The impact of language barriers on financial toxicity for Spanish-speaking patients undergoing cancer treatment.

Abstract

e13504 Background: Financial toxicity refers to the economic burden experienced by patients due to medical care costs. Cancer treatment often involves surgery, chemotherapy, and radiation, resulting in high out-of-pocket expenses even for insured patients. Factors such as limited insurance coverage, job loss, and being the sole household income provider further exacerbate this burden. Language barriers may intensify financial toxicity among Spanish-speaking patients by limiting their ability to understand and communicate financial concerns. This study examines how language barriers may worsen financial toxicity for Spanish-speaking patients undergoing cancer treatment. Methods: Nine Health medical providers were interviewed about their experiences caring for Spanish-speaking patients undergoing cancer treatment. Participants included oncologists, surgeons, pharmacists, nurses, social workers, patient navigators, and interpreters. Interviews explored communication of financial information, available resources, the impact of language barriers, and how financial stress affects patient health and treatment. Results: Four of nine interviewees reported interacting with Spanish-speaking patients daily, three interacted more than twice per week, and two interacted once per week or less. Despite these interactions, seven of nine providers were unaware of how patients receive information regardingtreatment-related financial costs. Discussion of financial concerns varied by provider: three addressed finances at every visit, three rarely discussed them, one did so in about half of visits, and two raised the issue only when patients struggled with copayments. Providers identified common financial challenges, including transportation, rent, food insecurity, housing instability, family expenses, loss of income, and copayments. These challenges were reported to limit or interrupt treatment, delay diagnoses, and increase stress for patients and their families. Although financial resources were described as limited for all patients, Spanish-speaking patients face additional barriers, including English-only materials, fear related to legal status, and limited access to Spanish-speaking staff. Proposed solutions included early financial screening, increased use of in-person interpreters, physician training on treatment costs, and multilingual educational materials. Conclusions: Financial toxicity negatively affects treatment continuity and patient well-being. Spanish-speaking patients are disproportionately impacted due to language-related barriers. Early financial screening and improved language support may help mitigate these challenges. Future research will involve interviewing Spanish-speaking patients to compare patient and provider perspectives and identify strategies to better support patients experiencing financial hardship.