Dr. Christabel Cheung and colleague introduce new concept of administrative toxicity in cancer care.
University of Maryland School of Social Work Associate Professor Christabel K. Cheung and Frantz M. Berthaud, senior vice president of Oncology Services at University Medical Center of El Paso in El Paso, Texas, introduce and define the concept of “administrative toxicity” in a new article published in Oncology Issues. The authors conceptualize administrative toxicity as the cumulative burden of nonclinical processes, including authorization requirements, documentation, coordination demands, and coverage determinations, that can create delays, distress, and disruptions in the delivery of timely, evidence-based cancer care. Moving beyond existing concepts of financial and time toxicity, Berthaud and Cheung propose a multidimensional framework that positions administrative toxicity as a systemic exposure affecting patients, caregivers, clinicians, and cancer programs. Their framework identifies four interrelated domains of administrative toxicity and calls attention to its consequences for access, equity, patient and clinician well-being, and the sustainability of cancer care. The authors also outline actionable strategies for cancer programs and identify priorities for advancing measurement, accountability, and policy and health system reform.
Watch Dr. Cheung discuss administrative toxicity and why it matters for cancer care on Instagram, and follow her @dr.cbel.
Citation:
Berthaud, F. M., & Cheung, C. K. (2026). Administrative toxicity: The hidden harm in cancer care – And how oncology programs can reduce it. Oncology Issues, 41(3). https://journals.accc-cancer.org/view/the-hidden-harm-of-administrative-toxicity