Cancer treatment is incredibly expensive, and places a tremendous burden on patients--even those with insurance. The majority of bankruptcies in the United States are due to unpaid medical bills, and the rate of medical bankruptcies rapidly rises each year. Despite recent healthcare reform efforts, medical costs continue to disrupt the already difficult lives of cancer patients. While oncologists such as myself focus our training on the clinical aspects of cancer care--writing chemotherapy orders, monitoring for tumor response, and managing toxicities such as nausea, infections, and neuropathy--we spend minimal time addressing the financial consequences, which Duke oncologist Dr.Yousuf Zafar describes as "financial toxicity." To learn more about the financial consequences of cancer care, I include a patient's candid description of how his life has been affected by the expenses related to his treatment for head and neck cancer. Dr. Zafar also explains his research related to financial toxicity, and how it likely affects cancer treatment outcomes in unexpected, often unacknowledged, ways. I hope to raise awareness about the devastating impact of the expense secondary to the well-meaning treatments we prescribe, and promote discussion about actions we can take to alleviate this burden, so our cancer patients can focus on their health without the devastation of enormous bills they are unable to pay.

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