Cancer Care: Patients Reject ‘Time Toxicity,’ Prefer ‘Time Commitment’

Patients undergoing cancer treatment are increasingly voicing concerns about the language used to describe the time commitments involved in their care. Even as researchers have begun to quantify the “time toxicity” of cancer care – the burden of appointments, travel, and administrative tasks – many patients and caregivers find the term itself to be negative and unhelpful, preferring terms that acknowledge the time as an investment in their health rather than a drain on their lives. This nuance is prompting a re-evaluation of how clinicians discuss these time demands with their patients, aiming for greater trust and shared decision-making.

The concept of “time toxicity” emerged from studies documenting the significant time burden placed on cancer patients and their families. Research presented at the 2025 ASCO Annual Meeting, for example, found that patients spent an average of 491 minutes per week on tasks related to their cancer care. These investigations have spurred efforts to reduce these burdens, such as exploring shorter infusion times for treatments like pembrolizumab (Keytruda) and subcutaneous administration for breast cancer treatment (see study). However, a recent qualitative study suggests the term itself may be counterproductive.

The Language of Time and Cancer

Researchers at Queen’s University in Canada and The University of Sydney in Australia interviewed 45 stakeholders – including patients with advanced gastrointestinal cancer, their caregivers, and medical oncologists – to gauge their reactions to the term “time toxicity.” The findings, published in hemonc today on March 9, 2026, revealed that while some clinicians found the term useful for understanding the overall impact of care, many patients and caregivers perceived it as overly negative. Participants frequently described the time spent on treatment as an “investment” in their health, a chance to see important life events, or simply a necessary part of fighting the disease.

“Many patients perceive the time spent on treatment as being an investment in their health,” explained Samuel X. Stevens, BAppSc, MBBS, a common sense oncology fellow and medical oncologist involved in the study. “That’s the case in advanced disease but probably is increasingly the case in the early or curative setting, too, where people are really having the treatment to try and live longer and be cured.” One patient interviewed explicitly stated, “I’m here for a reason… I’m not here wasting my time,” highlighting the sense that treatment time is purposeful and valuable.

Caregivers echoed these sentiments, expressing concern that the term “toxicity” could reinforce negative thoughts about treatment and even impact a patient’s limited survival expectations. One caregiver noted, “I didn’t think [a negative term] was necessary. There’s enough negativity and mental health [concerns] anyway, without another term.”

Beyond “Time Toxicity”: Alternative Framing

The study participants proposed several alternative terms to describe the time commitments associated with cancer care. Approximately half of the suggestions were neutral, with “time commitment” being the most frequently offered alternative. Other options included “time impacts” and “time trade-off.” Some participants favored positive framing, such as “healing time” or “time investment,” while others suggested negative terms like “time cost” or “time burden.”

Stevens favors “time trade-off,” arguing that it acknowledges the inherent choices patients face when allocating their time. “When we’re talking to people with advanced cancer, time is limited, and all the time that they’re spending on treatment is time that they’re not spending doing things that they aim for to do,” he said. This framing acknowledges the sacrifices involved while avoiding the potentially demoralizing connotation of “toxicity.”

The Importance of Language in the Clinician-Patient Relationship

The researchers acknowledge that the study was limited to individuals with gastrointestinal cancer from a single healthcare system, and further research is needed to explore these perceptions across different cancer types and populations. However, they emphasize the importance of considering the impact of language on the clinician-patient relationship.

“This stuff might seem like window dressing on the outside, but from a patient’s perspective, I can imagine an oncologist who’s intentionally trying to talk about things in a way that they understand really [promotes] trust and communicates a message that they care,” Stevens said. “The foundation of everything that we do, in health care especially, is trust, and this is just one step in that direction.”

Future Directions and Ongoing Research

Stevens and his colleagues suggest that future research should focus on co-developing language with patients and caregivers to ensure it is accessible and resonates with their experiences. They also highlight the need for further investigation into how perceptions of “time trade-off” evolve throughout the course of cancer treatment, as patients’ priorities and perspectives may shift over time. Researchers are exploring ways to differentiate between the necessary time spent on essential medical care and the excess time wasted on administrative tasks or waiting periods, as the quality of time can significantly impact a patient’s overall experience.

Perhaps most importantly, Stevens believes that data on time burdens should become a standard component of clinical trials for new cancer drugs, providing clinicians and patients with a more comprehensive understanding of the overall impact of treatment. This information could empower patients to make more informed decisions about their care, weighing the potential benefits against the time commitments involved.

the goal is to move beyond simply quantifying “time toxicity” and towards a more nuanced and patient-centered approach to discussing the time demands of cancer care, fostering greater trust and collaboration between clinicians and those they serve.