Economic toxicity experience and coping strategies of parents of children with cancer: a systematic review of qualitative studies

Cancer patients’ parents bear a significant economic burden during their children’s cancer treatment, including high direct medical costs, income loss due to caring for the children and other related expenses, which leads to severe economic toxicity. This study aims to systematically integrate qualitative evidence regarding the economic toxicity experienced by cancer patients’ parents and their coping strategies, identify unmet needs, and provide a basis for formulating targeted support measures. This study followed the PRISMA systematic review guidelines. It conducted a systematic search of relevant qualitative studies in PubMed, Web of Science, EMBASE, CNKI, Wanfang Data, and VIP databases. The thematic synthesis method was used to analyze and construct themes for the data included in the studies. A total of 789 articles were initially obtained through the search. After screening, 6 studies were finally included. The thematic analysis identified three core themes and nine sub-themes: (1) The multi-dimensional impact of economic toxicity: financial burden, emotions, and family turmoil; (2) Seeking control in the face of chaos: coping strategies and family resilience; and (3) The double-edged sword of support systems: facilitators and obstacles. The parents of children with cancer exhibit complex emotional responses, diverse coping behaviors, and significant unmet support needs under the influence of economic toxicity. The research results emphasize the urgent need to establish an active, coordinated and comprehensive support system covering the entire disease course at both the clinical practice and policy levels. By integrating measures such as economic navigation, early screening, resource integration and psychological, social support for caregivers, the economic burden on the families of the children can be effectively reduced and their quality of life can be improved.