Cancer doesn't discriminate, as the saying goes. It can devastate anyone, regardless of ethnicity, age, political persuasion, religion or financial situation. As anyone shocked by the death of Steve Jobs in 2011 realized, cancer doesn't care if you're one of the wealthiest people on the planet.
But being broke adds a new, troubling challenge for those diagnosed with the disease.
Even if you have health insurance to pay for your treatment, you may not be in the position to take off work to focus on fighting your disease. You may not be able to travel to a particular hospital or clinic that specializes in the form of cancer you have. Even if you're insured, copays on medicine may drain your bank account.
"A diagnosis of cancer has so many stresses associated with it -- the physical challenges, the emotional aspect as well -- but I think the financial aspect of stress is often overlooked, and a lot of providers don't know how to help with that and don't bring it up," says Alyssa Rieber, chief of medical oncology at the Lyndon B. Johnson Hospital Oncology Service in Houston, which treats one of the largest uninsured populations in the country. Rieber has seen it all.
"We're in a big crisis in the cost of cancer treatment, and there is no way this is sustainable," she says.
So if you are financially challenged and have been diagnosed with cancer -- or know someone in that situation -- don't give up. Here's an action plan.
Research. There may be more resources out there than you realize, and the worst thing you can do is not look for them. Rieber says she felt especially bad for a cancer victim last year who was in her early 40s.
"She didn't have insurance and was working, and then stopped working because she became ill. She was diagnosed with lung cancer in March of 2013, and she wanted to wait until she had insurance to get access to care, but she never did get insurance because she was too weak to work," Rieber says.
Months later, the woman learned about the LBJ Hospital Oncology Service, which was practically in her backyard. She established eligibility in November but wasn't treated by Rieber or her staff. She wound up in hospice care and died soon after.
So if you have cancer but aren't insured yet, or you are insured but still need financial assistance, don't assume there isn't help -- and don't wait until your financial picture clears up to look for it.
"Some diagnoses you can get away with not treating for a while, but that doesn't work with cancer," Rieber says.
You might be surprised by what resources are available, says Stacey Huber, an American Cancer Society patient resource navigator at Mercy Medical Center in Baltimore.
Among Huber's favorite nonprofits that help cancer patients is CancerCare, an organization that has been providing free counseling and support groups since 1944 to people over the phone, online and in person -- and one of the major points of discussion is the financial challenges of cancer.
Huber also likes Cleaning for a Reason, a national nonprofit that assists women with cancer by cleaning their houses for free. She adds that the American Cancer Society may have free wigs for cancer patients and says its Road to Recovery group assists patients with rides to treatments. The Leukemia and Lymphoma Society offers copay assistance programs and local grants that may help with living expenses.
And, of course, if you have a child with cancer, St. Jude Children's Research Hospital offers all of its services for free.
If you need financial help and don't know what to do, you should discuss this with someone at your local health department who will know what resources are in your area and state, Huber says.
"Each state has different programs and funding that may be able to provide assistance," Huber says. "Here in Maryland, we have a program for breast and cervical cancer patients. If the patient meets the criteria, they may be eligible for coverage for treatment, scans and prescriptions relating to their breast or cervical cancer needs."
If nothing else, call 877-336-7287, the number for the Patrick Dempsey Center for Cancer Hope & Healing in Lewiston, Maine. Anyone in any location can call, says Mary Dempsey, the center's assistant director and sister of the star of the ABC series "Grey's Anatomy." The center, founded in 2008, was inspired by Dempsey's mother, Amanda, who has a rare form of ovarian cancer. It provides free support, education and integrative medicine to anyone affected by cancer.
You may live nowhere near Maine, but if you don't know what services are in your area, Mary Dempsey says a financial counselor at the Dempsey Center may be able to guide you to a service or organization in your area.
Gather your paperwork. Getting financial assistance to help you fight cancer is, unfortunately, like buying a house or car or applying for a loan. You'll need to prove that your finances are what you say they are, which means gathering paycheck stubs, tax documentation and anything else relating to your income. You'll also likely need written documentation of your cancer diagnosis.
If you're truly hurting financially and know that you're going to need to step away from your job, Huber says, "I recommend people who get diagnosed with cancer go to their local social service department and apply for medical assistance, food stamps and temporary disability. This can be a long and challenging process, and sometimes patients are not eligible for these services."
Tell everyone in a position to help that you're in need. Nobody is saying you have to beg for money on Facebook or set up a crowdfunding page for donations, although those are valid options that many people understandably take. But certainly talk to people who are in a position to help you, like your patient navigator at the hospital or its social worker, Huber suggests.
"Each person and case is different, so the navigator or social worker can work on an individual basis with the patient to let them know what may be available to them," she says.
Huber also suggests checking with the pharmaceutical company that makes your medication to see if it has a copay assistance program. She likes the website needymeds.org, a nonprofit that helps people find local programs that may provide financial assistance for their medications.
Look for grants. They're out there. Cancer.net has a financial assistance page that will lead people to grants. CancerCare also offers financial assistance, and managecancer.org has links to resources that offer financial help.
It isn't your imagination. It is harder if you're in the middle class. If you have been diagnosed with cancer and are firmly entrenched in the middle class, you should know that you may have to do more research and talk to more people than you'd ever imagine. That's because there are more programs that help those at the bottom of the financial ladder than those in the middle. Even with insurance, middle-class patients may believe they have to go bankrupt to qualify for the programs out there.
That isn't quite true, however -- or it doesn't need to be. "There are resources and ways to receive cancer care for people who are struggling financially -- even for the middle class," Rieber says. "But it is hard to find them."
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