By Adriana Ermter
In our bi-monthly column, senior writer and editor Adriana Ermter shares her personal experiences with breast cancer
Money was not my first thought when I was diagnosed with breast cancer. To be fair, I never used to think about money when it came to my health. I mean, I live in Canada. I pay taxes that feed into our healthcare system. What was there to consider? Turns out a lot.
Like many Canadians, I grew up believing our universal healthcare system would protect me if I ever became seriously ill. And Canada’s publicly funded healthcare system does provide essential and life-saving care. Provincial healthcare plans cover medically necessary hospital and physician services, including most breast cancer surgeries, radiation and chemotherapy treatments, but cancer care extends beyond these capacities and hospital walls. It affects every aspect of daily living, from employment and transportation to mental health, fertility, rehabilitation, nutrition, prescription medications and quite simply, paying the bills. Those expenses can add up quickly, especially during a time when many of us are unable to work consistently or, even, at all.
Only when it came to my career and ability to work did I stop and think about money. I was single, the ink on my divorce papers barely dry. My company didn’t offer short-term disability, so not working wasn’t an option. And I didn’t meet the requirements for financial aid. While there are great foundations like Cure Foundation and Breast Cancer Support Fund that support women financially through breast cancer, I was too young, earned too much money, did not have dependents and I wasn’t sick enough. I get it. There’s only so much money to go around and if I had to choose who to give it to, too, I would also pick the single, underpaid woman with children and stage 3 cancer. It’s the right choice. But it doesn’t make the money worries go away.
The Medical Costs Canadian Universal Healthcare Covers
Fortunately, in most provinces and territories, medically necessary services related to a breast cancer diagnosis are publicly funded. This includes appointments with family doctors, oncologists, surgeons, radiologists and other specialists. Diagnostic imaging such as mammograms, ultrasounds, MRIs, CT scans and biopsies are generally covered, as are hospital stays and surgeries, including lumpectomies and mastectomies. Radiation therapy and intravenous chemotherapy administered in hospitals or cancer centres are also publicly funded. Follow-up appointments and many laboratory tests are included as well. These services are considered critical and lifesaving, and we have access to them without direct billing at the point of care.
Your Out-of-Pocket Costs
However, there are many costs associated with breast cancer that fall outside this bubble. Prescription medications taken at home are one of the largest gaps in coverage. Oral cancer drugs, anti-nausea medications, pain management prescriptions, hormone therapies and supportive treatments may only be partially covered depending on a person’s age, income, employment benefits or provincial drug plan eligibility. I had drug coverage through my workplace, thankfully, so for the first year, my prescription medications were 80 per cent covered. When I left that job, however, the insurance coverage stopped. My Tamoxifen, anti-nausea, anti-anxiety and pain medication prescriptions alone cost over $500 each month. For people like me, without private insurance, these out-of-pocket costs are overwhelming.
Beyond medication, expenses such as wigs, breast prostheses, post-surgical bras, physiotherapy, psychotherapy, fertility preservation, complementary therapies, childcare, parking, accommodations during treatment and transportation to and from cancer centres are often paid for personally. Organizations like Look Good Feel Better and Kelly Shires Foundation offer support in these many of these areas, while some hospitals provide services such as volunteers to talk to for insight and understanding or free transportation to and from treatment.
The Reality of Lost Income
Still, lost income due to recovery is an issue. Many patients reduce their working hours or leave work entirely during treatment and recovery, creating additional financial strain at exactly the wrong time. After two months working full time through treatment with only one week off for my surgery, my doctor put me on part-time leave. The workload at the office combined with the mental and physical stress of major surgery and cancer treatments had made me sicker. My body was regressing, not healing. I was too tired to cook, clean and, on many occasions, even to brush my teeth. I needed to rest, but not working full time riddled me with anxiety. The bills piled up.
Statistics Canada’s updated research on the economic burden of breast cancer highlights how significant these costs can become. According to recent findings, healthcare costs increase substantially depending on the stage of disease at diagnosis and the complexity of care required. Patients diagnosed with later-stage breast cancer often face more aggressive treatments, more appointments, longer recovery periods and increased supportive care needs. While publicly funded services absorb a large portion of direct medical costs, patients themselves still carry many indirect and uninsured expenses. For newly diagnosed women, this reality can be shocking. The emotional devastation of hearing a cancer diagnosis is quickly followed by the practical fear of how to pay for everything that comes next.
The Financial Toxicity is Real
This is where the term “financial toxicity” enters the conversation. It refers to the harmful financial distress experienced by patients because of medical treatment and its associated costs. It is not simply about paying a few extra bills. It can mean draining savings accounts, accumulating debt, delaying mortgage payments, postponing retirement, relying on family members for financial support or choosing between medications and household expenses. For younger women, it may also affect fertility decisions, career advancement and long-term financial security. For older women living on fixed incomes, it can mean impossible choices between food, transportation and supportive care.
What makes financial toxicity particularly cruel is that it often lingers long after active treatment ends. Survivorship itself can be expensive. Ongoing medications, reconstruction procedures, physiotherapy, counselling, surveillance imaging and managing chronic side effects can continue for years. About eight months after my surgery, I began experiencing pain in my right armpit. The cancer wasn’t growing back, but scar tissue was. I was extremely protective of my right armpit and right breast area and didn’t want anyone to look at it or touch me. But I needed physiotherapy desperately. The weekly appointments cost $80. A price tag I couldn’t afford, yet, also, a service I couldn’t afford not to do. Not if I wanted to use my right arm. So, I maxed out my credit card.
Some women never fully recover financially from their diagnosis, even if they recover physically. I feel like that some days. I’m still paying off my credit cards. The stress of mounting expenses can also impact mental health, relationships and your overall quality of life. I know it has mine. I’ve exchanged travelling to sunny vacation spots for weekly psychotherapy appointments, I “Like” my friend’s Instagram posts at fancy restaurants instead of joining them and walking the neighbourhood has long replaced my spin membership.
Breast cancer changes our lives in so many ways and way beyond the actual diagnosis. Yes, we are fortunate to have access to publicly funded cancer care (and I continue to be grateful for this), but we must acknowledge the gaps that leave so many of us vulnerable during one of the most difficult periods of our lives. We need to talk about the true costs of breast cancer—to reduce stigma around financial hardship and encourage conversations about policy improvements, workplace protections, drug coverage and supportive care funding. It’s why I advocate for charities and foundations like Canadian Breast Cancer Network who are making a difference by creating awareness. It’s why I prefer to see donor money go towards creating policy change for greater access to scanning for early diagnosis and prevention, and to charities who support individuals like you and me. Because no one facing a life-threatening disease should also have to fear financial ruin simply for trying to survive.
Adriana Ermter is a multi award-winning writer and editor. Her work can be read in FASHION, IN Magazine, 29Secrets.com, RethinkBreastCancer.ca and AmongMen.com. The former Beauty Director for FASHION and Editor-in-Chief for Salon and Childview magazines lives in Toronto with her two very spoiled rescue cats, Murphy and Olive. You can follow Adriana on Instagram @AdrianaErmter
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