The Cost of a Breast Cancer Diagnosis

When all funds become emergency funds.

Photo credit: eLife — the journal, CC BY 2.0.

When I’m feeling anxious, I redo my budget.

I’ve memorized the numbers now: the amount in my biweekly paycheck, how much I pull out for savings, the remainder after my taxes. I know the amounts experts recommend saving for retirement, debt repayment, and how much I should be paying on rent. I track spending habits and calculate percentages and write them all in the same black journal that I’ve started carrying with me since the end of April. Something about sketching out the new equations is soothing. It occupies my brain just enough so that I stop thinking about whatever’s provoking my mental math at the time.

But, despite all the number-crunching, the end result is always the same: there’s no new money coming in, and there’s too much going out.

Since I started my first full-time job as a medical researcher at 22, I’ve been a compulsive saver. I set a goal of achieving financial independence, even though I had never taken a personal finance class and lacked the relevant information needed to create a sustainable plan. Instead, I put my research background to use and quickly found the best protocols and formulas for achieving my goal. I learned that, as a woman, I was at a disadvantage for earning and saving money, and redoubled my efforts by picking up part-time jobs to increase my earnings. Even with my low earnings and multiple jobs, I was proud to see my small monthly contributions increase my savings over time.

By 26, I had saved about $3,000 to support my move to New York City and my enrollment in a neuroscience PhD program.

At 27, I depleted that cushion to pay for the procedure to freeze my eggs.

In April, near the completion of my first year in my program, I was diagnosed with breast cancer. After assessing my health status and prospective treatment options, my oncologist suggested I look into fertility preservation. At the time, we were unsure of whether I would need to have chemotherapy, but we did know that I would be on a minimum five-year regimen of tamoxifen, and both treatments carry a risk of infertility.

The decision was a no-brainer, but it was emotionally and financially costly. Despite receiving a “special cancer rate” from the fertility clinic and free medication from some amazing charities, my procedure cost $7,000, with additional payments of $1,000 per year to store my eggs. I paid for the procedure up front and out of pocket: eating up all of my savings, using a small loan from my parents, and charging the remaining cost to my credit card. The entire process from diagnosis to consultation was incredibly fast, my insurance company wouldn’t cover this “voluntary procedure,” and there were no payment plans available; if I didn’t have the money, I couldn’t freeze my eggs. For a time I was over $2,000 in debt, which I recently and proudly paid off completely. Were it not for my diagnosis and the possibility of infertility, I would have been able to keep and grow that money for the future—but I elected to plan for the future in a different way.

I also picked up two part-time jobs to start building my savings again (after all, I have medical bills to pay). In the short term, tutoring and working as a teaching assistant for ten hours per week is providing me with the money that I need to pay my day-to-day expenses. In the long term, this work is delaying my graduation by using up my time during a year when I should be focusing on developing my thesis proposal, gathering preliminary data, and moving forward on my PhD project. The longer I remain a student, the longer my earnings will be limited to my graduate stipend and my part-time work. I am sacrificing my future earning potential to meet my immediate needs — something that is directly attributable to my cancer diagnosis.

I’m also taking on a large amount of medical debt, and I have yet to pay any of this debt back because I still don’t know the appropriate amount to pay. Miscommunication between my two forms of insurance (and thank goodness I have insurance) and the hospital have resulted in multiple bills being sent to collections, for amounts ranging from $15 to $1,600. This giant mistake, beyond causing incredible amounts of stress, is ruining my credit score. While I have been assured by my [pro-bono] lawyer that the mistake will be cleared, he also advised patience, as it may take a very long time. Dealing with the insurance companies is frustrating and time-consuming, and as these calls can only be made during normal business hours, they are taking away even more time from my studies.

To cope with the stresses and promote my own complete mental and physical recovery I’ve been attending counseling and physical therapy—which means additional expenses. Counseling is essential for decreasing my anxiety and preserving my sanity, which are necessary as I try to complete my graduate program. But prioritizing my mental health comes at a cost. Similarly, completing physical therapy should be non-negotiable; I am only 27 years old, and it’s in my best interests to make a full physical recovery from my four surgeries. But I have delayed my physical therapy and am unlikely to attend the recommended number of sessions because they are very expensive and, as another “voluntary procedure,” I pay for them out of pocket.

Cancer has directly impacted my personal finances by depleting my savings and adding additional necessary expenses. No matter how many calculations I do and what money I try to move around, there isn’t enough to keep me on track. But adjacent to each equation in my journal is a statement of gratitude for almost every day on this journey so far: the support I have from friends and family, the flexibility of my graduate program, the amazing team of doctors and nurses and therapists who have put me back on the road to health. I’ve accepted that my life is part of a new reality that I will need to adapt to, but I’m trying as hard as I can to remain steadfast in my goals: a PhD, a career, someday a family. I hope that someday I can take a break from crunching numbers and concentrate on being “normal” (doctor’s orders) and making the most of my new cancer-free life.

Anastasia Efthymiou is a graduate student in neuroscience.