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Cited by 876Economic and Financial Impacts of CancerCancer survivorship and careCancer-related cognitive impairment studies

The financial burden and distress of patients with cancer: Understanding and stepping‐up action on the financial toxicity of cancer treatment

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Carrera, Pricivel M., Kantarjian, Hagop M., Blinder, Victoria S.·2018·CA: A Cancer Journal for Clinicians
DOI 10.3322/caac.21443PMC PMC6652174
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Abstract

“Financial toxicity” has now become a familiar term used in the discussion of cancer drugs, and it is gaining traction in the literature given the high price of newer classes of therapies. However, as a phenomenon in the contemporary treatment and care of people with cancer, financial toxicity is not fully understood, with the discussion on mitigation mainly geared toward interventions at the health system level. Although important, health policy prescriptions take time before their intended results manifest, if they are implemented at all. They require corresponding strategies at the individual patient level. In this review, the authors discuss the nature of financial toxicity, defined as the objective financial burden and subjective financial distress of patients with cancer, as a result of treatments using innovative drugs and concomitant health services. They discuss coping with financial toxicity by patients and how maladaptive coping leads to poor health and nonhealth outcomes. They cover management strategies for oncologists, including having the difficult and urgent conversation about the cost and value of cancer treatment, availability of and access to resources, and assessment of financial toxicity as part of supportive care in the provision of comprehensive cancer care. CA Cancer J Clin 2018;68:153‐165 . © 2018 American Cancer Society .

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  • Previous studies have reported that greater financial toxicity is associated with increased anxiety and psychological distress.

    “previous studies that have reported greater financial toxicity being associated with increased anxiety and psychological distress.”

    From The burdens, coping strategies, and unmet needs of family caregivers of Chinese patients with lymphoma receiving commercial CAR-T-cell therapy: A qualitative study (2026) · cites this paper as [44]

    In “Evidence About Financial Burden on and Financial Distress by Patients With Cancer” (page unavailable), the review reports that higher psychological distress was significantly associated with financial toxicity. “Cancer Drugs and Financial Toxicity” discusses financial distress alongside anxiety, but does not report an association between greater financial toxicity and increased anxiety specifically. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

  • Although these sacrifices were perceived as meaningful demonstrations of love and familial commitment, they also risked household financial instability, anxiety about accumulated debt, and vulnerability to future crises.

    “Although these sacrifices were perceived as meaningful demonstrations of love and familial commitment, they also risked household financial instability, anxiety about accumulated debt, and vulnerability to future crises.”

    From The burdens, coping strategies, and unmet needs of family caregivers of Chinese patients with lymphoma receiving commercial CAR-T-cell therapy: A qualitative study (2026) · cites this paper as [59]

    In “A Household Economic Perspective on Financial Toxicity” (page unavailable), the paper describes families using savings, selling assets, and borrowing to cope with cancer costs, and says accumulated debt affects household welfare. It also describes financial distress and worry about coping strategies. It does not describe these sacrifices as demonstrations of love or familial commitment, or specifically discuss vulnerability to future crises. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • The decision to change the attention control from finances to nutrition was made because of increasing acknowledgment of the relevance and salience of financial toxicity among cancer survivors.

    “This decision was made because of the increasing acknowledgment of the relevance and salience of financial toxicity experienced among cancer survivors [54]”

    From A digital, coach-assisted intervention to address the psychosocial needs of young adult cancer survivors: Randomized controlled trial protocol and intervention adaptation process (2024) · cites this paper as [54]

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Cited by

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Authors
Carrera, P. M., Kantarjian, H. M., & Blinder, V. S.
Affiliations
  • University of Twente (NL)
  • The University of Texas MD Anderson Cancer Center (US)
  • Memorial Sloan Kettering Cancer Center (US)
Corresponding author
Carrera, Pricivel M.
ORCID
Venue
CA: A Cancer Journal for Clinicians
Publisher
Wiley
Published
2018-01-16
Volume
68
Issue
2
Pages
153-165
ISSN
  • 0007-9235 (ISSN-L)
  • 1542-4863
DOI
10.3322/caac.21443
PMC
PMC6652174
OpenAlex
W2783091042
Cited by
876
References
3
Citations by year
2026: 69 · 2025: 106 · 2024: 162 · 2023: 115 · 2022: 139 · 2021: 113 · 2020: 92 · 2019: 61 · 2018: 15 · 2017: 1
FWCI
18.53
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • CA A Cancer Journal for Clinicians (publishedVersion)
  • PubMed (publishedVersion)
  • University of Twente Research Information (publishedVersion, other-oa)
  • PubMed Central (acceptedVersion)
  • University of Twente Research Information (submittedVersion, other-oa)
Funders
U.S. Department of Health and Human Services (P30 CA 008748)
Topics
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Economic and Financial Impacts of Cancer
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cancer-related cognitive impairment studies
Keywords
financial toxicity, cancer treatment costs, financial burden, financial distress, patient coping, maladaptive coping, oncologist-patient communication, access to finance, supportive care, comprehensive cancer care, expensive cancer drugs
MeSH terms
Antineoplastic Agents, Financing, Personal, Health Policy, Humans, Neoplasms, Stress, Psychological, Health Care Costs, Cost of Illness

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