“Financial toxicity” has now become a familiar term used in the discussion of cancer drugs, and it is gaining traction in the literature given the high price of newer classes of therapies. However, as a phenomenon in the contemporary treatment and care of people with cancer, financial toxicity is not fully understood, with the discussion on mitigation mainly geared toward interventions at the health system level. Although important, health policy prescriptions take time before their intended results manifest, if they are implemented at all. They require corresponding strategies at the individual patient level. In this review, the authors discuss the nature of financial toxicity, defined as the objective financial burden and subjective financial distress of patients with cancer, as a result of treatments using innovative drugs and concomitant health services. They discuss coping with financial toxicity by patients and how maladaptive coping leads to poor health and nonhealth outcomes. They cover management strategies for oncologists, including having the difficult and urgent conversation about the cost and value of cancer treatment, availability of and access to resources, and assessment of financial toxicity as part of supportive care in the provision of comprehensive cancer care. CA Cancer J Clin 2018;68:153‐165. © 2018 American Cancer Society.

中文翻译：

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癌症患者的经济负担和痛苦：了解癌症治疗的经济毒性并采取行动

“经济毒性”现已成为癌症药物讨论中的一个熟悉术语，并且鉴于新型疗法的高昂价格，它在文献中越来越受到关注。然而，作为当代癌症患者治疗和护理中的一种现象，经济毒性尚未得到充分理解，关于缓解措施的讨论主要针对卫生系统层面的干预措施。尽管卫生政策处方很重要，但如果要实施的话，其预期结果还需要一段时间才能显现出来。他们需要针对个体患者采取相应的策略。在这篇综述中，作者讨论了经济毒性的本质，经济毒性被定义为癌症患者因使用创新药物和伴随的卫生服务进行治疗而造成的客观经济负担和主观经济困境。他们讨论了患者如何应对经济毒性，以及适应不良的应对方式如何导致不良的健康和非健康结果。它们涵盖了肿瘤学家的管理策略，包括就癌症治疗的成本和价值、资源的可用性和获取以及财务毒性评估作为提供全面癌症护理的支持性护理的一部分进行困难而紧迫的对话。加州癌症临床杂志 2018；68：153‐165。© 2018 美国癌症协会。