Social and Legal Needs in Patients and Families With Cancer: Interaction With Patient-Level Financial Toxicity.

Abstract

Adverse financial burden and its effect on patients resulting from the costs associated with cancer care, both direct and indirect, is known as financial toxicity. This review explores the interplay between financial toxicity and key social and legal needs in cancer care. Drawing from the WHO's framework and the ASCO's policy statement on social determinants of health, we propose a conceptual model that discusses five key needs-housing insecurity, food insecurity, transportation and access barriers, employment disruptions, and psychosocial needs-which interact with, and are affected by financial toxicity, and adversely influence patients' well-being and adherence to treatment. We review literature addressing the scope of each of these key needs, their effect on patients with cancer, and how each increases the overall burden of cancer treatment. There is an emphasis on both the patient and the caregiver as one unit navigating through cancer treatment together. The aim is to guide interventions at the patient-provider, institutional, and policy levels that alleviate financial toxicity and improve overall care delivery for patients and caregivers by addressing underappreciated social and legal needs.