CANCER BUZZ Association of Cancer Care Centers

Social determinants of health have been proven to impact access to care, but further delineation is necessary to describe their effect on treatment selection itself. To mitigate this knowledge gap, the Association of Cancer Care Centers (ACCC) sought to identify the impact that social determinants of health may have on guideline-concordant treatment selection in hormone receptor positive, HER2 negative, metastatic breast cancer and early breast cancer. In this episode, CANCER BUZZ speaks with Niharika Dixit, MD, medical oncologist at Zuckerberg San Francisco General Hospital and professor of medicine at UCSF Helen Diller Family Comprehensive Cancer Center. Dr. Dixit sheds light on inadequate insurance coverage and the challenges faced by health systems during comprehensive treatment planning. She considers the impact of social determinants of health on screening, timely diagnosis, treatment tolerability, and adherence.

“Many of the patients who have barriers related to social determinants of health would not be included in the clinical trials that determine the guidelines for treating breast cancer. I cannot overstate the importance of that—addressing social determinants of health brings more patients who are from racial and ethnic minoritized groups, who would make our clinical trials richer and our evidence-based guidelines more generalizable.”—Niharika Dixit, MD

Niharika Dixit, MD
Medical Oncologist
Zuckerberg San Francisco General Hospital
San Francisco, CA
Professor of Medicine
UCSF Helen Diller Family Comprehensive Cancer Center
San Francisco, CA
This podcast was developed in connection with the ACCC educational initiative Social Drivers of Health in Metastatic Breast Cancer and made possible with support by Pfizer.
Resources:
ACCC Social Drivers of Health in Metastatic Breast Cancer
Social Determinants of Health and Health Equity
 

Immunotherapy is redefining survivorship to include an increasing population of patients who live with cancer and navigate toxicities that differ from those that accompany traditional treatments. In this episode, CANCER BUZZ speaks with Brittney Baer, BSN, RN, patient care coordinator for the Immune Effector Cell program at Vanderbilt University Medical Center’s Vanderbilt-Ingram Cancer Center, about key strategies and solutions to prioritize patient quality of life by addressing barriers to holistic survivorship care. 
“I think simply talking to your patients and seeing what they would like to see [in terms of survivorship care] out of your cancer center—you don't have to start a huge holistic program right away...whether it be a nutritional program, a one-day-a-week meditation class, or a yoga class...start small and then start growing from there.”—Brittney Baer, BSN, RN
Brittney Baer, BSN, RN
Patient Care Coordinator, Immune Effector Cell Program 
Vanderbilt University Medical Center - Vanderbilt-Ingram Cancer Center 
 Nashville, TN 
 
This episode was made possible by support from Bristol Myers Squibb and developed in connection with ACCC’s Immuno-Oncology Institute, which is made possible by support from Bristol Myers Squibb, Merck & Co., and AstraZeneca.
Resources:
About the Institute - ACCC 
IO Institute Survivorship Resources 
State of Survivorship Survey - NCCS 

Germline and somatic testing for  in prostate cancer can improve outcomes and promote early detection and prevention, yet many patients are not aware of testing and the impact it can have on treatment options. In this episode, CANCER BUZZ speaks with David Gill, MD, medical oncologist at Intermountain Healthcare’s Intermountain Cancer Center and Lindsey Byrne, MS, LCGC, licensed certified genetic counselor at The Ohio State University Comprehensive Cancer Center, who discuss how genetic counselors and increased patient education can help cancer programs close the practice gap and promote guideline-concordant testing among patients diagnosed with prostate cancer.  
 
“I’d really advocate—even in your patients with a negative NGS panel—please still consider getting germline testing in those patients.” –David Gill, MD
 
“We know that individuals, yes, they’re dealing with a diagnosis of cancer, but the first thing people say to me when I sit down with them is, ‘All right, I have this figured out, but what does this mean for my family?’ They’re really worried about their family, and that’s where our focus is, to help take care of that.”—Lindsey Byrne, MS, LCGC
 
David Gill, MD 
Medical Oncologist  
Intermountain Healthcare - Intermountain Cancer Center  
Salt Lake City, Utah 
 
Lindsey Byrne, MS, LCGC 
Licensed Certified Genetic Counselor 
The Ohio State University Comprehensive Cancer Center – The James
Columbus, Ohio 
 
This episode was developed in connection with the ACCC education program Germline and Somatic Testing for Mutations to Optimize Outcomes in Metastatic Prostate Cancer and is supported by AstraZeneca, Johnson & Johnson, and Pfizer.
 
Resources:
Germline and Somatic Testing for Mutations to Optimize Outcomes in Metastatic Prostate Cancer - ACCC
Abstract: Homologous recombination repair gene mutation (HRRm) testing patterns and treatment selection from a real-world cohort of patients with metastatic castration-resistant prostate cancer (mCRPC) 
Abstract: Utilization of genetic counseling and testing for patients with prostate cancer following integration of a genetic counselor into a genitourinary cancer clinic 

Anemia can negatively affect quality of life and treatment outcomes for patients with high-risk myelodysplastic syndrome (MDS) and acute myeloid leukemia. In this episode, CANCER BUZZ speaks with Amy DeZern, MD, MHS, director, Bone Marrow Failure and MDS Program, Johns Hopkins University School of Medicine in Baltimore, Maryland, Donald Moore, PharmD, BCPS, BCOP, DPLA, FCCP, clinical oncology pharmacy manager, Atrium Health Levine Cancer in Charlotte, North Carolina, and David Sallman, MD, assistant member, Department of Malignant Hematology, Moffitt Cancer Center in Tampa, Florida. Their discussion elucidates an array of patient-centered approaches, touches on social determinants of health, and highlights collaborative measures to support care coordination in the management of anemia in patients with high-risk myelodysplastic syndrome and acute myeloid leukemia.
 
“It really does take a village to manage the anemia of high-risk MDS…We as providers need to think through transfusion mitigation strategies but also keep our patients safe.” –Amy DeZern, MD, MHS
 
“Health disparities can play a really important role in affecting outcomes. And a lot of that is multifactorial—it may be due to patients without insurance having a higher tendency to delay seeking care due to the associated cost of seeking medical attention, and therefore they may present sicker.”—Donald Moore, PharmD, BCPS, BCOP, DPLA, FCCP
“There’s no question, especially as therapies are getting more complex, and the side effects as far as the severity of cytopenias are increasing, this collaboration between blood bank centers and community oncologists is going to be increasingly important.”—David Sallman, MD
Amy DeZern, MD, MHS
Director, Bone Marrow Failure and MDS Program
Professor of Oncology and Medicine
Johns Hopkins University School of Medicine
Baltimore, MD
 
Donald Moore, PharmD, BCPS, BCOP, DPLA, FCCP
Clinical Oncology Pharmacy Manager
Atrium Health Levine Cancer
Charlotte, NC
 
David Sallman, MD
Assistant Member, Department of Malignant Hematology
Moffitt Cancer Center
Tampa, Florida
 
This episode was developed in connection with an initiative of the ACCC education program Myelodyplastic Syndromes, Optimal Management of Anemia in Adults with High-Risk MDS, which is supported by Gilead.
 
Resources:
Myelodysplastic Syndromes - ACCC
Achieving & Maintaining Better Outcomes for Patients with Acute Myeloid Leukemia Project - ACCC
Disparities in Acute Myeloid Leukemia - ACCC
 

Prior to 2020, patients newly diagnosed with breast cancer at Atrium Health Wake Forest Baptist’s Comprehensive Cancer Center experienced high variability in the number of days it took to see a breast cancer provider. Scheduling was decentralized across the departments and rarely could multiple visits be coordinated to occur on the same day, within the same location. Addressing this issue required a coordinated, multidisciplinary approach that involved engaging the cancer center leadership across 3 treatment departments—medical, radiation, and surgical oncology—administration, physicians, advanced practice providers (APPs), patient navigation, genetic counseling, scheduling, imaging, lab, and pathology. The primary goals of the initiative were to transform patient experience and improve timeliness to care for every newly diagnosed patient.
Guest:
Hunter Hayes, MBA
Associate Principal
The Chartis Group
 
“Being able to get patients seen quickly; being able to retain patients for their full cancer treatment is incredibly important…competition is growing and being able to keep those patients and keep their experience positive is critical.”
 
Read more in “Improving the Care of Patients Newly Diagnosed With Breast Cancer” coming in your Volume 38, Number 2, Oncology Issues.
 
Resources:
Improving Cancer Care Teamwork: Five Patient-Centered Strategies to Strengthen Care Coordination
Machine Learning and Predictive Analytics Solution Transforms Infusion Center Operations
Location Technology Improves Efficiency, Safety & the Patient Experience
Breast Care ACCESS Project

Improving timely identification and referral of patients who may be eligible for chimeric antigen receptor (CAR) T-cell therapy is critical for improving outcomes for patients with hematologic malignancies. On February 7, 2024, ACCC hosted a virtual Working Summit: Advancing CAR T-Cell Therapy Care Continuity and Collaborative Patient Education to explore topics including patient and caregiver needs as well as care coordination between referring providers and certified CAR T-cell therapy centers.  
In this episode, CANCER BUZZ speaks with Amy D. Smith, FNP-BC, director of the Meredith and Jeannie Ray Cancer Center at Ivinson Memorial Hospital and co-chair of the Summit about the event’s key findings, which can guide cancer programs in building a framework for optimized CAR T-cell therapy care coordination. 
“The goal really was how do we get those patients [receiving CAR T-cell therapy] back here and get them back into some kind of normalcy in their life sooner? A lot of that is building relationships and having trust with those providers in the academic centers that are performing the CAR T, so that they know that we can provide safe care at home.” –Amy D. Smith, FNP-BC
“Keeping care close to home is near to my heart, living in a rural area. That was one takeaway... how do we collaborate better to make this happen for our patients and care teams? –Amy D. Smith, FNP-BC
Amy D. Smith, FNP-BC
Director, Meredith and Jeannie Ray Cancer Center
Ivinson Memorial Hospital
Laramie, WY
 
This episode was developed in connection with the ACCC education program Tips for Early Patient Identification for CAR T-Cell Therapy and Care Continuity with Community Providers and made possible with support by Kite Pharma, Johnson & Johnson, and Legend Biotech, and through partnerships with Cancer Support Community, the Association of American Cancer Institutes, and the Advanced Practitioner Society for Hematology and Oncology.
Resources:
ACCC CAR T-Cell Therapy Focus Group Highlights   Tips for Early Patient Identification for CAR T-Cell Therapy and Care Continuity with Community Providers  Community CAR T-Cell Patient Identification Framework – CANCER BUZZ [Mini Podcast] Ep 138  If They Recur, You Should Refer—A Community Oncologist Patient ID Roundtable Summary  – from Oncology Issues Vol. 38, No. 6