The physical, emotional and psychological impact of a cancer diagnosis is devastating enough, but in many situations the disease also inflicts a financial wallop upon its victims. When I was told that I had uterine and ovarian cancer, I was paralyzed with fear and in a state of denial. But soon literally hundreds of details raced through my mind.  As a single, self-employed woman one of my immediate concerns involved my finances and whether I was going to be able to continue working as a freelance journalist. “Oh shit,” I thought. “How many months will I be out of action?”

In their book, Picking Up the Pieces, authors Sherri Magee and Kathy Scalzo describe the types of loss that cancer involves and the damage that it can inflict on our lives. “While we expect to grieve the loss of a loved one, we are unprepared for—even shocked by—the magnitude of loss that comes with a life-threatening illness,” they write. Magee and Scalzo make it clear that the most recognizable form of loss is physical, but they go on to discuss the fact that many cancer patients also experience a loss of income or savings or even the loss of their job.

The financial burden for Canadian cancer survivors is significant. As one might assume there is declining income due to lost wages, EI limits, and gaps in government safety nets. Less obvious are extra costs such as medication, chemotherapy expenses, childcare, travel costs and homecare. These can all become part of the equation when you are dealing with a cancer diagnosis, treatment and survivorship. While everyone’s financial and employment situation will be somewhat unique, there are common elements. For example, within the Canadian context lost income usually has a larger effect than out-of-pocket costs for those battling cancer. Certainly, this has been my personal experience and the experience of most other people I know of.

My freelance business was essentially inactive for approximately one year while I was forced to undergo several major abdominal surgeries and five cycles of chemotherapy. Today, my cancer is in remission and I’ve begun to work again, however understandably I’m no longer able to accept the number of assignments that I used to or handle as many clients. Ultimately family members and government assistance have been keeping me afloat for the past two years. I’ve learned that situations such as mine are prevalent, a study of national wage loss from cancer showed that 91 per cent of households suffer a loss of income or rise in expenses as a direct result of a cancer diagnosis. For some, these pressures become a “perfect storm” and lead to serious financial distress—hardship so severe that some families never recover.

In 2010, the Manitoba division of the Canadian Cancer Society and the Canadian Cancer Action Network coauthored a report focusing on the financial hardship of cancer in Canada. The report titled The Financial Hardship of Cancer: A Call for Action concludes that a lack of awareness and a false sense of security have left Canadians unprepared to deal with these challenges. We are ill-equipped both as individuals and as a society. Most Canadians don’t know that a cancer diagnosis has caused some people to declare bankruptcy, lose their homes, lose all of their savings, make less than optimal treatment decisions or become dependent on taxpayer-funded programs for the rest of their lives. Until cancer comes into their own lives, they believe the myth that all health care is free. Most never imagined that they could face such difficult challenges at such a vulnerable time of their lives. The reality comes as a shock to many.

For me, reading The Financial Hardship of Cancer simply confirmed many of the facts that I’ve already learned through bitter experience. For example, those hit hardest financially are people with low income and/or no disability insurance—a group that includes a higher proportion of seasonal, part-time or self-employed workers. Regrettably, I consider myself a member of this most vulnerable demographic. Amid all the bad news, however, I did find a glimmer of hope or a reason for cautious optimism. The authors of the report emphasize that there are many opportunities to reduce the possibility of severe income loss following a cancer diagnosis, primarily through improvements to the social safety net.

Above all, the report strongly recommends that programs be aligned with today’s cancer journey. The authors argue that certain federal safety net programs are increasingly unable to meet the needs of cancer patients. For example, some rules are out of step with the increasing survival rate following a cancer diagnosis, and today’s dynamic economy, where job displacement and career interruptions are more common. Obviously such limitations only prevent support programs from fulfilling their ultimate mandate, which is to carry people through difficult times so they can become financially independent in the long term. Modernizing many aspects of the system would not only be extraordinarily beneficial to cancer patients, it could potentially save Canadian taxpayer dollars over time.