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Side Effects of Cancer: Why Money Conversations Should Be Part of Your Treatment Plan
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Money. It’s on the list of touchy subjects that can be difficult to talk about when you’re sitting around the dinner table with family, friends, or colleagues.
This taboo carries over into the doctor’s office, too. According to Dr. Yousuf Zafar, Gastrointestinal Medical Oncologist and member of the Family Reach Board of Directors and Research Advisory Board, “[patients and caregivers] suffer in silence, they take on the medical debt, they take the time off to care for their family members, and they do it all in silence because they think it’s the right thing to do.”
Still, pushing through the discomfort and normalizing conversations about the financial side of cancer and available resources are vital to a patient’s cancer journey.
Talking about the financial side effects of cancer
Talking about finances is hard, and not just because it can be uncomfortable. Often, neither healthcare professionals nor families have time to go through the financial impact of cancer treatment. Plus, with so much medical and health insurance jargon to unpack, families are often too focused on the clinical side of their journey to worry about the financial elements.
There’s also a common misconception that the most expensive treatment is the “best” treatment, though this is not always the case. Still, patients and caregivers may worry that if they voice their financial concerns to their oncologist, they won’t receive the best care.
Financial toxicity comes from more than just the cost of treatment, though. The term “financial toxicity” refers to the combination of factors that cause financial crises for families during cancer treatment. Loss of income paired with higher expenses, including out-of-pocket medical bills, transportation, and other related costs, leads to worse outcomes for patients. This can include bankruptcy, higher mortality rates, and more.
Care teams should take into account a patient or family’s risk of lost income, increased transportation costs, food or housing insecurity, and other financial side effects when creating a treatment plan. Additionally, healthcare professionals can help educate patients on all aspects of their care — including price — and direct families to financial support resources when needed.
Without these conversations, the financial stress can pile up and patients won’t know how to ask for help before it’s too late.
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The importance of financial treatment during cancer
Let’s take a look at a hypothetical cancer patient, Jane. In the first scenario, she experiences financial distress without any support and in the second, her treatment course plays out differently when it includes financial conversations and interventions.
Jane’s cancer journey without financial intervention
Jane is diagnosed with cancer. She has insurance through her employer, so she’s not concerned about the cost of care. After all, isn’t that the whole point of insurance?
Jane gets her first bill, and it turns out a few of her chemo pills and appointments with specialists aren’t covered by her insurance. She puts them on her credit card, frustrated by the extra cost. She thinks about where she could pull the extra money from, which starts to give her a great deal of anxiety.
Jane’s bills continue to add up as she puts gas and medicine on her credit card. She’s stressed and exhausted after treatment, so she’s also putting fast food on her credit card, even though she usually prefers to cook at home.
At the end of the month, she pours over her finances and realizes there just isn’t enough money to cover her mortgage payment and utilities on top of the growing credit card bills. She skips paying one of her bills, knowing they’ll send her a warning and she’ll have to pay a late fee, but at least she has some more time and can put the money toward groceries for her family.
For the duration of her treatment, Jane continues paying what she can while incurring interest and late fees that she worries will take years to pay back.
Jane’s cancer journey with financial intervention
Jane is diagnosed with cancer. She has insurance through her employer, so she’s not concerned about the cost of care. After all, isn’t that the whole point of insurance?
Jane’s oncologist asks about her financial situation when they meet for the first time. She asks Jane if she knows the details of her insurance coverage and if she would like one of the patient advocates to take a look at her benefits with her. Jane agrees that would be helpful.
After looking over Jane’s insurance plan, the advocate realizes that many of her medications and appointments with specialists may not be completely covered by her insurance. They help Jane identify a slightly different treatment regimen as well as a few patient assistance programs that can discount her medicine.
That was a huge help, but there are still other costs associated with her treatment that keep adding up, like the extra trips to the gas station so she can get to and from her appointments each week.
While getting scans one day, Jane’s nurse tells her the social worker on staff has gas gift cards and asks Jane if she would like one. After the social worker gives Jane a gas card, they spend some time talking about other concerns. Jane briefly mentions the stress of having to keep track of all of her family’s finances while she’s going through treatment.
The social worker refers Jane to Family Reach, and a Resource Navigator pairs Jane with a free financial planner to relieve the burden of managing her finances. They also recommend a local support group for adult cancer patients, and help her save on grocery costs by directing her to local food banks and a current partnership with Freshly, which will send four weeks of meals right to her door.
Breaking down financial barriers to cancer care
The financial crisis that too often follows a cancer diagnosis can have a long-lasting impact on patients and their families. This harsh reality of cancer inspired our founders to start Family Reach 25 years ago.
One of them remembers talking about how lucky they were that they only had to drive 50 miles roundtrip for his sister’s treatment and had friends who gave them gas cards for the drives, and wondering how other families managed with even longer commutes. Our family founders looked at their fellow patients and families and saw a bigger problem than just cancer.
Now Family Reach has comprehensive financial services to help families before they hit critical financial breaking points. This includes more than just grants, adding in-kind partnerships, financial planning and education, resource navigation, and more to help families preserve their financial health.
It can be hard to talk about finances when help is needed but know that it’s always okay to ask for help — whether from a social worker, oncologist, friend, or Family Reach.
Learn more about our services or make a donation to help us reach more families with this support.
Devin Traxler, MSW, LSW
Lead Resource Navigator • Family Reach Staff
Devin Traxler is a social worker in our New Jersey office. She is one of our Resource Navigators and enjoys working with families and social workers across the country. When she’s at home, she likes to hang out with her cat and two dogs, and work on art projects.
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