A discrepancy may exist between patient expectations and physician engagement concerning financial toxicity after a cancer diagnosis and treatment, according to a study published in Cancer

Cancer often leads to employment disruptions and financial difficulty among patients with the disease, and evidence suggests that financial burden is associated with overall distress, lower health-related quality of life, and satisfaction with cancer care. Whether physician attention and interactions with patients properly address this issue however, has not been adequately investigated. 

For this study, researchers assessed questionnaire responses of 2502 patients with early-stage breast cancer and their healthcare providers; 370 surgeons, 306 medical oncologists, and 169 radiation oncologists responded to surveys. Patient and physician attitudes and communication of financial toxicity, patient desires for clinician engagement, as well as patient unmet needs pertaining to financial toxicity were evaluated. 

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Results showed that 50.9%, 15.6%, and 43.2% of medical oncologists, surgeons, and radiation oncologists, respectively, reported that someone in their practice frequently or always discusses financial toxicity with patients. Of the 945 women who worried about finances, however, 72.8% (679) reported that their physicians and staff did not help, and of 523 women who wanted to talk to their physicians about the impact of breast cancer on employment or finances, 55.4% (283) reported that such conversations never occurred. 

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The desire to speak to physicians about financial toxicity remains high; 15.2% of white, 31.1% of black, 30.3% of Latina, and 25.4% of Asian patients reported wanting to talk to physicians about the financial impact of cancer. 

The authors concluded that “all physicians must assess patients for financial toxicity and learn how to communicate effectively about it. To cure a patient’s disease at the cost of financial ruin falls short of the physician’s duty to serve, and failure to recognize and mitigate a patient’s financial distress is no longer acceptable.”


Jagsi R, Ward KC, Abrahamse PH, et al. Unmet need for clinician engagement regarding financial toxicity after diagnosis of breast cancer[published online July 23, 2018]. Cancer. doi: 10.1002/cncr.31532