Some baby boomers are burning through their retirement savings to pay for cancer treatments. Then they have to go back to work.

The American Cancer Society estimates over 2 million new cancer diagnoses and about 600,000 cancer deaths this year in the US, though the cancer mortality rate has fallen since 1991. About 40% of people with a cancer diagnosis deplete their life savings within the first two years, while cancer survivors are 2.7 times more likely to file bankruptcy. This particularly impacts older adults, who are more prone to many cancers and are often ineligible for clinical trials.

Plus, Dr. Karen Knudsen, CEO of the American Cancer Society, told BI that financial limitations can hamstring a patient’s recovery. “What is very common is either skipping doses for cancer therapy or halving their doses so they can extend the time which their current prescription will allow them to stay on the drug or therapy.”

Dozens of older Americans told BI in recent months that their Social Security and pensions aren’t enough to get by without working. Some said they have to rely only on Social Security due to health issues, while others said they’ve taken jobs at Walmart, a hospital, or with Uber to supplement government assistance.

For this story, BI spoke to 10 older Americans with health issues. Most of them said they’re scraping by due in part to high medical costs. Many have sacrificed vacations, home repairs, or even medical appointments to make ends meet.

“It could happen to anybody overnight,” Mullen said. “Your life could be turned upside down in a split second because you never know if you’re going to get sick or you’re going to get hurt.”

Medicare doesn’t cover it all

Making sacrifices and setting a strict grocery budget

Health issues lead some older Americans to skip medical appointments, sacrifice the quality of their diets, and quit their jobs entirely. It means that their illnesses are taking more than their health — the fabric of their lives is changed entirely, leaving many lonely and without the creature comforts that can make life enjoyable.

That’s a far cry from the vision of retirement many had — and it shows the very real impact of the cracks that some of America’s seniors fall into. They might spend their lives living middle-class, only to slide into poverty in their old age.

When Marion, 70, quit her job in restaurant management due to health issues, she cashed out her 401(k) early and moved in with her sister and her sister’s boyfriend to save money.

To supplement the $1,200 in disability she received a month, she started cleaning houses and selling her art.

Like many baby boomers BI spoke with, Marion cut back on discretionary spending like vacations, dining out, cosmetic treatments, and new clothes purchases. Others have drastically reduced spending on necessities like healthy food.

Robert Papalia, 74, has capped grocery spending for himself and his wife at under $100 a week, rotating through 30 credit cards to afford all their health and housing repair bills. He retired early in 2010 because of his wife’s health issues, living on his company’s pension and Social Security but struggling to afford medical bills and high property taxes.

“Do we have money in the bank? Yes. Is it a lot of money? No,” Papalia said. “I look at my wallet at the end of the day, and it’s a difference between night and day.”

Leonard Bianconi, 67, can’t afford to go out to eat or buy many groceries on his SNAP benefits, so he relies on food pantries. He finds fruits and vegetables often on the precipice of going bad — a major challenge for Bianconi, who’s diabetic and needs a fresh diet.

“Right now, I have no extra money to do anything. My life is pretty lonely. I don’t have any money to go anywhere. I can’t really do things. Even going to the cinema would be difficult,” Bianconi said.

Feeling grateful and clinging to hope