For many Indonesian women battling breast cancer, the fight isn’t only against the disease. It’s also against financial strain. A new study led by researchers from Universitas Padjadjaran and co-authors from Europe reveals that financial toxicity—the economic burden caused by cancer treatment—deeply impacts patients’ quality of life and overall well-being.

What Was the Study About?

Breast cancer is one of the most common cancers among Indonesian women. While medical advances are improving survival rates, the costs of treatment (e.g. surgery, chemotherapy, medications, hospital visits) are often overwhelming. The study involved 300 Indonesian breast cancer patients using standardized questionnaires to measure patients’ health-related quality of life (EQ-5D-5L), their broader well-being (EQ-HWB), and their level of financial toxicity.

What Is “Financial Toxicity”?

Financial toxicity describes the harmful side effects of expensive medical care.It is generally broken down into two types:

• Objective Financial Toxicity (OFT): These are the concrete, measurable financial actions a patient has to take, such as borrowing money, selling assets, or draining their savings to pay for care.
• Subjective Financial Toxicity (SFT): This is the personal, emotional side of the burden (e.g. the worry, stress, and perceived distress) that comes from the financial strain of their illness.

In Indonesia, where not all patients have full insurance coverage, financial toxicity is a major challenge.

Key Findings

The study uncovered several critical insights into the patient experience in Indonesia:

• Financial Toxicity is Widespread.

The burden is significant, with over half of the patients (51%) experiencing at least one form of objective financial hardship. Common actions included taking on debt (30.0%) and using personal savings (25.7%). Furthermore, 21% of patients suffered from high levels of subjective financial distress.

• Financial Distress Deeply Affects Mental and Physical Health.

Higher levels of subjective financial distress were strongly linked to more severe problems with anxiety, depression, pain, exhaustion, and frustration. Even objective hardship alone was significantly associated with greater feelings of exhaustion.

• The Burden on Well-being is Greater Than on Health Alone.

Financial toxicity explained a much larger portion of the variance in patients’ overall well-being (46.3%) than in their standard health-related quality of life (31.2%). This shows that financial strain impacts a wide range of life aspects far beyond just physical health symptoms.

Why Does It Matter?

This study proves that financial health is inseparable from a patient’s overall well-being. The findings provide a strong case for integrating financial support into cancer care. The researchers suggest that policymakers and healthcare providers should consider screening patients for financial risk to identify those who are most vulnerable. By implementing interventions like financial navigation programs and improving support for non-medical costs like transportation, the healthcare system can help alleviate this hidden burden, allowing patients to focus on what matters most: their recovery.

This was adapted from: Pangestu, S., Purba, F. D., Setyowibowo, H., & Mukuria, C. (2025). Associations between financial toxicity, health-related quality of life, and well-being in Indonesian patients with breast cancer. Quality of Life Research. Advance online publication. https://doi.org/10.1007/s11136-025-03925-y