When receiving a cancer diagnosis, many people’s first instinct is to pull out their insurance policies to check if the coverage is enough for expensive targeted drugs or chemotherapy. If the coverage seems sufficient, they usually breathe a sigh of relief, thinking the financial alarm has been defused. But in reality, that’s only the first page of the cancer bill.
According to international research on the definition of “Financial Toxicity,” the financial impact of cancer comes not only from direct medical costs, but also includes transportation and travel costs, income loss due to work interruption or reduced working hours, and non-medical expenditures such as care support costs—these indirect costs are severely underestimated in most research and are often the main cause that drains family cash flow [1]. A survey by the American Cancer Society also pointed out that as many as three-quarters of cancer patients worry about being unable to simultaneously pay for cancer treatment and daily living expenses [2].
Breaking Down the Three Hidden Costs: Where Does the Money Go?
Although the individual amounts of these hidden expenditures may not be as alarming as out-of-pocket drug costs, because they are “persistent” daily expenses, they accumulate into a significant amount:
Nutritional Supplement Costs: You Need to Eat to Have the Strength to Fight
During treatment, patients often experience appetite loss or oral ulcers due to side effects. To maintain white blood cell count and body weight, regular home-cooked meals are often insufficient, requiring high-density special nutritional supplements, high-protein powders, or purchasing quality easy-to-chew foods. The Taiwan Cancer Foundation noted that for oral cancer patients, for example, the daily cost of special nutritional supplements for tube feeding far exceeds typical daily food expenditures; and the salary shortfall from stopping employment combined with purchasing nutritional supplements represents the dual financial pressure most commonly faced by young cancer patients [3].
Loss of Earning Capacity: An Invisible Double Income Gap
This is the most commonly overlooked hidden black hole. Due to physical weakness or frequent clinic visits, patients typically need to apply for unpaid leave; while caregivers nearby (spouses or children) often must also take leave to accompany them. Research commissioned by the Ministry of Labor shows that the annual resignation or unemployment rate of Taiwan’s cancer-diagnosed workers after diagnosis reaches approximately 14%, far higher than the general unemployment rate of 4% for all workers; only 51% of those diagnosed with cancer remain employed by the fifth year after diagnosis [4]. A study targeting Chinese caregivers also found that 45.6% of primary family caregivers reduced working hours during the active treatment phase, and 17.4% even completely stopped working [5]. This “one person gets sick, two people stop working” situation can instantly slash family income in half, doubling the pressure of daily life.
Transportation and Care Costs: Necessary Expenses for Safety
During chemotherapy, patients’ immunity is extremely low. To avoid exposure to infections on public transportation, trips to medical centers typically require taxis; when family members cannot take leave, professional hospital attendants must be temporarily hired. According to current market rates in Taiwan, the daily 24-hour cost of a Taiwanese caregiver ranges from approximately NT$2,700 to NT$4,800 [6]. These scattered transportation and care costs add up to a considerable amount over time.
The Solution: Build Your Own “Emergency Medical Reserve Fund”
Since hidden expenses are unavoidable, how do we prepare for them? The answer is to establish a dedicated “emergency medical reserve fund.”
General financial advice teaches people to prepare 3 to 6 months of “living expenses” in case of unemployment. But for serious illnesses, the standard for this reserve fund must be raised.
How to calculate? Based on the family’s monthly “basic living costs + estimated nutrition/transportation expenses,” prepare at least 6 months’ worth. For example, if the family’s monthly basic expenses are NT$50,000, plus anti-cancer additional expenses of NT$15,000, multiplied by 6 months, you should have an additional NT$390,000 in cash savings for your family.
Dedicated purpose: This money should be separate from regular investment accounts or daily expense accounts. It is like a fire extinguisher at home—not to be touched under normal circumstances, but once treatment begins, this money ensures that during the first six months, you won’t be worrying about where the next meal or transportation money will come from.
Conclusion: Stabilize Your Heart, First Stabilize Your Finances
Facing cancer requires tremendous courage, and a large part of that courage is built on “stable real-life conditions.”
Don’t let these hidden expenses become the last straw that breaks the camel’s back. While healthy now, review the reserve funds in your accounts; if you’re already in the middle of treatment, feel free to use digital budgeting tools to clarify monthly cash flow. When you turn the invisible black holes into a clear spreadsheet, the sense of fear will diminish, and you can devote more energy to the road of recovery.
【Expert Reminder】
If the family’s cash flow is truly tight, courageously seek outside help. The Cancer Hope Foundation provides multiple services including emergency assistance funds, nutritional product subsidies, medical transportation subsidies, and caregiver support; the Taiwan Cancer Foundation also has emergency relief programs for cancer patients, accessible through referrals by social workers at cooperating hospitals [7]. These resources all exist to support you through difficult times.
References
Lethborg C, et al. The Out-of-Pocket Cost Burden of Cancer Care — A Systematic Literature Review. Current Oncology. 2021. PMC8025828.
American Cancer Society. Financial Hardship — Cost of Cancer.
台灣癌症基金會。罹癌後，哪些社會資源可以幫我？
勞動部。職場罹癌勞工就業促進及勞動力提升研究。 全民勞教e網。
Liu S, Su M, Yao N, Zhang N, Wang J, Anderson RT, Sun X. Employment changes among Chinese family caregivers of long-term cancer survivors. BMC Public Health. 2020;20(1):1755. doi: 10.1186/s12889-020-09922-9. PMC7690119.
Home心線上照護媒合平台。2024 看護費用一天多少錢？最新看護費用與行情。 2023年9月10日
癌症希望基金會。資源補助 — 急難救助金、營養品補助、就醫交通、照顧人力。