A major national survey of people affected by cancer provides an in-depth examination of how families cope with cancer and highlights problems of health insurance and health care costs through the lens of those who have experienced this major illness. The results show how health care and health insurance systems can fail to protect people when they are most in need.

Conducted jointly by USA Today, the Kaiser Family Foundation, and the Harvard School of Public Health, the survey shows the disease’s devastating impact often extends beyond an individual patient to affect entire families – sometimes causing financial crises, strained relationships, and physical and mental health issues for those who love and care for people diagnosed with cancer.

The survey found that one in four families affected by cancer say the experience led the person with the disease to use up all or most of their savings, and one in eight say they borrowed money from relatives. The illness also made it harder for some to find and keep health insurance – with about one in 10 saying they couldn’t buy health insurance because they had been diagnosed with cancer, and 6% saying they lost their coverage as a result of the disease.