Anticipatory Guidance: Developing a Patient Navigation Pathway to Reduce the Financial Toxicity of Cancer

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Christabel K. Cheung, PhD, MSW Laundette Jones, PhD, MPH Haelim Lee, MSW Jordan N. Bridges, BSc Reginald Tucker-Seeley, MA, ScM, ScD Melissa Ana Liriano Vyfhuis, MD, PhD Maria C. Gianelle, BS Bria N. Thomas, MBS Gail Betz, MLIS Laurie Waldo, MSW, LCSW-C Alan S. Hirsch, LCSW-C Shana O. Ntiri, MD, MPH


Background: Healthcare providers have an influential role in the experience of financial toxicity among their cancer patients, yet patients commonly report unmet needs and dissatisfaction regarding communication with their providers about financial concerns.

Aims: The purpose of this study is to develop a novel financial navigation pathway that leverages existing patient financial services and resources with corresponding patient-centered, community-informed strategies, via study participants, that may be utilized in routine care to reduce financial hardship among cancer patients.

Methods: We conducted in-depth interviews (n=50) with 34 cancer patients and 16 cancer care professionals at a National Cancer Institute designated comprehensive cancer center located in a dense urban area of the US between December 2022 to June 2023.

Results: Content analyses resulted in emergent themes and representative quotations on experiences of financial hardship within the material, behavioral, and psychosocial domains. Investigators used emergent themes to develop financial strategies and construct a financial navigation pathway to screen patients for and intervene upon the financial toxicity of cancer in routine care.

Conclusion: This study followed an innovative approach by constructing a financial navigation pathway tool that follows the oncological workflow at a National Cancer Institute designated comprehensive cancer center. Future research is needed to test the tool’s impact on financial toxicity, cancer outcomes, and other health-related outcomes, and to better understand how much patient navigation is needed to bring about meaningful change.

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CHEUNG, PHD, MSW, Christabel K. et al. Anticipatory Guidance: Developing a Patient Navigation Pathway to Reduce the Financial Toxicity of Cancer. Medical Research Archives, [S.l.], v. 11, n. 10, oct. 2023. ISSN 2375-1924. Available at: <>. Date accessed: 11 dec. 2023. doi:
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