Is Time Really On Our Side?

This week I learned of a new to me term around cancer treatment and the challenges it presents for patients: Time Toxicity. And I began to wonder about that term with respect to Pink Fund’s mission addressing the challenge of financial toxicity.

“Time toxicity” as a concept is gaining traction. Patients spend hours, days, even weeks or months, receiving treatment. Driving to appointments, waiting in waiting rooms, undergoing tests, recovering — the time all adds up, but it’s rarely acknowledged,” so writes Elsa Pearson Sites, Policy Director, Partnered Evidence-based Policy Resource Center, Veteran’s Health Administration.

Sites is clear about the patient burden.

“Patients are the only participants in the health care system without any formal expertise. Yet they’re the ones rearranging their work and childcare schedules to make the only appointment slot they were offered. They’re the ones spending hours on the phone fighting with insurance companies to get their care covered.”

“Time toxicity" and "financial toxicity" are two concepts associated with cancer treatment, emphasizing the multi-faceted challenges patients face during their journey with the disease. Both highlight the indirect ways cancer affects patients beyond the direct physical impact of the illness and its treatments.

Financial Toxicity addresses the economic burden of cancer treatment on patients. It encompasses more than just high out-of-pocket costs for treatment. Time spent during treatment in waiting rooms and during recovery can equate to hours off work and missed paychecks. Frequent trips to healthcare facilities can lead to additional costs for childcare, transportation and lodging.

Ultimately, the goal in addressing time and financial toxicity is to ensure that the patient's quality of life is preserved as much as possible during and after cancer treatment.

Since launching Pink Fund in 2006, I have always wondered why treatment protocols in the provider setting are not more sensitive to patient’s work and family schedules, allowing for evening and weekend infusions and radiotherapy (what is a weekend?).

After all, imagine if patients did not have to take UNPAID time off from work for treatment.  Would that reduce the economic burden they face, impact treatment adherence, reduce medically related bankruptcies and improve survivorship outcomes?

Hospitals operate 24/7 and I get it, most after “normal” business hours services are reserved for emergency services, like gunshot wounds ( and when your four year old runs into a door jam on Christmas Eve gushing blood and requiring stitches).  And you certainly cannot ask a woman about to deliver to come back Monday morning at 8 a.m.

The overall "time burden" can be mentally, emotionally, physically, and financially draining for patients.

So, let me ask you this, dear readers: Would we be able to mitigate both time and financial toxicity by offering healthcare services during hours that are friendlier, or providing clearer communication on wait times, even expanding telehealth services to reduce trips to and from healthcare facilities?

I am begging the question and looking to you for answers.