Patti Tyree was afraid cancer would steal her future. Instead, the cost of treating it has.
She had hoped to buy a small farm with money inherited from her mother. But copayments for just one $18,000 round of breast chemotherapy and one shot of a nearly $15,000 blood-boosting drug cost her $2,000. Bills for other treatments are still coming, and almost half of her $25,000 inheritance is gone.
"I supposedly have pretty good insurance," said Tyree, 57, a recently retired federal worker who lives near Roanoke, Va. "How can anybody afford this?"
Forty years after the National Cancer Act launched the "war on cancer," the battle is not just trying to find cures and better treatments but also being able to afford them.
New drugs often cost $100,000 or more a year. Patients are being put on them sooner and for a longer time. The latest trend is to use these drugs in combination, guided by genetic tests that allow more personalized treatment but also add to its expense. In addition, radiation treatment is becoming more high-tech, and each leap in technology has brought a quantum leap in expense.
The financial strain is showing: Some programs that help people pay their bills have seen a rise in requests, and medical bills are a leading cause of bankruptcies.
"Patients have to pay more for their premiums, more for their copayments, more for their deductibles. It's become harder to afford what we have," said Dr. Michael Hassett, a cancer specialist and policy researcher at Dana-Farber Cancer Institute in Boston.
Insurers also are being squeezed by laws that require coverage and restrict raising premiums. And the burden is growing on Medicare, which in some cases is paying for treatments and tests that have not been shown to benefit patients.
Why have costs escalated so much? To some extent, it's the price of success.
Cancer deaths have been declining in the United States since the early 1990s. Two out of 3 people now live at least five years after a cancer diagnosis, up from 1 out of 2 in the 1970s.
Modern treatments have fewer side effects, but they are far more toxic financially.
Of the nation's 10 most expensive medical conditions, cancer has the highest per-person price. The total cost of treating cancer in the U.S. rose from $95.5 billion in 2000 to $124.6 billion in 2010, the National Cancer Institute estimates.