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A burden shared: the financial, psychological, and health-related consequences borne by family members and caregivers of people with cancer in India

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Abstract

In India, approximately 1.4 million new cases of cancer are recorded annually, with 26.7 million people living with cancer in 2021. Providing care for family members with cancer impacts caregivers’ health and financial resources. Effects on caregivers’ health and financial resources, understood as family and caregiver “financial toxicity” of cancer, are important to explore in the Indian context, where family members often serve as caregivers, in light of cultural attitudes towards family. This is reinforced by other structural issues such as grave disparities in socioeconomic status, barriers in access to care, and limited access to supportive care services for many patients. Effects on family caregivers’ financial resources are particularly prevalent in India given the increased dependency on out-of-pocket financing for healthcare, disparate access to insurance coverage, and limitations in public expenditure on healthcare. In this paper, we explore family and caregiver financial toxicity of cancer in the Indian context, highlighting the multiple psychosocial aspects through which these factors may play out. We suggest steps forward, including future directions in (1) health services research, (2) community-level interventions, and (3) policy changes. We underscore that multidisciplinary and multi-sectoral efforts are needed to study and address family and caregiver financial toxicity in India.

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Author information

Authors and Affiliations

  1. Department of Medicine, University of Cambridge, Cambridge, UK

    Sruthi Ranganathan

  2. Rise To Survive Cancer, New Delhi, India

    Vivek Tomar

  3. Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Fumiko Chino & Edward Christopher Dee

  4. Department of Radiation Oncology and Affordability Working Group, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Fumiko Chino

  5. Massachusetts Institute of Technology, Cambridge, MA, USA

    Bhav Jain

  6. University of Pennsylvania, Philadelphia, PA, USA

    Tej A. Patel

  7. Department of Oncology, MOSC Medical College, Ernakulam, Kerala, 682311, India

    Aju Mathew

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  1. Sruthi Ranganathan
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SR and ECD wrote the first draft of the manuscript. VT, FC, TP, BJ, and AM edited and reviewed the manuscript. All authors reviewed and accepted the final version of the manuscript.

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Correspondence to Edward Christopher Dee.

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ECD and FC are funded in part through the Cancer Center Support Grant from the National Cancer Institute (P30 CA008748). VT is a member of the IASLC, a member of the National Cancer Grid, India, and an Honorary Advisor as patient advocate for Novartis and Roche.

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Ranganathan, S., Tomar, V., Chino, F. et al. A burden shared: the financial, psychological, and health-related consequences borne by family members and caregivers of people with cancer in India. Support Care Cancer 31, 420 (2023). https://doi.org/10.1007/s00520-023-07886-1

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