments will be successful and how much you’ll be forced to endure. Undoubtedly, the “C word” can take an emotional and financial toll.

While both can go hand in hand, cancer’s financial impacts may be dramatic. For many patients and their families, these effects don’t just go away after treatment – they last for years. 

Financial toxicity encompasses more than the money people shell out for chemotherapy sessions and cancer care. It also includes missed time from work, job loss, and putting other financial goals on hold.

Financial toxicity in healthcare means higher out-of-pocket costs and higher deductibles or copays, too. Treatment protocols can be more intense for breast cancer patients, creating an even greater financial hardship for them and their families.  This post will explain what financial toxicity is and how it affects breast cancer patients.

What Is Financial Toxicity in Breast Cancer?  

The term financial toxicity was coined in 2013 by Doctors Yousuf Zafar and Amy Abernethy at Duke Cancer Institute.

It describes the negative impact medical expenses can have on patients and their families.  When an inability to work while in active treatment results in lost income, patients experience a poorer  quality of life, leading to negative mental and physical side effects, in some cases bankruptcy, which can lead to homelessness.

The definition of financial toxicity isn’t one-dimensional. It often refers to the difficulties breast cancer patients have with covering treatment expenses. Yet financial toxicity for oncology patients can include all the financial hardships of seeking medical care.

Someone’s insurance coverage, income level before the diagnosis, and support network tie into financial toxicity. A single individual with a high-deductible insurance plan is at greater risk for financial distress than someone with a well-salaried partner and more generous health benefits. A younger patient might also face increased financial toxicity if their savings and income are lower.  

Financial toxicity includes the cost of treatment and all the expenses associated with getting care. A single person may have to pay for transportation to and from medical facilities. They only have their income and financial assets to depend on, making bankruptcy over healthcare financial hardships more likely. A job loss or demotion due to illness and care can add to their financial distress and can make navigating financial problems feel very heavy.     

What Percentage of Cancer Patients Experience Financial Toxicity?

In high-income countries like the United States, about 35.5% of breast cancer patients experience financial toxicity. But in low to middle-income countries, financial toxicity for breast cancer patients can be as high as 78.8%. Even in the U.S., the lifetime costs associated with treatment are around $100,000.

A diagnosis of metastatic breast cancer doubles those average expenses to $200,000. And it’s not unheard of to exceed these lifetime averages. While there are similarities between patients, each breast cancer diagnosis is unique.   

What Factors Can Contribute to Financial Toxicity?

Demographics make up many of the factors contributing to financial toxicity. Some of the more influential characteristics are race, age, gender, and socioeconomic status. For instance, people of color, younger individuals, and women tend to have lower average incomes. Individuals in these demographic groups are also more heavily concentrated in the service sector. 

The nature of these jobs means a breast cancer diagnosis is likely to cause them to miss work. Patients with service sector jobs may also have to step away from their roles because of the effects of cancer care. It’s more challenging to complete entire shifts in person and deal with the public face-to-face when you’re not feeling well.

While taking short-term disability is an option, these benefits aren’t always available or affordable.

 If a breast cancer patient is already living paycheck to paycheck, it increases their burden. In many cases, people with a lower socioeconomic status don’t have savings.

Those without a family or life partner may not have access to sufficient resources. While the financial impact of cancer on families is serious, single individuals may face added burdens. But within individual demographic categories are layers of factors. For example, single mothers already paying for childcare may face financial toxicity sooner than single women without children.

What Are the Determinants of Financial Toxicity?

What determines financial toxicity is whether breast cancer patients can afford all the costs associated with treatment. For most people, this means maintaining employment and adequate health insurance. It also means keeping a roof over their head and paying for necessities like utilities.

When someone experiences financial toxicity, they may be unable to keep up with basic expenses. The effects of cancer treatment can affect health insurance coverage, job performance, and career paths. Financial toxicity also reaches more than individual patients.  It affects their families as well.

The impact of cancer on society stems from the effects of the illness. When someone can’t work, teammates must rapidly adjust. Likewise, when a family member becomes ill, others must step in as caregivers or take over their responsibilities. This dynamic can create domino effects within organizational and family units as additional people become stretched too thin.

The emotional impact of cancer is yet another determinant of financial toxicity. Negative emotions influence decision-making capabilities, job performance, and quality of life. Cancer patients and their loved ones are at an increased risk of depression or anxiety, which may exacerbate financial difficulties.

What Is the Financial Burden of Cancer Patients?

The financial burden of cancer patients can quickly add up to hundreds of thousands of dollars. Breast cancer caught at early stages may be less expensive over someone’s lifetime. However, health insurance coverage plays a major role in screening, diagnostics, and treatment.

Insurance plans with high deductibles and additional out-of-pocket costs may impede access to care. This includes routine screening mammograms and diagnostic tests such as biopsies. Even with good insurance, breast biopsies can run into the thousands of dollars. A person without the money to pay for diagnostic mammograms and other tests may avoid getting them.

Delays in screening and diagnostics can lead to undetected breast cancer that metastasizes. By the time the individual finds out they have cancer, the financial hardship of treatment goes through the roof. The disease is more difficult to treat, adding to the social impact of breast cancer. With advanced cases, treatment costs go up and survival rates go down, touching families, co-workers, and friends.   

How Does Pink Fund Help Fight Financial Toxicity?

Pink Fund is a nonprofit organization that fights financial toxicity by assisting breast cancer patients with basic living expenses. Yes, many patients and their families need help with the average cost of cancer treatment per year. But when a breadwinner has to take extended leave from work, it can also jeopardize housing and putting food on the table.

A cancer diagnosis in the family can likewise influence more than one member’s earning potential. Caregivers may have to choose more flexible work or give up career plans completely. Pink Fund makes a difference by helping to pay for housing, utility bills, insurance, and transportation. When people donate to breast cancer through Pink Fund, they help patients remove barriers to the treatment they need.