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The Hidden Cost of Cancer: Helping Clients Cope with Financial Toxicity

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"Am I going to die? Can I pay for my cancer treatment?"

-Deborah, newly diagnosed with metastatic cancer

Abstract

Financial toxicity is a term that is increasingly used in the medical literature to describe objective and subjective measures of financial strain that many people with cancer face as a result of costly care and treatment. The author first reviews the literature for evidence of financial toxicity and its impact on quality of life, especially anxiety and depression. Maslow’s (Motivation and personality, 2nd edn., Harper & Row, New York, 1970) hierarchy of needs is then presented as a theoretical basis for the impact of financial stress on clients’ ability to cope with their cancer experience. Finally, a clinical vignette illustrates the double burden of cancer and financial strain, highlighting the need to assess for and address financial hardship as a key part of our clinical practice. Psychosocial interventions—such as problem-solving, cognitive-behavioral therapy, family and group support, and meaning-centered therapy—may be utilized to decrease cancer-related distress, even when financial toxicity cannot be fully alleviated. Once financial obstacles are identified and acknowledged, however, the pathway to effective coping is clearer.

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Acknowledgements

The author wishes to thank the following people for their guidance, support, and feedback—Susan Gerbino, Jeane Anastas, Carolyn Messner, and Glenn Meuche.

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  1. New York University Silver School of Social Work & CancerCare, Inc., 275 Seventh Avenue, 22nd floor, New York, NY, 10001, USA

    Maria Chi

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Correspondence to Maria Chi.

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Chi, M. The Hidden Cost of Cancer: Helping Clients Cope with Financial Toxicity. Clin Soc Work J 47, 249–257 (2019). https://doi.org/10.1007/s10615-017-0640-7

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