There’s a quote from Henry David Thoreau that Arjun Gupta, MD, says guides his approach to cancer care: The price of anything is the amount of life you exchange for it.

Gupta, an M Health Fairview gastrointestinal oncologist, says that despite their best intentions, cancer doctors don’t always fully appreciate how much time—and life—a person spends being treated for cancer. It’s more than the time spent at a clinic visit or a chemotherapy appointment, he says. It’s the time spent driving to the hospital, waiting to see the doctor, recovering from treatment, talking on the phone with insurance providers—the time spent not enjoying life.

In 2022, Gupta coined the term “time toxicity” as a first step in identifying and quantifying the time cost of receiving cancer treatment. Based on his research, which is supported by philanthropy, he argues that the time commitments associated with cancer care—just like the physical toll of certain drugs and the financial burdens of treatment—should be considered when creating a person’s care plan.

“It’s our responsibility to make sure that patients and their loved ones can spend their precious time doing the things they love,” he says.

How do you measure time in the context of a cancer diagnosis? 

We interviewed patients, their loved ones, and members of their care team to figure out what time commitments felt burdensome. One theme emerged: Any time a person has to get out of their pajamas, get into the car, come to the clinic or the hospital for any amount of time—that can take up their whole day. We call these days “health care contact days.”

How do you talk about “contact days” with patients and their families? 

We recognize that not all contact days are equally burdensome and that not all contact days are bad, right? It depends on each individual. So I can say to a person, “With treatment A, you will have 15 contact days in the next month, and with treatment B, you will have five contact days.” Treatment B may not technically offer the same survival benefits as treatment A, but it’s less of a time commitment. And so people can then apply their own values and lifestyle to those numbers.

What does that look like in practice? 

Maybe one person lives next to the cancer center and they enjoy visits to the clinic; these visits are a kind of social outing. For them, more contact days might be a good thing. But maybe another person lives hundreds of miles away and even a single contact day in a month is a lot. It’s all about asking the person what they want their care to look like, giving them the information, and allowing them to make the most informed choice.