According to the American Cancer Society, 1 in every 18 Americans is a Cancer survivor. Although most people immediately think about the physical toll of having cancer, living with cancer is also extremely mentally taxing and puts an immense amount of financial strain on families. 

According to Cleveland Clinic oncology social worker Nancy Tamburro, learning of a cancer diagnosis is extremely difficult for patients to grasp. 

“It takes about seven times for the person to hear the word ‘cancer’ for them to even understand that they have been diagnosed with something serious,” Tamburro said. “Initially they’re either stunned or numb and really not processing all of it. As time goes on, they realize the seriousness of the disease and the adjustments that they have to make physically, emotionally and psychologically.”

Dr. Shearwood McClelland, a radiation oncologist at the University of Oklahoma Medical Center, explained that on top of the illness itself, a diagnosis brings logistical challenges.

“All of a sudden [patients] have to become very familiar with the [process of scheduling appointments, as well as] follow-up appointments and treatments,” McClelland said. “[There are also] a lot more hoops that doctors have to jump through to get care for their patients. This increases stress on patients because there are delays and they’re not sure if they’re going to be able to get the care they need.”

A cancer patient who is not identified to protect their privacy recalls the stress they felt prior to receiving treatment for their diagnosis.

 “That period was [a lot of] anxiety because I already had cancer within me, and it was just a long wait I had for a couple of more investigations,” they said.

According to Dr. Joel Saltzman, a medical oncologist at Cleveland Clinic, these lifestyle adjustments extend to new means of support and lifestyle changes.

“Often people change their diet, they change their exercise patterns and focus on what’s important in their life,” Saltzman said. “[They] often have social workers to help, nutritionists to help and physical therapists to help.”

The unpredictable nature of cancer also contributes to its negative mental health impact. Tamburro says that a diagnosis is especially overwhelming because it is human nature to want to know what to expect. 

 “It is overwhelming because, as Americans, we like to know,” she said. “We like to know what we’re doing today. We like to know what we’re doing tonight. We like to know all kinds of things. And, unfortunately, cancer is something that we don’t always know.”

Part of the uncertainty of having cancer comes from the constant scans, all of which bring up immense fear since each time a patient goes in for a new scan they don’t know what to expect. 

“Even if you get surgery and there’s no evidence of disease left, whenever they do a follow-up scan, there’s always going to be anxiety,” said McClelland. “They even have a term [for it]. They call it ‘scanxiety.’”

Eileen Coan, medical librarian at the Gathering Place, a local nonprofit that supports cancer patients and their families, shared that the fears of cancer don’t end when a scan is found clear because recurrence is unpredictable; there’s no way to assume if it will or won’t reappear.

“You can’t prepare for recurrence. It will or won’t happen,” Coan said. “You can eat better. You can exercise. But that’s not a guarantee.” 

Just as the fear of recurrence takes a toll on the patient, so does the feeling of abandonment as soon as treatment ends. Even though the patient may be physically well enough to return to a normal life, they may not feel ready mentally. 

“[In] that moment when they [graduate from their treatment] and everyone around them is like, oh good, that’s over with. They’re fine. [Patients frequently feel] like, no, not so much,” Coan said. “Because if they’ve been focused for six months or a year, [on] treatment, doctor’s appointment, scans, and then the doctors say, well, you’ve graduated, you’re done.”

“They feel abandoned,” she added. “And they feel like all that help they were getting just stops, and that’s a hard adjustment, too.” 

In addition to these stresses, several studies have found that patients’ biggest worries don’t come from a fear of dying or being in pain, but rather from the fear of becoming a burden to those around them.  

“A lot of these patients’ mental health is affected by a sense of lower self-esteem, a sense of loss of independence and a fear of inconveniencing, burdening, putting on more work for the people that they love the most,” Tamburro said.

Of course, family members and close friends are there to support the patient; however, this doesn’t mean they don’t struggle as well. 

While cancer takes a toll on patients, the emotional burden also extends to their families. 

“We think the rest of the family is under as much stress as the patient, it’s just different,” Coan said. “The caregiver is terrified for their loved one.  And whether it’s a child or a parent or a partner, they want to fix it, and this is not something they can fix.”

Emotional support can be complicated. Well-meaning caregivers might cling to positivity, but according to social workers, that approach can sometimes restrict the patient from being able to process their reality.

“Probably the most common thing that people say [when trying to be] encouraging is ‘you’ve got to be positive. You’ll never beat this if you’re not positive,’” Coan said. “That’s not true.” 

“When people are overly optimistic, a lot of it is [an] inability at that time to really face what could happen,” said Tamburro. “Sometimes that toxic positivity is just for protection, but it doesn’t allow people to really discuss their real fears.”

While of course living with cancer brings along challenging mental health struggles, its financial burden is just as severe. 

“Sometimes parents who are alive may have decisions about helping their child with cancer through their retirement savings,” said Dr. Shearwood McClelland, a radiation oncologist at the University of Oklahoma Medical Center. “It’s a question about … do I pay my electric bill or do I do this treatment? Can I ration my treatment for another two weeks so that I can pay rent?”

Even with insurance, Americans face barriers to healthcare. According to an issue brief from the Kaiser Family Foundation (KFF) published in July 2025, almost half of adults in the U.S. say health care is difficult to afford, with 25% reporting that they or someone in their household has struggled to pay medical bills in the past year.

Almost a third of all adults reported having skipped or delayed care due to cost, and among the uninsured, that statistic rises to 75%. 

Almost 40% of insured adults worry about keeping up with their monthly premiums, and the majority of adults say they are at least somewhat concerned about being able to afford unexpected medical bills in the future.

The disconnect between health insurance and care costs catches a lot of patients off guard. 

“A lot of patients are surprised by how little their insurance covers when they actually need it,” McClelland said. “They’re like, ‘oh, I’m saving money [with a cheaper insurance plan]’ But then when they actually need it, then all of a sudden the insurance is like, ‘well, we don’t cover that.’”

Many doctors also aren’t aware of the cost of treatment. 

“If … the doctor recommends [something] and the patient [asks] ‘how much does that cost?’ The doctor has no idea at all,” McClelland said. “And they don’t know if the patients can afford it or not.”

“It’s often a surprise because we have such a complicated healthcare system and even for reimbursement, it’s hard to get a ‘sticker price’ for the care,” Saltzman said. “Especially as our cancer therapies get more specialized, they get more and more expensive.”

For many patients, treatment is time-consuming and causes time off work. According to the American Cancer Society, nearly three in four cancer patients and survivors report missing work during treatment, and more than a third who missed work did not receive pay for the time off. Losing employment can lead to a loss of health insurance, creating a devastating cycle.

“The medical system is broken and the insurance system is broken,” said Coan. “You pay for insurance out of your pocket and then you have to meet a huge deductible … so that’s out of pocket. And then you have co-pays and then there are things that aren’t covered.” 

Some nonprofit organizations actually offer relief, but it is limited. 

“For some of the cancers, like the blood cancers, which are the leukemias, lymphomas and myeloma, the National Leukemia and Lymphoma Society has a very generous financial aid [program], so they can help pay doctor bills, but they can also buy you a new washer dryer if yours breaks or make a mortgage payment if you have to skip,” Coan said. “For breast cancer, there’s about six different ones, but there are plenty of cancers that don’t have that … and people really struggle. People end up on food stamps. People end up having utilities shut off.” 

In Cleveland, MetroHealth has accepted patients regardless of insurance status. With a network of over 20 community-based locations, 97% of Cuyahoga County’s residents live within a 10-minute drive of a facility. 

However, according to a MetroHealth press release, the system has had to make strategic decisions to stay sustainable due to “financial pressures affecting the healthcare industry.” 

Effective October 3, 2025, MetroHealth closed six outpatient sites as part of its budget stabilization strategy. According to reporting by Cleveland.com , these closings are a result of losses caused by a doubling of uncompensated care costs since 2022 and a predicted rise of 11.8 million underinsured Americans due to federal Medicaid cuts. 

Many of the staff and services are being moved to larger, central locations. Additionally, MetroHealth experienced a $50 million operating loss in 2024. And, its expenditures on charity care exceed $1 million per day. However, the hospital system is exploring more efficient strategies to continue its mission and remain accessible.

The financial challenge goes beyond medical bills. There are many factors that can exacerbate these burdens. 

“It’s not typically the financial issues of the treatments, but it’s more the coordination of care,” Saltzman said. “So, getting back and forth to the clinic, having someone to take care of their kids, or losing their job and then losing their health insurance.”

After experiencing these hardships firsthand, many patients become motivated to make a difference in the community. 

“Sometimes when the cancer patient is maybe well past [their cancer journey], they feel better and they wonder, ‘okay, what can I do?’” said Coan. “Sometimes they become legal advocates. They become government and policy advocates, talking at both at the state level and at the national level.”

Clearly, cancer requires a lot of adjustment and perseverance through considerable hardships, fears and anxieties, and it isn’t a disease that will go away overnight. 

“It’s just about building that inner strength and courage and the endurance, which comes because each day is new, and each treatment would have [its] side effects,” said the anonymous patient mentioned above. “I think you just need to go on. And this is life… cancer or no cancer.”