Housing Instability During Cancer Treatment

Housing instability during treatment is not always about losing a home. Four separate situations get the same label.

You may have stable housing that is simply too far from the cancer center. You may have housing that is not safe during low blood counts, such as an overcrowded unit or one with mold. You may be facing eviction or a utility shutoff because income dropped. Or you may have nowhere to go at discharge.

Each one has a different fix and a different phone number. Sort out which one you have before anyone starts making calls.

Some cancer treatment schedules make living at home impossible for months.

NCI describes what a stem cell transplant demands. The whole process takes a few months. Even outside the hospital, patients often must stay near the transplant center instead of going home. After discharge, visits run two or three times a week. If all goes well, going home comes 100 days after donor stem cells are given. Immune recovery takes several months after an autologous transplant, and 1 to 2 years after an allogeneic one.

Radiation has its own version of this. Daily treatment five days a week for several weeks is hard to do from three hours away.

So the housing question is a treatment question. Raise it at the visit where the schedule is set, not after you have already missed appointments.

NCI's financial toxicity summary for clinicians puts numbers on the squeeze.

• Between 33% and 80% of cancer survivors used savings to pay medical costs.
• Between 2% and 34% borrowed money or took on medical debt.
• 1.7% filed for bankruptcy within 5 years of diagnosis, and survivors were 2.7 times more likely to file than people without cancer.
• Between 22.5% and 64% reported financial stress and worry about paying bills.
• Recently diagnosed survivors aged 18 to 64 spent $1,107 a year out of pocket, against $617 for people with no cancer history.

NCI also names two measurement tools clinics can use: the COST measure, short for Comprehensive Score for Financial Toxicity, and the Personal Financial Wellness Scale. If your center screens with either, ask for your score and what it triggers.

The American Cancer Society runs Hope Lodge, which provides free rooms for people in treatment away from home, plus a caregiver. ACS reports 31 Hope Lodge communities across the United States and Puerto Rico, with 1,100 private guest rooms. Some locations also provide rides to the treatment center.

The eligibility test is narrow and worth knowing. You qualify if you have cancer or care for someone who does, you would benefit from staying overnight near your treatment center, and you are treated at one of the 31 Hope Lodge locations. ACS estimates that lodging for a typical six to eight week course can otherwise reach $17,000.

To ask for a room, call 1-800-227-2345 or use the contact form. ACS says it replies by email within three business days, so start before your first treatment date, not after.

Start with 211. USA.gov directs people to call 211 to find a local shelter and to reach state programs for emergency rent help. This is the fastest route to what actually exists in your county tonight.

Then find your Continuum of Care. HUD funds homelessness services through Continuum of Care programs run by nonprofits and local governments. HUD Exchange runs a CoC contact search and a HUD field office locator, so you can reach the group that controls local housing slots rather than calling agencies at random.

Handle utilities separately. The Low Income Home Energy Assistance Program, or LIHEAP, helps low-income households with home energy bills, including heating and cooling. It is federally funded through HHS and run by state, tribal, and territorial grantees, so applications are filed locally.

Know that vouchers are slow. Section 8, formally the Housing Choice Voucher program, is listed by USA.gov among federal rental assistance options. It is worth applying for, but treat it as a long-term step, not a solution for next month.

USA.gov's general line is 1-844-872-4681 if you cannot find the right state agency.

VA runs a separate system, and it moves faster than the general one.

The National Call Center for Homeless Veterans answers at 877-424-3838, free and confidential, 24 hours a day. VA names three main programs: HUD-VASH for permanent supportive housing, SSVF for homelessness prevention and rapid re-housing, and Grant and Per Diem for transitional housing with support services.

Say the word "cancer" and the word "treatment" on that call. Timing matters to their placement decisions.

1. Photograph every notice. Write the deadline printed on it in your phone calendar, then set a reminder for two days earlier.
2. Call 211 the same day you get an eviction or shutoff notice, and ask specifically about emergency rental assistance in your county.
3. Ask the cancer center for a letter stating your treatment schedule and how long it runs. Many housing and utility programs weigh documented medical need.
4. Ask the scheduler whether your treatment can be transferred to a site closer to where you can actually live.
5. Ask billing whether the hospital has charity care and whether it covers lodging or travel.

• How many weeks does my schedule require me to be within driving distance?
• Is this center a Hope Lodge location, and if not, what lodging does it partner with?
• Does the center have a fund for lodging, gas, or parking?
• Who here writes letters for housing and utility programs?
• Is there a legal aid partner for eviction cases?

For related reading, see Financial Assistance for Cancer, Cancer and Disability, and Understanding Your Health Insurance.

• National Cancer Institute — Financial Toxicity and Cancer Treatment (PDQ), Health Professional Version
• National Cancer Institute — Stem Cell Transplant
• American Cancer Society — Hope Lodge
• USA.gov — Emergency Housing Assistance
• USA.gov — Housing Help
• HUD Exchange — Continuum of Care Program
• HHS Office of Community Services — LIHEAP
• U.S. Department of Veterans Affairs — VA Homeless Programs