Financial toxicity in cancer treatment extends far beyond economic calculations, revealing deep psychological and societal inequalities that shape the experiences of patients and caregivers in India.Financial strain of treatment is increasingly recognized as a critical challenge for patients and family caregivers in low- and middle-income countries, including India. This study explores the impact of financial toxicity on decision process in cancer treatment, relationships and psychosocial distress from the perspectives of both cancer patients and their family caregivers. A sample of 47 participants (20 cancer patients; 27 primary caregivers) was selected via purposive sampling. Using interpretative phenomenological analysis, four major themes were culled out: high cost of treatment, overhead expenses and debts; impact on little big decisions; influence on family dynamics and atmosphere; and moral distress. Addressing financial toxicity holistically is essential not only to improve treatment adherence and outcomes but also to safeguard the psychological well-being and relational stability of patients and their families in India.