Veena Shankaran, M.D., Fred Hutchinson Cancer Research Center, Seattle
Gastrointestinal medical oncologist Veena Shankaran researches the impacts and risks when cancer patients face financial strain from costly treatments. She wants to help mitigate those burdens. Early on, she was moved by a patient dying from colon cancer. To get a new oral cancer drug, that patient’s share of the prescription cost was $1,870 a month, charged on three credit cards, including one belonging to her 24-year-old son. Three months and $5,610 later, the cancer worsened and she entered hospice care.
“As her oncologist,” Dr. Shankaran recalls, “I was not aware her costs were so high.”
Had she known, Dr. Shankaran might have referred her to patient assistance programs. “This experience highlighted the unfortunate disconnect that sometimes exists between well-meaning oncologists and the day-to-day difficulties patients face,” she says.
Dr. Shankaran led a study that found nearly 40 percent of colorectal cancer patients in western Washington experienced major debt, income declines and loss of their homes because of costly treatments. It found cancer patients statewide file for bankruptcy at higher rates than people without cancer, and for those patients, bankruptcy is a risk factor for death. One theory holds that financial hardship may lead patients to stop taking medicine and to thwart clinic follow-ups and surveillance.
As a leading “financial toxicity” researcher, Dr. Shankaran has outlined steps the oncology community can take. She seeks collaboration and has partnered with a bankruptcy court judge and a consumer education organization to develop a financial counseling program for new cancer patients. Dr. Shankaran has also received approval to conduct a national, multicenter study on the role of financial counseling to mitigate burdens for cancer patients and caregivers.
Jonathan Himmelfarb, M.D., Kidney Research Institute, Seattle
Director of Seattle’s Kidney Research Institute since 2008, physician-turned-researcher Jonathan Himmelfarb is dedicated to finding innovative kidney disease treatments. He has recruited kidney experts and diverse specialists while seeking regular public input. Dr. Himmelfarb is helping find genetic clues to create an atlas of key cells and targets for patient-precise therapies. A “Kidney on a Chip” project envisions plastic-encased, credit card-size chips of human kidney cells to seed these microscopic systems with diseases for widespread treatment testing. In a quest to create portable vest-like devices enabling freedom from dialysis centers, Himmelfarb helped start a dialysis innovation center that’s designing one.