Impact of Cancer
Care
Financial Assistance Program on client financial toxicity and emotional distress.
Authors: Zaleta Alexandra Katherine , Olson Julie S. , Rodriguez Vilmarie , Caba Angelique , Divers Sandra , Moraleda Fernando , Verini Christine 
Published: September 2024

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Background:
The financial impact of cancer can include high out-of-pocket costs, compensatory trade-offs (e.g., postponing treatment), and emotional distress. Cancer
Care
developed its Financial Assistance (FA) Program to assist with cancer-related costs and reduce client financial and emotional burden. We examined the impact of Cancer
Care
’s FA Program on financial toxicity and emotional distress in clients undergoing cancer treatment.
Methods:
731 patients enrolled in Cancer
Care
’s FA Program (1/23-12/23) completed an evaluation survey. Clients were primarily women (71%); mean age=58 (
SD
=13); 47% were non-Hispanic White, 33% non-Hispanic Black, 12% Hispanic. 84% were not employed; median household income $20K; 98% insured. Most frequent diagnoses: breast (26%), multiple myeloma (8%), and colon (5%) cancers; mean years since diagnosis=3 (
SD
=6). All were on treatment (85% chemo; 38% radiation; 13% hormone; 11% immunotherapy). We used descriptive and multivariable regression analyses to examine the impact of FA and the correlates of reduced financial stress (yes/no) and emotional distress (not at all–extremely), controlling for socio-demographics.
Results:
The median grant award was $300 (max: $3000). FA was most often used for transportation (48%), household costs (43%), food (40%), and medical costs (30%). Only 38% of clients were aware of non-insurance financial resources during treatment. Financial compensatory trade-offs included delaying treatment (19%), choosing a less expensive treatment (7%), and stopping treatment (5%). Regarding financial toxicity, 61% reported that FA reduced their financial stress. In logistic regression, factors associated with greater likelihood of reduced financial stress after FA were larger grant amounts (
OR
=1.05;
p
=.04), using FA for transportation (
OR
=1.59;
p
=.00) or medical costs (
OR
=1.44;
p
=.04), and unemployment (
OR
=1.69;
p
=.02). Regarding emotional distress, 67% were distressed/extremely distressed before FA, vs. 25% after FA (
t
=-21.72;
p
=.00). In linear regression, using FA for medical costs was associated with lower distress (
B
=-.29;
p
=.00), and stopping treatment due to finances was associated with higher distress (
B
=.52;
p
=.00), controlling for baseline distress. Using FA for other needs was not significantly associated with reduced financial/emotional distress. 50% said FA met their needs well/very well; 78% were satisfied/very satisfied with the program.
Conclusions:
Our results show the impact of Cancer
Care
’s FA Program on reducing client financial toxicity and emotional distress, known factors in treatment adherence, quality of life, and survival. Notably, use of FA for medical and transportation costs, and grant amount, were significantly associated with improved client outcomes. Clients using funds for other basic needs may have multiple stressors requiring comprehensive multilevel support beyond FA alone.