The Punishing Cost of Cancer Care

By Mikkael A. Sekeres, M.D.

“I think it’s time to switch therapies,” I told my patient, as he and his wife sat next to each other by the wall of my exam room.

He stared at me, unblinking, through his chipped, wire-rimmed glasses as his wife looked quickly down at the medication list she clutched in her hands. Her worn purse sat on the floor by her chair. “Switching therapies” was a euphemism for “your cancer is progressing,” a point I didn’t need to hammer home with them – they both knew the score.

“O.K.” he said, taking a deep breath. “What’s next?”

We had been navigating his cancer together for a year-and-a-half, balancing the most effective treatments we could devise with what his health insurance would cover, and what he could afford. The 90-mile drive to Cleveland was itself an economic strain, gas prices being what they were and their aging car becoming increasingly more finicky, particularly during the cold winter months.... Read the full post on NYT's Well Blog.