From economic burden to patient-centered solutions: the evolving landscape of financial toxicity in oncology

Financial burden has emerged as a significant challenge in oncology, adversely affecting patients' quality of life, treatment adherence, and long-term outcomes. While research on cancer-related financial toxicity (FT) has grown rapidly, a comprehensive bibliometric analysis of its knowledge structure, thematic evolution, and emerging trends remains scarce.

Publications on FT among cancer patients, published from 2003 to January 19, 2026, were retrieved from the Web of Science Core Collection and Scopus databases. Bibliometric and science mapping analyses were conducted using CiteSpace, VOSviewer, and R software to assess publication trends, collaboration networks, research hotspots, and thematic evolution.

Research on FT in cancer patients has experienced substantial growth over the past two decades, with increasing interdisciplinary integration. The focus has shifted from descriptive economic burden assessments to patient-centered and system-oriented approaches, conceptualizing FT as a modifiable risk embedded within social and clinical contexts. Social support and multidisciplinary management have emerged as major interconnected research hotspots, emphasizing that effective mitigation of FT requires addressing both upstream social determinants of health and downstream integration of coordinated clinical interventions. Emerging keywords suggest that measurement and conceptualization, behavioral consequences, socioeconomic impact, and intervention & health system response are likely to influence future research directions.

This bibliometric analysis reveals that FT research has evolved into a comprehensive conceptual framework, positioning FT as a modifiable, system-level risk in cancer care. By synthesizing evidence on social support and multidisciplinary management, this study proposes a model linking social determinants, clinical assessment, and coordinated interventions. These findings offer valuable insights to guide future research and the development of targeted strategies aimed at alleviating financial burden and improving survivorship care, supporting the integration of FT management into patient-centered oncology practice.