Financial Toxicity Can Affect Cancer Outcomes, But Nurses Can Help


There are resources for patients who are struggling to pay for their treatment, but nurses must initiate the conversation.

When someone receives a cancer diagnosis, the top priorities are usually to get an accurate diagnosis and then start treatment. But then, fast forward a month or 2, the patient starts receiving bills for that treatment — and it’s too late to negotiate price or investigate other treatment options.

“We think that [process of selecting treatments and understanding prices] should be well-defined upfront, so that when you are in your cancer experience, 45, 60 days later when you’re not feeling well, you’re not dealing with that on top of other things,” said Linda Bohannon, RN, BSN, MSM, president of the Cancer Support Community and an oncology nurse.

Bohannon said that providers should be the ones to bring up financial concerns with their patients. “We learned over time that patients don’t necessarily share when they’re feeling financial toxicity with their health care team for a whole host of reasons.”

Cancer Support Community recently published their 2020 Cancer Experience Registry Report, which touches on topics such as psychosocial issues and financial toxicity. Findings showed that 7 out of 10 patients who were surveyed said that no one from their health care team discussed cost of their care. Additionally, 1 out of 10 patients reported postponing filling prescriptions while 1 out of 3 said they depleted savings or retirement costs to pay for treatment.

When an individual is faced with financial toxicity, they may end up not going to all their health care visits, not filling prescriptions, or cutting pills in half to make them last longer, or not buying enough groceries to keep themselves nourished. All of these things can have a negative impact on patient outcomes.

“We know that people do better when they stay on their treatment plan,” Bohannon said. “And what we find with financial toxicity is that a lot of times, people wither, don’t stay on their treatment plan, or make significant tradeoffs that could also impact what the long-term outcomes look like.”

Oncology nurses can refer patients to the Cancer Support Community Helpline if they are facing financial or other psychosocial distress.

“We are here to support them,” Bohannon said. “We will take them through distress screening, understand what may be bothering them, and intervene accordingly. We do have a database of about 10,000 resources that we can refer patients to, both at a national and local level. Our main goal is to really be a partner with the health care team to ensure that patients have optimal outcomes.”

More from Cancer Support Community:

  • Helpline phone number: 1-888-793-9355, open Monday-Friday 9am to 9pm EASTERN and 9am-5pm EASTERN on Saturday and Sunday.
  • Cancer Support Community homepage:
  • 2020 Cancer Experience Registry Report:
  • To order a print copy of the report, please email:

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