Background: Each year, it is estimated that over 200 000 children and adolescents are diagnosed with cancer, and 80% of these reside in low-middle-income countries, with 90% mortality. There are enormous psychosocial needs of these patients, families, and care-givers, which are primarily affected by the communities' social, economic, cultural, and religious factors.

Aim: To elucidate the significant psychosocial and socio-economic issues faced by the caregivers of children suffering from different types of cancer at the Children's Hospital Lahore.

Study design: Prospective cohort study

Place and duration of study: Department of Paediatric Hematology and Oncology, Children's Hospital Lahore Pakistan from 1st January 2018 to 30th June 2018

Methodology: Two hundred family members/caregivers of the patients were enrolled with ages ranging from <1 to 15 years (43% <5 years and 57% >5years old).

Results: Male to female ratio was 1.2:1. 52% belonged to hematological malignancies and 48% from solid tumor groups. Most of these children had malnutrition with anemia (81% with Hb <10g%) and small weight forage in 63% cases at presentation. 80% of families had more than three children, with the youngest child being less than five years in 75%. 95% of families relied on public transport, with 65% of them traveling 100-500Km with 2-10 hours duration to reach the primary treatment center. 80% had a monthly income of less than USD150. 68% of these families had to borrow money for trip to hospital (p-Value=0.003), and 58% took a loan for treatment course.

Conclusion: The significant socio-economic challenges faced by these families and caregivers included large family size with low incomes increasing their financial difficulties, logistic burden like traveling long distances to access health care, and parental employment and family dynamics disruptions.

Keywords: Socioeconomic Challenges, Childhood Cancer, Low-Middle-Income Countries