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Everyday Support

Dear Iris: Bills, Bills, Bills

Dear Iris,

I recently started treatment and there’s a lot on my plate, both physically and mentally. Last week I received several bills that were much higher than I anticipated. I’m starting to get worried about how I’m going to take care of my family and keep up with — what seems like — an endless stream of medical bills.


Dear H,

It’s natural to feel overwhelmed by the financial aspect of cancer treatment. Many people with cancer face financial concerns related to changes in income while on treatment and a potential increase in medical-based expenses.

First, I want to reassure you that there are a number of possible resources available to you. These could be available at your medical center, through local and national organizations supporting cancer patients, or through federal programs.

What you qualify for will vary based on your location, income, and diagnosis. Because of the variation in what’s available, I’ve done some research to help you get started. Here are my top tips:   

  • Get organized: Getting organized can help you feel a greater sense of control over your cancer experience as well as minimize feelings of anxiety or distress. An organizational system such as a monthly household budget that includes information about direct medical expenses (i.e., medication co-pays, hospital bills) and expenses related to treatment (i.e., food, transportation, temporary lodging) can help you map out how your money is being spent towards cancer treatment and what questions/needs you may have. Here’s an excellent checklist for this activity: Checklist to Avoid Financial Toxicity (

  • Talk with your medical team: Ask your medical team if there is someone at your treating facility, such as a social worker, patient advocate, or financial counselor, who you can talk with about the financial aspects of treatment. Ask for a list of cancer support organizations that may provide financial assistance for your specific cancer diagnosis/treatment. You may also be able to ask them about additional ways to cut cancer-related costs, such as getting pharmacy discount cards or generic medications.

  • Contact your billing department. You may be able to make your medical bills feel more manageable by speaking with the billing department of your oncology clinic. Ask about a financial assistance application and/or if you can establish a payment plan for medical bills. Even small, consistent payments towards your medical bills can help avoid bills going to collections. Review medical bills for any inaccuracies that may end up costing you more money than you owe.

It sounds like you have a lot going on right now. I hope that these resources will help you feel more prepared and less stressed about the changes you’re facing.

Have a question? 

Loreal Massiah, MSW, LCSW, OSW-C, TTS

Senior Oncology Social Worker

Iris Oncology

Loreal Massiah is a licensed clinical social worker with 14 years of oncology experience focused on supporting patients and their families throughout the cancer journey. She has a certification in oncology social work as well as tobacco cessation counseling. Loreal has had the pleasure of working alongside cancer survivors in advocacy roles to promote change in access to affordable treatment throughout the country; she has extensive experience working in cancer survivorship and caregiver support; she also has a special interest in health equity, diversity, and inclusion in medical care.

This article meets Iris standards for medical accuracy. It has been fact-checked by the Iris Clinical Editorial Board, our team of oncology experts who ensure that the content is evidence based and up to date. The Iris Clinical Editorial Board includes board-certified oncologists and pharmacists, psychologists, advanced practice providers, licensed clinical social workers, oncology-certified nurses, and dietitians.