ArticleThe oncologist2026
Advanced cancer treatment decisions and their patient-facing financial burdens: a thematic analysis.
Article in The oncologist, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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5 authors.
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Abstract
backgroundMost research about the high costs of cancer care has focused on characterizing and mitigating the financial hardship patients and families experience after cancer-directed therapy. Few studies have examined how these costs prospectively influence treatment decision-making. Even fewer address how costs impact decisions about symptom-directed therapies. We aim to describe how patient-facing costs of care influence decisions about cancer-directed and symptom-directed therapies for advanced cancer. MATERIALS AND
methodsWe analyzed semi-structured interviews with patients, care partners, clinicians, and health system leaders and clinical observations collected by investigators at 3 National Care Institute-designated US cancer centers between July 2019 and May 2021. Two analysts conducted thematic analysis based on the Model of Financial Burden After Cancer Diagnosis.
resultsAnalysis of 157 interviews and 92 observations identified 4 themes: (1) insurance influenced treatment choice and location; (2) medical costs influenced treatment choice, location, and timing; (3) non-medical costs influenced treatment location and timing; and (4) employment changes influenced treatment choice and timing. Patients and care partners emphasized costs of symptom-directed therapies; staff focused on costs of cancer-directed therapies. Patients and care partners described how employment influenced decisions about starting or continuing cancer-directed therapy, while staff noted how employment affected decisions about symptom-directed therapy.
conclusionsPatient-facing costs profoundly influence treatment decisions in advanced cancer care, but differences in perspective among patients, care partners, and clinicians can lead to oversights in treatment decision-making. Eliciting and incorporating patients' varied priorities into treatment decisions can minimize these oversights, better align treatment with goals of care, and reduce financial hardship.
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