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Geographic Distance to Care and Financial Toxicity During Pediatric Cancer Treatment: A Qualitative Framework
Timothy J D Ohlsen1,2, Anika J Larson3, Malika R Hale4
1Ben Towne Center for Childhood Cancer and Blood Disorders Research, Seattle Children's Research Institute, Seattle, Washington, USA.
Pediatric Blood & Cancer
|January 17, 2026
Summary
Geographic distance to pediatric cancer care worsens financial toxicity for families. Remote families face income loss, increased spending, and reduced ability to cope with treatment costs.
Area of Science:
- Oncology
- Health Services Research
- Sociomedical Sciences
Background:
- Cancer care incurs significant financial burden on families.
- Geographic remoteness creates access barriers for pediatric cancer patients.
- These barriers can exacerbate financial toxicity for families.
Purpose of the Study:
- To explore how geographic distance to pediatric cancer care impacts families' financial toxicity.
- To understand the lived experiences of caregivers regarding financial toxicity and geographic distance.
Main Methods:
- Semi-structured interviews with 21 adult caregivers of children with cancer.
- Caregivers categorized as geographically distant (>60 min travel) or proximal.
- Framework analysis of interview transcripts to identify themes related to distance and financial toxicity.
Main Results:
- Most geographically distant families (13/14) reported distance worsened financial toxicity.
- Key themes: difficulty maintaining income, increased household spending (travel, housing), and diminished capacity to manage financial toxicity.
- Geographic distance significantly impacts families' financial well-being during pediatric cancer treatment.
Conclusions:
- Geographic distance is a critical factor intensifying financial toxicity for pediatric cancer families.
- Interventions are needed to mitigate financial toxicity.
- Geographically distant families require tailored support solutions.
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