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Financial Toxicity and Treatment Satisfaction Among Lebanese Patients With Cancer: Indirect Associations Involving
Pauline Jakal1, Mirna Fawaz2, Souheil Hallit1,3
1School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon.
JCO Global Oncology
|July 29, 2026
Summary
Financial toxicity in cancer patients during Lebanon's economic crisis significantly increases psychological distress, which in turn lowers treatment satisfaction. Integrated psychosocial support and financial navigation are crucial for cancer care in collapsing health systems.
Area of Science:
- Oncology
- Health Economics
- Psychosocial Oncology
Background:
- Lebanon's economic collapse severely impacts cancer care access and patient finances.
- Financial toxicity and psychological distress are known barriers to cancer treatment adherence and experience.
- The interplay between financial toxicity and psychological distress in collapsing health systems remains understudied.
Purpose of the Study:
- To assess the indirect association between financial toxicity and treatment satisfaction among Lebanese adults with cancer.
- To investigate the mediating role of psychological distress in the relationship between financial toxicity and treatment satisfaction.
Main Methods:
- Cross-sectional survey of 308 adult cancer patients in Lebanon.
- Validated Arabic instruments used: COST-FACIT (financial toxicity), PHQ-4 (anxiety/depression), FACIT-TS-G (treatment satisfaction).
- Mediation analysis using Hayes' PROCESS Model 4, controlling for sociodemographic and clinical factors.
Main Results:
- Greater financial toxicity (lower COST scores) correlated with higher psychological distress (P < .001).
- Increased psychological distress was linked to lower treatment satisfaction (P < .001).
- Financial toxicity indirectly impacted treatment satisfaction through psychological distress, with a significant direct association also observed.
Conclusions:
- Financial toxicity is associated with increased psychological distress and reduced treatment satisfaction in Lebanese cancer patients during the economic crisis.
- Psychological distress significantly mediates the relationship between financial toxicity and treatment satisfaction.
- Integrated psychosocial support and financial navigation are essential in resource-limited oncology settings.
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