[Unpleaseant news.]

An impressive amount of new drugs and new indications is arriving in the cancer arena. Financial affordability of so much innovation is difficult everywhere. In Europe, the access to new drugs is not uniform and particularly the patients of Eastern countries frequently cannot receive effective drugs. In the United States financial distress is acknowledged to be a side effect of new expensive drugs. However, we surprisingly found that financial problems are associated with worse cancer patients outcomes also in Italy, where a public health system exists and pays anticancer drugs. Namely, we found that patients with baseline financial problems have a 35% higher risk of worsening their quality of life after treatment and that patients who develop or worsen financial problems during treatment (so-called financial toxicity) have a 20% higher death risk. Financial problems and their potential impact on the outcome of cancer patients should be matter of attention also outside the United States.