Everyone agrees lack of money shouldn’t be a barrier to life-saving cancer care. But when cancer metastasizes to bank accounts it can reduce the odds of survival.
When King Charles was diagnosed with cancer, he remarked that it was quite a shock. But at least he didn’t have to face the added trauma of financial hardship that so many cancer patients and families are forced to confront. After my brother was diagnosed with a rare form of blood cancer that had already reached Stage 4, I soon realized we were fighting a two-front war: one against the disease that was attacking his body; the other battling the financial toxicity cancer so often inflicts on a family’s budget.
Most patients and families expect the combination of disease and its treatment will be challenging. What they don’t anticipate, and are ill-prepared for, is what happens when cancer metastasizes to their bank account.
The sequelae of cancer’s financial toxicity are found in all health-care models, including single-payer systems like Canada’s. Cancer will cost the average patient in Canada $33,000 during their lifetime, with many patients and families facing burdensome out-of-pocket costs.
Shocking as the diagnosis itself is, the battle with financial toxicity gets worse for Canadian families with an annual income under $50,000. For them, reduced job earnings and the unmanageable out-of-pocket costs of travel, medication not covered by provincial drug plans, specialized diets and even hospital parking increase the likelihood of foregoing treatment. When you consider that cancer is Canada’s leading cause of death, with an estimated 247,100 Canadians diagnosed in 2024, the dimensions of the problem leap to a staggering scale.
Consider hospital parking. Long seen by many worldwide, including in the United Kingdom, as a perverse barrier to health-care access, these charges hold caring for loved ones hostage to the hospital parking meter. With rates as high as $30 a day in some major urban centres, and the prospect of a quick $75 ticket if you don’t pay, I have seen many families scramble to come up with the cash to park their cars so they could be with a loved one. I went through that ordeal myself every day for more than a year.
But staggering out-of-pocket costs are only the beginning. One in four Canadians surveyed in 2025 worried that if they were diagnosed with cancer, they’d lose their job. As a caregiver, I also discovered that restarting an interrupted career can be a challenge. Today’s high-demand workplace is not universally sympathetic when it comes to welcoming a return to work or hiring from a cancer experience. Troubling, too, some friends and former co-workers are known to engage in the painful practice of cancer ghosting.
In addition to delayed care, financial toxicity is associated with poorer health-related outcomes and impaired quality of life issues for patients and caregivers. Cancer patients and families experiencing these economic burdens are at a threefold greater risk of developing mental health conditions like depression and anxiety. In Italy, which like Canada, the U.K. and other European Union countries has publicly funded health care at the point of use, financial toxicity was associated with a statistically significant higher risk of death among cancer patients.
Financial toxicity was associated with a statistically significant higher risk of death among cancer patients.
The perversity of this reality is unmissable. A cancer that might otherwise be successfully treated instead progresses into something more ominous because treatment adherence becomes compromised or patients and families can’t afford the associated costs of care. As a long-time health-care advocate for higher standards of patient- and family-centred care, I am at a loss to understand why financial toxicity has not been elevated to the threat level it presents to patient safety.
It’s hard enough to live with the worries, challenges and exhaustion of cancer. It’s impossible at the same time to wrestle with skyrocketing costs, shrinking income and a stalled career. We need a financial prescription for what is clearly a huge financial epidemic. As a former financial policy maker, I think one is in reach for Canada that can begin to provide practical support to patients and families where it is most needed.
I’ve proposed the creation of a partnership between the federal government and the financial sector through what I’m calling the Canadian Cancer Recovery Fund. In a highly concentrated industry heavily invested in keeping regulators and the public happy, Canadian banks have an incentive, as well as the infrastructure, to administer such a program. It could begin modestly with participating banks taking applications and providing up to $5,000 a year in forgivable loans for cancer patients or caregivers facing financial hardship, with the federal government providing required funding guarantees, as it has in other arrangements. Making needed money available for out-of-pocket costs before they can compromise or delay care can save lives and reduce the twin burdens of emotional and financial stress. It’s a goal well worth the support of Canadians banks and a government headed by a prime minister who, in a happy coincidence, is a respected former central banker.
It’s long past time for policy makers to step up to the promise of the Canada Health Act, which guarantees the right to “reasonable access to health services without financial or other barriers.” Four decades of experience have convincingly demonstrated that the costs faced by cancer patients and families is a financial barrier that too many cannot overcome, with otherwise avoidable outcomes that are irreparable and should offend the public conscience.
With an anticipated 61 per cent increase in cancer cases globally over the next 25 years, the whole world is faced with one incontestable reality: the size of a bank account should not determine who survives cancer.
