It sometimes seems baffling to me: I put my life on the line for research to produce a cancer medication that — if and when it is put on the market — I probably could not afford. Its miraculous prolongation of my existence, for which I am ever grateful, deepens my concern about those who will be unable to benefit from it.

When I enrolled in a Phase I clinical trial in 2012, I knew that the pills had never before been tested on human beings. The risk was great, but the drug was free. Were it to be approved by the Food and Drug Administration, it would probably be priced like a similar drug for recurrent ovarian cancer, a Parp inhibitor called Rucaparib: about $20,000 a month. Would I have been able to negotiate with my insurance company to plunk down a mind-boggling $240,000 a year for a medication that might not have worked? Even if I could have guessed that this drug would be effective, where would I have come up with the money to keep paying for it? I have already used it for six years, at what could have been a cost of $1,440,000.

We are all familiar with the physical toxicity triggered ironically by both cancer and its treatments: pain, fatigue, nausea, weight loss, edema, constipation and diarrhea. These ills can be acute (harmful in the short term), sub-chronic (harmful for more than a year) or chronic (harmful over an extended period or a lifetime). Increasingly, investigators like Dr. S. Yousuf Zafar use the term financial toxicity to describe the acute, sub-chronic and chronic burdens of insured, underinsured and uninsured people impaired or destroyed by the high costs of care. While medicine transforms cancer into a chronic disease with which patients can live for an extended period of time, financial toxicity threatens to turn chronic, too.

A white paper by Family Reach, a national nonprofit dedicated to alleviating the financial burden of cancer, and Xcenda, a consulting group, draws on earlier studies to explain that “Adult patients are 2.65 times more likely to file for bankruptcy than patients of a similar age without cancer. Patients who filed for bankruptcy had a 79 percent greater risk of early mortality than patients who did not.” In other words, cancer treatment escalates the possibility of penury, and treatment-produced fiscal catastrophes are tied to cancer deaths.