Financial stress is part of cancer care, too!

For many people living with cancer, the challenges do not end when treatment does. Even as appointments become less frequent and scans turn into part of routine follow-up, administrative burdens and accompanying financial stress can persist. Bills may arrive unexpectedly, insurance coverage can feel uncertain, and paperwork can quickly become overwhelming. Over time, this ongoing strain can take a real toll on survivors’ well-being.

A study published this year in Supportive Care in Cancer takes a closer look at how that kind of financial stress shows up psychologically. Rather than treating financial hardship as a background condition or a simple measure of income, the researchers ask how distress tied to money, and to the practical demands of navigating care, relates to anxiety and depression among cancer survivors.

The work builds on years of research showing that financial worry is common after cancer. Dr. Salene Jones, an associate professor at Fred Hutch Cancer Center and senior author of the study, highlighted the significance of this work. Dr. Jones explained, “while administrative burdens are known to be a problem, few studies examined how it affects patients. This study showed that administrative burdens like prior authorizations, surprise bills, and trouble getting reasonable accommodations are associated with worse financial health in cancer survivors.”

The study draws on survey data from 459 adult cancer survivors living in the United States. The group included people with a wide range of cancer diagnoses, with breast cancer being the most common. Rather than relying on single survey questions or broad measures of hardship, the research team used carefully developed and tested sets of survey questions designed specifically to capture financial stress. These question sets distinguish between two related but different experiences: financial anxiety and financial depression. Instead of asking whether someone feels anxious or depressed in general, the questions focus on whether those feelings are tied directly to concerns about money, insurance coverage, employment, or medical costs.

Alongside the financial distress measures, participants completed the Generalized Anxiety Disorder-7 (GAD-7) and the Patient Health Questionnaire-8 (PHQ-8) which are standard screening tools for anxiety and depression. The researchers then used hierarchical regression models to examine how much financial anxiety and financial depression contributed to overall anxiety and depressive symptoms after accounting for demographic, socioeconomic, and clinical factors.

The findings showed that financial anxiety was strongly associated with higher levels of generalized anxiety, even after adjusting for age, income, education, and treatment status. For depression, the relationship was even more pronounced; financial depression emerged as the single strongest predictor of depressive symptoms, explaining a large share of the variation in depression scores on its own. The study’s findings suggest that screening for anxiety or depression alone may miss an important part of the picture. If financial stress is driving psychological distress, addressing mood symptoms without addressing finances may only go so far. Interventions that reduce administrative complexity or provide hands-on financial navigation could have mental health benefits as well.

This study builds on the team’s broader research examining how administrative burdens in healthcare function as pathways to financial harm in cancer care. Looking ahead, the team is using these findings to better understand which of these challenges are most harmful over time. Dr. Jones noted that “we need to see which administrative burdens lead to financial hardship in people with cancer.” The team has completed data collection for a longitudinal survey that will follow survivors over time, allowing them to identify which administrative barriers are most likely to precede worsening financial and psychological outcomes. The goal is to move beyond documenting distress and toward understanding where intervention could make the biggest difference.

The researchers are careful not to frame financial distress as an individual failure or lack of resilience. Instead, their work points to structural features of cancer care that place ongoing demands on patients long after treatment ends. Financial hardship, they argue, is shaped not only by what care costs, but by how care is accessed, authorized, billed, and managed. As cancer survival rates continue to improve, attention is shifting toward what survivorship actually looks like in practice. This study adds to growing evidence that financial and administrative pressures are central to that experience. Reducing them may be just as important as treating the disease itself.

Fred Hutch/University of Washington/Seattle Children’s Cancer Consortium Member Dr. Salene Jones contributed to this research.

This study was funded by a pilot grant from the Emotional Well-Being and Economic Burden Research Network

Yi, J. C., Henrikson, N. B., Panattoni, L., Liao, Y., & Jones, S. M. W. (2025). Relationships between financial distress and anxiety and depression in cancer survivors. Supportive care in cancer: official journal of the Multinational Association of Supportive Care in Cancer, 33(12), 1084.