Mitigating Financial Toxicity

When cancer is diagnosed, a myriad of complex and multifaceted financial issues may impact patients, their caregivers, and families. In 2013, researchers coined the term financial toxicity to refer to the financial side effects induced by the cost of cancer treatment. Research shows that not addressing the contributing factors of financial toxicity creates distress, anxiety, and depression, and threaten a patient’s return to optimum health.

Nurse navigators can play a role in mitigating the financial toxicity of a cancer diagnosis by ensuring that patients have access to critical information about cancer-related rights and resources, so that they can make educated decisions about their work, finances, and insurance coverage.

Getting and keeping adequate health insurance coverage is the primary means to minimizing the financial toxicity of a cancer diagnosis. Navigators can play a role in helping those who are uninsured get enrolled in health insurance coverage, but also help those who are insured make changes to their coverage to lower their out-of-pocket costs and improve the adequacy of coverage.

For patients with a new diagnosis or who are still in treatment, there are ways to minimize expenses and to access financial assistance options. For patients who have completed the bulk of their cancer care, they may be most concerned with how to manage their medical bills and rebuild their credit. For patients who have already triaged most of the financial impact of their diagnosis and treatment, they may be more focused on adopting long-term financial strategies.

A cancer diagnosis may have significant short- and long-term impacts on employment and income for patients with cancer and their caregivers. A patient with newly diagnosed cancer has a number of employment options that might vary based on their situation, including working through treatment, reducing their work hours to part-time, taking time off work for a shorter or longer period of time, making a career change, filing for short-term or long-term disability benefits to replace their wages while taking time off work, resigning, or retiring. Caregivers are also often faced with employment decisions. Nearly half of survivors surveyed said a household member reduced his or her work hours to provide caregiving services.

The inability to work and the subsequent loss in income can contribute to the financial burden of a cancer diagnosis. Nurse navigators can point patients with cancer and their caregivers to 3 key places to look for information about their employment rights and benefits: federal and state employment laws, employment contracts, and employment policies. Having a better understanding of their employment rights can help patients continue to work or maintain their income while taking time off from work through short or long-term disability insurance policies purchased directly from an insurance company or offered by their employer, through state disability insurance programs, or through the 2 federal long-term disability programs (Social Security Disability Insurance or Supplemental Security Income).

Triage Cancer offers a number of resources to help patients make educated choices about their employment, finances, and insurance options, and to train healthcare professionals to help navigate their patients through these issues.