A recent study highlights the financial challenges faced by families with children undergoing treatment for acute lymphoblastic leukemia (ALL), the most prevalent form of pediatric cancer. Conducted by researchers at the Cancer Center at Children’s Hospital of Philadelphia, the study reveals that nearly a third of these families encounter significant financial hardships during their child’s chemotherapy treatment.
According to Dr. Daniel Zheng, the first author and an attending oncologist at the hospital, this research is groundbreaking in pediatric oncology. It specifically examines the financial impact of cancer treatment by assessing household material hardship and income loss over time. “Many families reported experiencing financial difficulties as early as six months into treatment,” Dr. Zheng stated.
The study involved 422 families whose children were enrolled in clinical trials for previously untreated ALL from 2017 to 2021 across eight medical centers in the U.S. and Canada. Participants were asked to complete surveys at four intervals during treatment, focusing on household income and the ability to cover essential living expenses.
At the six-month mark, the findings showed that 19.3% of families struggled with basic costs, while 20.3% reported a loss of 25% or more of their annual income. By the end of the 24-month chemotherapy period, 30% of families faced difficulties meeting living expenses, and 31.5% had lost a quarter or more of their income. Alarmingly, 24.3% of families who initially reported no financial issues developed hardships later in treatment.
The study’s participants included a diverse demographic, with 15% identifying as Hispanic and 7% as non-Hispanic Black. Notably, 40% of families had an annual income below 200% of the federal poverty level. These figures suggest that children from certain backgrounds, including those in single-parent households or relying on public insurance, are particularly vulnerable to new financial difficulties during treatment.
“We wanted to understand the nature and extent of the financial hardship that treatment for childhood cancer creates for families so that we can better support them during this journey,” Dr. Zheng explained. The study’s primary focus was on “financial toxicity,” which refers to the emergence of new financial challenges, such as the inability to pay for housing, food, or utilities.
Dr. Zheng emphasized the importance of addressing these financial strains, noting, “It was striking to us that by 24 months, nearly a third of the families were unable to meet basic living costs at some point during their child’s ALL treatment.”
The research also acknowledges its limitations. It primarily reflects the experiences of families participating in a clinical trial at centers in the northeastern U.S. and Canada. “Our data may underestimate the overall level of financial toxicity experienced by families with children being treated for ALL,” Dr. Zheng cautioned.
Ongoing research aims to identify effective interventions to mitigate financial toxicity for families of children undergoing cancer treatment. For instance, Dr. Puja Umaretiya and Dr. Kira Bona are leading clinical trials exploring whether benefits counseling and cash payments can alleviate financial hardships among low-income families.
Dr. Zheng will present this significant study on December 7, 2025, at 16:45 Eastern time in W230 of the Orange County Convention Center, highlighting the critical need for support systems for families navigating the complexities of childhood cancer treatment.
