Psychosocial effects of cancer economics on patients and their families.

Cancer frequently follows an unpredictable course, with patients experiencing numerous disruptions in their lives. Concomitantly, the enormous financial burdens that accompany the onset and subsequent treatment of cancer become even more overwhelming. Regardless of socioeconomic status, almost all families confronted with cancer and its treatment will have financial problems. Poor people are more likely to be diagnosed with cancer when the disease is advanced and treatment options are significantly more limited. Limited access to medical care carries the additional risk of denied access to community resources, which often are made through referrals from the health care system. For the middle-class family with insurance, as medication costs increase (whether they are covered or not), financial deprivations accumulate as out-of-pocket expenditures, because of required insurance deductibles and copayments and wages lost because of aspects of the treatment. Therefore, even those who are insured can be financially devastated by substantial gaps in coverage. A diagnosis of cancer compounds the struggle for survival and introduces new financial, physical, and psychologic demands. As a nation, we must ensure that cancer prevention, detection, treatment, and rehabilitation services are accessible and available to all who need them, regardless of their ability to pay.