In the United States, paying for cancer care isn’t easy. Even patients with health insurance often have a hard time paying for medical bills, travel, drugs and living expenses while seeking treatment. That’s why a growing number of patients are turning to online crowdfunding sites to help pay their bills, reports JAMA Internal Medicine.

According to the study, which analyzed more than 1,000 GoFundMe campaigns seeking donations on behalf of cancer patients, more than one quarter of those who seek help online are underinsured. Researchers also found that most patients received only around a quarter of the funding goal they set. Half of these goals were set at $10,000 or higher.

Researchers also explored the types of expenses cancer crowdfunding campaigns were seeking to address. About 40% of campaigns asked for help with medical bills, 25% for help with medical travel expenses and 23% for nonmedical bills. Less than 2% of campaigns mentioned alternative cancer treatments.

The study is part of a larger research project examining the influence of the Affordable Care Act (ACA) on cancer treatment and the use of crowdfunding for cancer care. Other studies are looking at the role traveling to specialty cancer centers plays in medical costs and how using fundraising sites can help patients access more types of treatment.

“The use of GoFundMe shows us…that for many, the present safety net is inadequate and can create financial ruin,” said Benjamin Breyer, MD, a researcher at the University of California, San Francisco, a senior study author who spoke to Reuters about the findings. “Getting sick shouldn’t create financial devastation, and patients should have access to affordable, high-value care.”

The study notes that technological innovations, expensive new therapies and improved access to treatment have all contributed to the rising costs of cancer care in the United States. Study authors also pointed out that the results suggest that the financial burden of cancer care requires increased attention and advocacy from the cancer community—not just online donations.

To learn more about the risks of crowdfunding and cancer, click here.

For help covering the financial costs of cancer care, see “Cancer, Hands Off My Bank Account!”