According to new analysis conducted by Thomson Reuters, One in eight people with advanced cancer turned down recommended care because of the cost. Moreover, among patients with incomes under $40,000, one in four in advanced stages of the disease refused treatment. For example, of late-stage colon cancer patients, 12% spent more than $25,000 out of pocket, according to the survey, in which 1,767 people answered an online questionnaire. The analysis’ findings are similar to a 2006 study in Cancer, which found that cost caused more than 20% of all cancer survivors — not just those with advanced cases — to delay or miss needed care.

Experts say the signs of stress are everywhere:

• Nearly 20% of Americans have problems paying their medical bills, according to a report in September from the Center for Studying Health System Change.

• One in four cancer patients or their families said they used up all or most of their savings to pay for treatment, according to a 2006 survey of nearly 1,000 survivors and their families by USA TODAY, the Kaiser Family Foundation and the Harvard School of Public Health.

• One in 10 in that survey said they were unable to pay for basic necessities, such as food, heat and housing.

Even though there are great advancements in cancer treatment, the advancements come at a high cost. As costs rise, insurers are shifting a greater share to patients, says Neal Meropol of Philadelphia's Fox-Chase Cancer Center. Many plans now require patients to pay for 20% of their health care and costs don’t seem to be going down anytime soon.