Cancer treatment has long been linked with physical, emotional, and psychological challenges. However, for numerous patients, another significant burden (the financial cost of treatment) impacts their journey in equally significant ways. Increasingly termed financial toxicity, this type of strain is becoming a major factor influencing cancer results. Nevertheless, it is still under-recognized in everyday clinical practice.

**The steep cost of survival**

Financial toxicity refers to the economic difficulties brought on by cancer treatment expenses. It includes not only out-of-pocket medical expenses but also indirect costs like lost wages, transportation, accommodation, and child care. For a lot of families, the financial pressure starts at the point of diagnosis and persists long after treatment concludes.

Research reveals a troubling scenario. Cancer patients are more prone than their counterparts to encounter debt, bankruptcy, and job loss. A study featured in JAMA Oncology discovered that more than forty percent of cancer patients have drained their life savings within two years of being diagnosed, a statistic that has likely escalated with increasing care costs and changes in insurance structures.

However, the financial burden is not merely an aftereffect; it can directly hinder treatment adherence. Some patients miss appointments or postpone filling prescriptions, while others skip recommended therapies entirely. These choices, made amidst financial stress, can change the course of treatment.

**The concealed cost: lack of clarity**

One of the most exasperating elements of financial toxicity is its unpredictability. Often, patients are unaware of the cost of a scan, lab test, or chemotherapy medication until the bill arrives. When available, cost estimators tend to be imprecise. In many situations, patients feel compelled to make significant decisions without the necessary information to make well-informed choices. This absence of clarity can lead to feelings of shame, silence, and delays in seeking assistance. Financial anxiety is often internalized even though it warrants as much clinical focus as fatigue, pain, or nausea.

**The necessity of discussing finances**

The positive aspect: Tackling financial toxicity begins with transparent communication between patients and healthcare teams. Early, candid discussions about possible care costs can help minimize surprises and link patients with available assistance. Financial advisors, patient navigators, and social workers can support everything from grant applications to arranging payment plans. Yet, many patients remain unaware of these resources or may feel too uncomfortable to ask.

It is essential for healthcare professionals to take the initiative in these discussions. Just as doctors routinely evaluate side effects and social support, they should inquire about financial pressures and direct patients toward assistance. When cost-related concerns are recognized and addressed, patients are more inclined to complete their treatments and preserve their quality of life.

**Advancing towards a more sustainable cancer care experience**

Although systemic changes are essential to enhance the affordability and transparency of cancer care, minor adjustments at the clinical level can lead to significant improvements today. Recognizing financial toxicity as a modifiable risk factor and addressing it with the same urgency as other complications could enable more patients to navigate their treatment without compromising their financial wellbeing. Cancer is challenging enough; managing costs shouldn’t be an obstacle for patients to tackle alone.

*Yousuf Zafar is a nationally esteemed oncologist, healthcare executive, and population health researcher with over 20 years of experience in cancer care, informatics, and value-driven service. He is a practicing oncologist, adjunct professor at Duke University, and chief medical officer at AccessHope, where he aims to broaden access to specialized cancer care knowledge for patients receiving treatment in the community. Dr. Zafar is fostering collaboration within the oncology community by partnering with National Cancer Institute-Designated Comprehensive Cancer Centers to remotely share the latest cancer knowledge with those who need it most, thereby filling a crucial gap for individuals lacking access to specialized facilities.*

*Previously, he served as senior vice president of medical informatics at Optum and Change Healthcare and held leadership positions at Duke Cancer Institute, where he pioneered an AI-driven cancer risk model that cut readmissions by 50 percent and doubled appropriate hospice referrals.*

*Dr. Zafar has published over 100 peer-reviewed articles, which can be accessed on ResearchGate, and has led research supported by the National Institutes of Health and the American Cancer Society. His expertise encompasses clinical trials, real-world evidence, precision medicine, and health equity.*

*He is a fellow of the American Society of Clinical Oncology and participates on advisory boards including Health Evolution, the Personalized Medicine Coalition, and WCG IRB. Additionally, he is a board member of Family Reach, a nonprofit organization assisting families in managing the financial challenges of cancer care. Dr. Zafar also shares professional insights and updates on LinkedIn and X @yzafar.*