HOPA’s Patient Advisory Board helps patients advocate for a pharmacist in every cancer care team
Pharmacy hours interviewed Karen Fancher, PharmD, BCOP, Associate Professor of Pharmacy Practice in Acute Care Oncology at Duquesne University School of Pharmacy and Member of the Hematology/Oncology Pharmacy Association Patient Advisory Committee ( HOPA), about the HOPA Patient Advisory Committee and its work in the field.
Alana Hippensteele: Hi, I’m Alana Hippensteele with Pharmacy hours, and with me are Karen Fancher, PharmD, BCOP, hematology/oncology pharmacist; associate professor of pharmaceutical practice in acute care in oncology at Duquesne University School of Pharmacy in Pittsburgh, Pennsylvania; and a member of the Hematology/Oncology Pharmacy Association (HOPA) Patient Advisory Committee. Karen is here to discuss her work on the HOPA Patient Advisory Board and how her experience as both a cancer patient and oncology pharmacy specialist informs that work.
This is the first interview of a new Pharmacy hours video series that will highlight the work of HOPA and its team members in the field of hematology/oncology pharmacy.
Could you tell me more about what the HOPA Patient Advisory Panel is and its work in the field?
Karen Fancher: Sure. So the Patient Advisory Committee is actually a sub-committee of a larger HOPA group called the Patient Outreach Committee. We are a brand new group, we have just completed our very first year.
We were made up of patients who have had cancer or are actively receiving cancer treatment and many of us are actually oncology pharmacists, so I’m not the only one. So we are finding our way and figuring out how we can best contribute to our mission. So our biggest efforts right now: Many of us will be attending HOPA on the Hill Day in September. So [we’ll be] helping to lobby Congress for oral chemotherapy disparities, as well as the concept that every patient should have an oncology pharmacist throughout their patient journey.
So we also respond to ad hoc requests, if there is a video like this or another request from HOPA members for a patient to speak, we are available for that as well. We are just starting our second year. So hopefully we will be addressing even more areas of impact over time.
Alana Hippensteele: Wonderful. How did you get involved in the patient advisory committee?
Karen Fancher: Yes, so I was diagnosed with cancer a little over 7 years ago, and I didn’t reveal it publicly for a while. It was quite embarrassing to be a pharmacist in oncology, then to have cancer and to be treated in my same establishment. So I kept it relatively private, at least in the HOPA landscape.
After about 5 years or so I decided that I should somehow make this public. It was never a secret, but it wasn’t just something I announced. So when I finally let people know, or at least my wider circle knows, David DeRemer, PharmD, BCOP, FCCP, FHOPA, the president of HOPA, actually extended me a personal invitation. He said, “We have this new committee, and I really think you would give it a unique perspective.” So he encouraged me to apply, and off we went.
Alana Hippensteele: Yeah, that’s really interesting. How has your own experience as a patient diagnosed with Stage IIA breast cancer influenced your work with the Patient Advisory Committee?
Karen Fancher: It’s a complicated question. I think the short answer is: I can give views from both sides, can’t I? I’ve been a patient, obviously, but I also hope to have a good working knowledge of the system, the health care system, this cancer journey system. So I hope the opinions I give reflect both sides of that, like what the patient might think, but also how the pharmacist might think when approaching that patient.
Alana Hippensteele: To the right? Absolutely. What led you to pursue your career as an oncology pharmacy specialist in the first place?
Karen Fancher: So, yes, it goes back a while. I think there’s this feeling that I’m going to say something like, my grandfather had cancer, and it changed my whole life, and I knew that was the path I wanted to go down – and it wasn’t. was just not my experience. I had no real passion for any area of pharmacy until my last year of school. When we got to the oncology pod, I really liked how these drugs worked. I figured out how they work better than heart medications or stuff like that.
Then I did a few rotations with the same teachers who had taught me in class, and I had the best experiences, and they became my mentors. I kind of went that route because that’s what I loved the most at the time. I don’t regret it for a second. I love my experiences with my patients whom I have to practice at a high level every day. I also really like the fact that I can participate in decisions without having to do anything gross, like touching patients, body parts or anything like that.
Alana Hippensteele: I totally understand. How has your experience as a cancer patient and oncology pharmacy specialist helped inform your perspective when working with patients?
Karen Fancher: If you asked me before I was diagnosed with cancer, do I understand what my patients are going through? I would have said yes. I would have been like, ‘Yes I understand.’ I did not understand.
I think what I’ve learned the most is that it’s okay for a patient to be angry. I got really carried away in all this, “You are a fighter, and you are a warrior and only good vibes.” All like that kind of rhetoric if you will. Then, when it was my turn, I was just angry enough. At least at first I was quite angry with the whole situation. So I think now I appreciate and forgive a little more, and I’m a little more understanding, when my patients aren’t always bright and happy and love girl power about breast cancer, and that kind of things. I hope I’m more understanding of their anger, because sometimes it sucks, and that’s okay to say.
Alana Hippensteele: Absolutely. Yeah, it’s really powerful. What points would you recommend other oncology pharmacists keep in mind regarding the patient experience when working with cancer patients?
Karen Fancher: So maybe first and foremost, just that patients get so much information from everyone trying to help an oncology pharmacist, and I still had people trying to tell me what drugs I should be on and what exercises I should do. And, as if I didn’t know my own medical condition well enough, everyone wanted to help me. But I got really questionable advice. So I would just say to oncology pharmacists that patients get information from all sources, from all angles, and you’re there to help them sort it out. But also, just appreciate the amount of information coming in from all directions. I would also say that I was really surprised at how many people advised me to do something alternative to taking something herbal. Again, I was aware of this when I thought about advising my patients, but now I’m definitely asking as a blank slate, ‘Are you taking any herbal medicines I should be aware of? It’s okay, I just need to know that. I think I’m more aware of it now.
Alana Hippensteele: On that note, are there any common herbal remedies you’ve heard cancer patients follow that might be something the oncology professionals or oncology pharmacist should note or be sure to ask?
Karen Fancher: Yes. Unfortunately, the selection of herbal and complementary products is so vast that it is difficult to identify 1 or 2 unique products that the patient might be taking. In my experience, patients usually come with a bottle that has about 7 ingredients. So I guess in the first place to be very careful that you’ve looked at each of those ingredients because again that proprietary blend of something might contain an ingredient that’s not compatible with the chemotherapy of this patient, or that increases their risk of bleeding, or what do you have.
I think I’m always surprised by the number of breast cancer patients who are advised to take a certain type of estrogen. Many times I see patients who have shown me a bottle that says my holistic prescriber recommended it, and there’s an estrogen derivative in there, and they don’t always have the same names . So unfortunately I can’t always spot it without checking a reliable source.
Alana Hippensteele: To the right. What’s on the horizon in your work on the HOPA Patient Advisory Board?
Karen Fancher: So we had a meeting yesterday. As I mentioned, we are having HOPA on Hill Day in September. A few of us are doing interviews as a recap of the HOPA conference we just attended. HOPA was so generous to invite all panel members to come as guests.
So many of us are interviewed for promotional material with HOPA. Several of us will be giving interviews for Joe Biden’s Cancer Moonshot Initiative, and against that there have been several other ad hoc requests that we hope to meet in the coming weeks.
Alana Hippensteele: To the right. That’s exciting. Final thoughts?
Karen Fancher: Well, thanks for asking. I appreciate the opportunity to show what we are doing and what we hope to accomplish. Number 1, ladies, get your mammograms. Number 2 you know I guess I really thought I’d be somehow immune or special and that stuff wouldn’t happen to me and my family because that’s what I dedicated my life. And that just wasn’t true. So even if you’re not a woman, you should get screened for any type of cancer you might be at risk for with age-appropriate screening. But also, it will be fine. It’s going to be fine. I’m always happy to talk to anyone who is interested or needs a second backup or just a vent.