Who Is Most Affected by Cancer Costs?

Money problems during cancer can affect anyone. Some factors make them more likely. Knowing you may be at higher risk is not meant to worry you. It is a reason to reach out for help early, before costs pile up. The National Cancer Institute describes several factors that raise the risk of financial toxicity, meaning money problems related to the cost of care.

People with cancer, and survivors, are more likely to have financial toxicity than people without cancer. Even people who have health insurance can face high out-of-pocket costs. Those are the costs your plan does not cover, such as copays, deductibles, and coinsurance. So this is not only about being uninsured.

Money strain during cancer is common, and it is not a sign you did anything wrong.

The risk can be higher for people with:

• advanced cancer.
• cancer that has come back (recurrent cancer).
• cancer with a poor outlook.
• more than one type of cancer.
• another chronic illness, such as heart disease or diabetes, along with cancer.

Part of the reason is that these situations make it harder to keep working. People treated with both chemotherapy and radiation therapy also tend to have higher out-of-pocket costs.

A younger age at diagnosis is linked to a higher risk. Younger people may have less savings and may be raising children. They are also not yet eligible for Medicare, which is generally for people 65 and older. Survivors of childhood cancer may be more likely to face money problems later, too.

Lower household income raises the risk as well. Losing a job has been shown to increase the risk of debt and bankruptcy.

Having no insurance means a high risk of financial toxicity, especially as cancer costs rise. But coverage alone does not remove the risk, because out-of-pocket costs can still be high. One study found that people with public insurance, such as Medicaid or Medicare, had a higher risk than people with private insurance. Part of the reason may be that they have fewer savings.

If several of these factors apply to you, that is all the more reason to ask for help early. A hospital social worker, a financial counselor, or a financial navigator can help. They can find programs and cost-saving options before the bills become overwhelming.

Whatever your risk, support exists — and asking sooner usually helps more.

Some studies have found that people who belong to racial and ethnic minority groups may be more likely to have money problems after a cancer diagnosis. The National Cancer Institute notes that more research is needed in this area. As with the other risk factors, this is about patterns across groups. It is not a prediction about any one person.

Financial strain can last well beyond treatment. Survivors may keep paying for ongoing care, or for late effects of their treatment. Survivors of childhood cancer may face higher costs over time. Whatever your situation, recognizing these patterns is a reason to keep support in place, not a cause for alarm.

This information is educational and is not a substitute for medical, legal, or financial advice. For your own situation, talk with your care team, a hospital social worker, or a financial counselor.

This article is based on public information from the National Cancer Institute:

• NCI — Financial Toxicity (Financial Distress) and Cancer Treatment (PDQ)