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Cancer Care Chronicles
December 7, 2017

My Unfortunate Introduction Into the Financial Toxicity of Cancer Care in America—March Forth

Author Affiliations
  • 1Department of Radiation Oncology, Duke University, Durham, North Carolina
JAMA Oncol. Published online December 7, 2017. doi:10.1001/jamaoncol.2017.4436

March fourth. It wasn’t just a date, but a command. Maybe it’s cliché, but in my own defense, “march forth” chose me.

My husband was diagnosed at age 27 as having aggressive neuroendocrine cancer. Fourteen months, 27 kg, and 3 hospitalizations later, Andrew died. On March 4, 2007, the life we had planned together—my art career, his work as an innovative computer scientist, the children we hoped to raise—was over before it had really even begun.

Andrew had graduate student health insurance when he learned 2 fateful diagnoses: (1) his months of vomiting and weight loss were due to a fast-spreading tumor and (2) he was grossly underinsured. Our subsequent struggle through the health care system highlighted dangerous holes in his coverage and left me realizing that many Americans are 1 diagnosis away from catastrophe. Even with health insurance, the high costs of cancer care are leaving some vulnerable American families adrift in debt.

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