Leita, a 42-year-old patient with locally advanced pancreatic cancer, was treated with 5-fluorouracil, irinotecan, and oxaliplatin followed by capecitabine and radiation therapy. After she completed initial treatment, a computed tomography scan conducted in preparation for a possible surgical resection revealed metastatic liver lesions. Leita’s surgery was cancelled, and she began second-line therapy with gemcitabine and nab-paclitaxel.

Not understanding terms like deductible, copay, premium, coinsurance, and out-of-pocket maximum prevents many Americans from selecting a health insurance plan that meets their financial needs. Fewer than 40% of patients enrolled in high-deductible healthcare plans engage in effective financial behaviors, such as comparing prices or discussing costs with clinicians. High costs are a barrier for many patients and survivors to access high-quality cancer and survivorship care.

Survivors need support to resume a high-quality, healthy “new normal” life after they complete their treatment. The services of a cancer survivorship clinic or program may help them manage the physical and emotional implications involved with ongoing care.

John is a 58-year-old patient who was diagnosed with glioblastoma two years ago. He initially responded well to radiation, temozolomide, and a tumor-treating fields device. His cancer recurred 18 months after diagnosis, and John underwent a second craniotomy that was complicated by a stroke. He became unable to verbally communicate, but John and his partner had previously discussed his desire to participate in clinical trials to help extend his life. The medical oncologist says that John will not qualify for a clinical trial because John is unable to give an informed consent, and John’s partner is frustrated that she can’t speak for him and respect his wishes.

Healthcare professionals are called to provide patient-centered care in an environment where they listen to patients’ goals and desires and support patient autonomy. However, heeding that call requires patients’ participation to voice their needs and concerns, and some patients may be reluctant to speak up for themselves.