Therapeutic and financial toxicity in the management of cancer in some tertiary health facilities

Cancer remains a significant public health concern globally, with treatment-associated financial and therapeutic toxicity posing major challenges, particularly in low- and middle-income countries. This study evaluates the therapeutic and financial burdens of cancer care among patients receiving treatment at two tertiary health institutions in Jos, Nigeria. A retrospective cross-sectional review of medical records was conducted over a five-year period (March 2018 to July 2023) at Jos University Teaching Hospital (JUTH) and Bingham University Teaching Hospital (BhUTH). Data were analyzed using descriptive statistics and WHO prescribing indicators while, therapeutic and financial toxicity were assessed based on cancer type, drug regimens, and treatment-related side effects. Of the 228 patients studied, females constituted the majority (77.6%), with cervical (28.1%) and breast cancer (24.1%) being the most prevalent. Polypharmacy and high use of injectables were common. Frequently prescribed drugs included cisplatin, paclitaxel, and doxorubicin, all associated with significant side effects such as myelosuppression, nausea, and alopecia. Financial analysis revealed mean chemotherapy costs of ₦732,585 (JUTH) and ₦481,989 (BhUTH), with considerable variation depending on treatment type and duration. Most patients bore out-of-pocket expenses, underscoring limited insurance coverage and significant financial burden. Cancer treatment in the studied institutions is characterized by substantial therapeutic and financial toxicity. The need for affordable care, improved insurance coverage, and safer therapeutic options is critical to enhance cancer care outcomes in resource-limited settings.