March 9, 2026 – Nearly half of patients receiving ambulatory cancer care experience a significant economic burden, often referred to as “financial toxicity,” which strains budgets, psychological resources, and impacts patients’ inner resilience, according to a new study in JAMA Network Open.

Conducted by a team of researchers including Professor Benjamin Corn of the Hebrew University of Jerusalem (HU) Department of Oncology in the Faculty of Medicine, the study found that the economic burden of cancer care quietly erodes two of the most important psychological resources patients rely on during treatment: hope and social support. As those weaken, overall life satisfaction declines, so protecting patients’ hope and sense of connection may be just as critical as covering their bills.

Using the Hope Theory, which defines hope as the ability to set meaningful goals and identify pathways and motivation to achieve them, the researchers examined how economic strain affects patients’ internal coping systems.

The study of 519 patients found that financial toxicity acts as a barrier to hope itself, including out-of-pocket medical expenses, lost income, debt accumulation, and persistent financial stress. As financial strain increases, patients report lower levels of hopefulness and weaker perceived social support. These two factors function as critical mediators: when they diminish, satisfaction with life drops significantly.

Most current interventions focus on practical solutions such as connecting patients with charities, optimizing insurance coverage, or arranging payment plans. These services are essential. But the study suggests they are insufficient on their own.

According to the corresponding author, Prof. David B. Feldman, Department of Counseling Psychology, Santa Clara University, “Our findings suggest that the sometimes enormous financial strain involved in cancer treatment does not just affect bank accounts; it can affect people’s hope. And when hope erodes, so does overall satisfaction with life. That means that providing people with financial support as well as support to nurture hope is not just something that is ‘nice to have,’ it may be a key part of helping many people live better during treatment.”

The research points toward a broader model of care, one that integrates financial support with structured interventions designed to strengthen psychological resilience and social connectedness.

The researchers conclude that psychosocial resilience should be treated as a primary clinical target and not a secondary consideration. Combining financial assistance with interventions that strengthen hope and social support may help protect patients from the deeper psychological toll of high-cost care. Cancer treatment is increasingly sophisticated. This study suggests that comprehensive care has to also be provided. It must address not only the disease, but the financial and psychological pressures that accompany it.

The research paper titled “Financial Toxicity, Hope, and Satisfaction With Life in Patients Receiving Ambulatory Cancer Care” published in Jama Network and can be accessed here.

Researchers:

Grace L. Smith, MD, PhD, MPH1,2; David B. Feldman, PhD3,4; Hilary Ma, MD5; Christina Checka, MD6; Michael E. Roth, MD7; James C. Tucker, MD8; Cynthia Anderson, MD9; Marin Xavier, MD10; Jodi Kagihara, MD11; Ethan B. Ludmir, MD1,12; Chi-Fang Wu, PhD14; Edna Paredes, MBA13; Kathrin Milbury, PhD15; Benjamin W. Corn, MD16

Institutions:

  1. Department of GI Radiation Oncology, MD Anderson Cancer Center, Houston, Texas
  2. Department of Health Services Research, MD Anderson Cancer Center, Houston, Texas
  3. Department of Counseling Psychology, Santa Clara University, Santa Clara, California
  4. Faculty of Psychology, Chulalongkorn University, Bangkok, Thailand
  5. Department of General Medical Oncology, MD Anderson Cancer Center, Houston, Texas
  6. Department of Breast Surgical Oncology, MD Anderson Cancer Center, Houston, Texas
  7. Department of Pediatrics, MD Anderson Cancer Center, Houston, Texas
  8. Lewis and Faye Cancer Center at DCH Regional Medical Center, Tuscaloosa, Alabama
  9. Baptist MD Anderson Cancer Center, Jacksonville, Florida
  10. Scripps Cancer Center, San Diego, California
  11. The Queen’s Medical Center, Honolulu, Hawaii
  12. Department of Biostatistics, MD Anderson Cancer Center, Houston, Texas
  13. Division of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas
  14. Health Services Research, MD Anderson Cancer Center, Houston, Texas
  15. Behavioral Science, MD Anderson Cancer Center, Houston, Texas
  16. Department of Oncology, Hebrew University Faculty of Medicine, Jerusalem, Israel