Do cancer patients get enough time off work? Most struggle to balance finances, job duties

Working adults often face a second major worry when they're living with a life-threatening cancer diagnosis ‒ financial hardship.

A new study reports nearly 3 in 5 working-age adults with cancer face at least one financial challenge, including taking unpaid leave or losing a job or health insurance, according to an American Cancer Society study published Tuesday.

These financial problems can make it difficult to pay for costly cancer care, delay treatment or create stress and worry, all factors that can weigh on an individual's health, experts said. The study also found that working adults often miss out on federally available medical leave.

"The high costs of cancer care are well documented," said Robin Yabroff, the American Cancer Society's scientific vice president of health services research. "Less attention is paid to financial hardship that patients can experience if they have to take time away from work without pay."

The study said 57% of people diagnosed with cancer had some financial hardship within the past year, compared with 53% of those without cancer. Cancer patients were nearly twice as likely to have a problem paying a medical bill compared with non-cancer patients. They also were more likely than non-cancer patients to delay or skip care due to costs, the study said.

Researchers focused on working-age adults between 18 and 64 who were not yet eligible for Medicare, the federal government's health program mainly for adults 65 and older. These working-age adults are far more likely to get health insurance through an employer, and these plans often include high deductibles, coinsurance or other cost-sharing features. Medical bills can quickly add up for cancer patients whose treatment costs for themselves and their insurer typically far exceed $100,000.

A bigger challenge can surface when people can no longer work full-time and are no longer eligible for their employer's health insurance. The study said health insurance status is one of the "strongest correlates" of financial hardship among cancer patients. Nearly 84% of working-age cancer patients who were uninsured reported some type of financial hardship.

How do people navigate the workplace with a cancer diagnosis?

Nearly half of adults with a cancer history could no longer work the same hours after their diagnosis. Many took an extended leave from work or adjusted their schedules, roles or career trajectory, including converting to part-time work, the study said.

Cancer patients who worked for employers that don't allow workplace accommodations such as flexible schedules or remote work were less likely to keep a job during cancer treatment, the study said.

About 40% of working adults with a cancer history didn't get paid sick leave from an employer. That was especially true for cancer survivors under 40 who earned lower incomes, the study said.

Do cancer patients get enough time off work?

For cancer survivors whose work gave them paid time off, the time was often not sufficient for them to get to appointments and complete administrative tasks.

People spent a great deal of time traveling to and from appointments and consulting doctors. Additional time off was needed for working cancer patients to get hospital care, undergo surgery or visit specialists such as radiation oncologists.

Newly diagnosed patients and cancer survivors also spent considerable time on administrative tasks – obtaining approvals from health insurance or contesting inflated medical bills or billing errors.

The Family and Medical Leave Act grants eligible employees with a serious health condition up to 12 weeks of unpaid leave. Employees are eligible if they work for an employer with at least 50 employees and live within 75 miles of work. However, the study said about half of adults with a cancer history were employed by small businesses that didn't have to comply with the federal leave law.

American Cancer Society representatives said the study's findings underscore the importance of family leave for working-age adults with a cancer history. Officials also urged Congress to create permanent health insurance subsidies for Affordable Care Act plans, extending subsidies that became more generous at the height of the COVID-19 pandemic, to give cancer patients an affordable health insurance alternative to employer plans.

"No one should be forced to choose between their treatment and their employment," said Lisa Lacasse, president of the American Cancer Society Cancer Action Network. "To truly protect patients from the high costs of cancer, Congress must enact paid family and medical leave."

Ken Alltucker is on X at @kalltucker, contact him by email at

This article originally appeared on USA TODAY: High costs of cancer: Survivors struggle with job demands, finances