Award-Winning Researcher to Study Financial Impact of Cancer Treatment

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Dr. Veena Shankaran, assistant professor of Medical Oncology at the University of Washington School of Medicine, explains her award-winning research study assessing the risk factors and impact of cancer treatment-related financial hardship on quality of life. She outlines the study goal to improve understanding of these financial challenges for patients to ultimately develop tools to help aid them and support high-level comprehensive cancer care. The Conquer Cancer Foundation recognized the importance of this work with a Career Development Award, providing a three-year cancer grant totaling $200,000.

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Please remember the opinions expressed on Patient Power are not necessarily the views of Seattle Cancer Care Alliance, its medical staff or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Andrew Schorr:

Hello and welcome to Patient Power, sponsored by the Seattle Cancer Care Alliance.  I’m Andrew Schorr. 

Congratulations are in order to our guest, Dr. Veena Shankaran, who is a specialist in gastrointestinal cancer at the Seattle Cancer Care Alliance, and also an assistant professor of medical oncology at the University of Washington.  Congratulations. Why?  Because she’s won at the big ASCO, American Society of Clinical Oncology meeting, a $200,000 Career Development Award for Research, and that’s from the Conquer Cancer Foundation. 

Congratulations, Dr. Shankaran.  Thanks for being with us on Patient Power once again. 

Dr. Shankaran:

Thank you so much. 

Andrew Schorr:

Tell us what this research is all about.  What are you studying, and what does it mean? 

Dr. Shankaran:

I’m absolutely excited.  This is a great award for junior investigators to have protected research time, and funding, to conduct studies that will be the next step towards future work and an independent research career.  This will be really instrumental to conducting an important study I think, and serve as a stepping stone to future funding, and a research career in cancer outcomes. 

Andrew Schorr:

Dr. Shankaran, what will this research money allow you to do? 

Dr. Shankaran:

This funding will provide money to conduct a study that I’ve also received funding through the Southwest Oncology Group to conduct, and it’s a study in metastatic colorectal cancer patients, designed to understand the financial impact of cancer treatments, and the impact of financial changes, related to cancer treatment on health-related quality of life.  Our goal is to understand the broad range of financial changes that happen as a result of cancer diagnosis and cancer treatments, and understand what elements of finances are affected by cancer treatment. 

Andrew Schorr:

Let’s see if I’ve got this right.  It’s a scientific study, with doctors participating around the US, and their metastatic colorectal cancer patients, looking at the financial hardships during treatment, and how that affects quality of life. 

Dr. Shankaran:

Right.  Exactly.  We’re going to be recruiting patients throughout community clinical oncology programs across the country, and these programs are part of the Southwest Oncology Group.  We’re going to be recruiting patients with metastatic colorectal cancer, and we’re going to be conducting a longitudinal study over a 12-month period of time.  And patients will be assessed at baseline for their general financial health, and then at four time points from diagnosis until one year following diagnosis, to really understand these various financial changes that I mentioned, and health-related quality of life. 

To my knowledge, this is the first study that will really be assessing patients prospectively, over a year, for a broad spectrum of treatment-related financial changes. 

Andrew Schorr:

Dr. Shankaran, I know you often see financial hardship among the patients that you see.  What do you hope will be learned from this study, and what difference do you hope it will make, going forward for patients? 

Dr. Shankaran:

The motivation to do this study really came out of a prior study, in which we surveyed patients throughout the Puget Sound region with colon cancer, stage III colon cancer, just to get a general sense of what financial hardships, or what the prevalence was for major financial hardships, related to treatment, things like going into debt as a result of treatment, having to borrow money from family members, having to sell your home, major financial changes.  And we were really surprised to find that close to 40 percent of patients in the Puget Sound region experienced these hardships. 

And so, that led to wanting to do a bigger study to explore who exactly is at risk for these hardships, when exactly during treatment do these changes occur, and why these changes are occurring.  Our previous study didn’t really delve into the timing and cause of these changes, so we’re really trying to understand who is at risk, and why do these things happen to people. 

Andrew Schorr:

What kind of specific things do you think could be developed for patients, to help them avoid additional pain? 

Dr. Shankaran:

I don’t think we can eliminate completely the financial impact of cancer treatment.  It’s an expensive disease.  Patients have to pay for treatments.  It’s life-changing.  It affects employment.  It affects the entire family, financially.  But what I hope we can accomplish is, A, to improve the conversation about financial hardship.  I really don’t think that’s occurring routinely, at all, in clinical practice, part of the rationale for doing this is to assess the feasibility of conducting these kinds of surveys, and assessing patients’ willingness to provide this information, so that ultimately we can incorporate these assessments into our routine clinical practice and alongside clinical trials. 

Secondly, if we can understand really what the major contributors are to financial hardship, and who is at risk for financial hardship, I hope that ultimately we can develop interventions to help these individuals who are at risk, and really develop more comprehensive financial assistance for patients, capitalizing on things like, pharmaceutical assistance programs, financial counseling and other interventions to help mitigate the burden, financial burden of cancer treatment. 

Andrew Schorr:

It seems like this is a research study looking at the whole person, the whole cancer patient, and not just their exact clinical situation, what’s their tumor type biology, etc. 

Dr. Shankaran:

Yes, absolutely.  We’re very used to, as clinicians, assessing the typical toxicities, like blood counts, nausea, diarrhea, but some of these factors we’re trying to assess, financial changes, changes in insurance, major financial hardships, these are as important, if not more important, in patients’ lives than any treatment-related side effect. 

I think it’s really crucial, as we assess the whole patient, to understand all of the things that patients are going through, and all of the factors that result from treatment that impact their quality of life, their overall stress, their happiness, their well-being and the well-being of their families. 

Andrew Schorr:

Dr. Veena Shankaran, from the Seattle Cancer Care Alliance, again, congratulations on your Career Development Award in, what sounds like, important research to help patients.  Thanks for being with us on Patient Power once again. 

Dr. Shankaran:

Thank you so much for having me. 

Andrew Schorr:

I’m Andrew Schorr.  Thank you for joining us.  And remember, knowledge can be the best medicine of all. 

Please remember the opinions expressed on Patient Power are not necessarily the views of Seattle Cancer Care Alliance, its medical staff or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

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