Supportive Care in Cancer

, Volume 26, Issue 4, pp 1315–1321 | Cite as

Oncology navigators’ perceptions of cancer-related financial burden and financial assistance resources

  • Jennifer C. SpencerEmail author
  • Cleo A. Samuel
  • Donald L. Rosenstein
  • Katherine E. Reeder-Hayes
  • Michelle L. Manning
  • Jean B. Sellers
  • Stephanie B. Wheeler
Original Article



As the cost of cancer treatment continues to rise, many patients are faced with significant emotional and financial burden. Oncology navigators guide patients through many aspects of care and therefore may be especially aware of patients’ financial distress. Our objective was to explore navigators’ perception of their patients’ financial burden and their role in addressing financial needs.

Materials and methods

We conducted a real-time online survey of attendees at an oncology navigators’ association conference. Participants included lay navigators, oncology nurse navigators, community health workers, and social workers. Questions assessed perceived burden in their patient population and their role in helping navigate patients through financial resources. Answers to open-ended questions are reported using identified themes.


Seventy-eight respondents participated in the survey, reporting that on average 75% of their patients experienced some degree of financial toxicity related to their cancer. Only 45% of navigators felt the majority of these patients were able to get some financial assistance, most often through assistance with medical costs (73%), subsidized insurance (36%), or non-medical expenses (31%). Commonly identified barriers for patients obtaining assistance included lack of resources (50%), lack of knowledge about resources (46%), and complex/duplicative paperwork (20%).


Oncology navigators reported a high burden of financial toxicity among their patients but insufficient knowledge or resources to address this need. This study underscores the importance of improved training and coordination for addressing financial burden, and the need to address community and system-level barriers.


Oncology navigator Financial assistance Financial toxicity 


Funding Information

Funding for this project was provided through the National Comprehensive Cancer Network and Pfizer Independent Grants for Learning & Change (PI: Wheeler and Rosenstein). Ms. Sellers reports payment as a consultant with Pfizer which was unrelated to the submitted work.

Compliance with ethical standards

Conflict of interest

None of the above authors have any conflicts of interest to disclose, beyond receiving independent grant funding from Pfizer. Informed consent was obtained from all individual participants included in the study. Results of this study have not been published or presented previously.

Human subjects

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2017

Authors and Affiliations

  1. 1.Department of Health Policy and ManagementGillings School of Global Public Health, University of North Carolina at Chapel HillChapel HillUSA
  2. 2.Lineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel HillChapel HillUSA

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