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Financial Toxicity: the Financial Side Effect of Cancer

In this post, learn more about financial toxicity and how to combat it.
PUBLISHED July 23, 2020
Bonnie Annis is a breast cancer survivor, diagnosed in 2014 with stage 2b invasive ductal carcinoma with metastasis to the lymph nodes. She is an avid photographer, freelance writer/blogger, wife, mother and grandmother.

A cancer diagnosis often brings a devastating blow to a person's life. The sudden surprise can quickly turn life upside down. Along with the need to make immediate, life changing decisions, a person may also experience the overwhelming costs of medical care.

Cancer is expensive. In fact, in the United States, it's one of the most expensive medical conditions to treat because patients often receive more than one type of care. Surgery, chemotherapy, radiation, and anti-hormone therapy are just a few of the many treatments associated with cancer.

A single procedure can produce many associated costs because of the various departments involved. For instance, when I had my breasts removed, I received bill after bill in the mail the week I came home from the hospital: from the medical testing lab for pre-surgical blood work, bills from the anesthesiologist for services rendered during surgery and also medications used to put me to sleep. The breast surgeon's office billed me for surgery but also included various other charges. The bills just kept coming and after that initial surgery and hospital stay, they totaled over $66,000! And that was just the beginning of my cancer care. There was much more to come, including a second surgery, CT scans, ultrasounds, MRIs, bone density scans, treatment for lymphedema, annual visits, lab work, medications, etc - you get the picture. And six years out, I'm still under medical care.

Even with good insurance, many medical charges associated with cancer care can be exorbitant.

Some insurance companies pay well, covering a certain percentage of each charge after a deductible has been met, and some don't. Some charges are often disputed or denied. But even if the insurance company pays their portion, the remaining percentage becomes the responsibility of the patient.

Mounting medical bills can negatively affect a person with cancer. In fact, there's a medical term to describe the effect: financial toxicity. It's used to describe problems patients may experience in relation to the high cost of medical care. When someone doesn't have health insurance or has a lot of medical costs not covered by insurance, financial problems can quickly lead to mounting debt or even bankruptcy. Financial toxicity may also affect a patient's quality of life or may prevent them from obtaining necessary medical care. For example, a patient may choose to forego taking prescribed medication or may fail to keep a doctor's appointment in order to save money. Cancer patients are more likely to experience this distress than people without cancer because of the many tests, procedures, surgeries, and medications involved.

According to cancer.gov's website, "Cancer survivors may have financial problems many years after they are diagnosed. This is because they may be paying for ongoing cancer treatment or care for late effects from their treatment."

Financial toxicity can be compounded when cancer affects a person's ability to continue working. This may lead to a loss of income or perhaps a discontinuation in health care services.

But for those weighed down by financial burdens, help is available.

Many hospitals offer financial assistance. Some offer grants for those with low income. Most hospitals have financial counselors who are willing to help or, outside organizations may provide resources. The Susan G. Komen organization has an extensive list of resources on their website.

Hospitals and medical facilities are usually willing to work with patients regarding medical bills, but what happens when unpaid bills are turned over to a collection agency?

Medical debt should never be ignored. Ignoring a debt does not negate it. Patients should immediately contact the collection agency, but before doing so, consumers should know their rights. According to the Federal Trade Commission's Consumer Information website, there are many steps consumers should follow in order to avoid a negative outcome.

Suffering from financial toxicity can be avoided, but patients need to be aware of their rights regarding medical debt.

Each year, billions of dollars of medical debt is sold to collection agencies for pennies on the dollar. Those agencies turn around and try to collect the cost of the original debt or as much as possible on it so they can turn a profit. Medical debt is big business for collection agencies and sometimes, they cross the line by violating statutes of limitation.

Health care is a vital service, especially for those affected by cancer, but the reality is, there are big costs behind it. Don't fall prey to the harmful side effects of debt.

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