HOPA’s Patient Advisory Panel Helps Patients Advocate for a Pharmacist on Every Cancer Care Team

Pharmacy Times interviewed Karen Fancher, PharmD, BCOP, an associate professor of pharmacy practice in Oncology Acute Care at Duquesne University School of Pharmacy and a member of the Patient Advisory Panel at the Hematology/Oncology Pharmacy Association (HOPA), on HOPA’s Patient Advisory Panel and its work in the field.

Alana Hippensteele: Hi, I’m Alana Hippensteele with Pharmacy Times, and joining me is Karen Fancher, PharmD, BCOP, a hematology/oncology pharmacist; an associate professor of pharmacy practice in Oncology Acute Care at Duquesne University School of Pharmacy in Pittsburgh, Pennsylvania; and a member of the Patient Advisory Panel at the Hematology/Oncology Pharmacy Association (HOPA). Karen is here to discuss her work on HOPA’s Patient Advisory Panel and how her experience as both a patient with cancer and an oncology pharmacy specialist informs that work.

This is the first interview in a new Pharmacy Times video series that will highlight the work of HOPA and its team members in the hematology/oncology pharmacy field.

Could you tell me more about what HOPA’s Patient Advisory Panel is and what work it does in the field?

Karen Fancher: Sure. So the Patient Advisory Panel is actually a subcommittee of a larger group at HOPA called the Patient Outreach Committee. We're a pretty new group, we just wrapped up our very first year.

We were composed of patients who have had cancer or actively are receiving treatment for cancer and several of us are actually oncology pharmacists, so I'm not the only one. So we're kind of finding our way and finding how we can best contribute to help our mission. So our biggest endeavors right now: Several of us are going to attend the 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's a video like this or another request from the HOPA membership for a patient to speak, we're available for that, too. We're just getting started in our second year. So I'm hoping that we're going to get into even more areas of impact as time goes on.

Alana Hippensteele: Wonderful. How did you first get involved in the Patient Advisory Panel?

Karen Fancher: Yeah, so I got diagnosed with cancer a little more than 7 years ago, and I did not reveal that publicly for quite some time. It was pretty awkward to be an oncology pharmacist, and then to get cancer and to be treated in my same institution. So I kept that relatively private, at least in the HOPA landscape.

After about 5 or so years, I decided I should kind of go public with this. It wasn't ever a secret, but it also wasn't just something I advertised. So when I finally did 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 that you'd give it a unique perspective.’ So he encouraged me to apply, and here we go.

Alana Hippensteele: Yeah, that's really interesting. How does your own experience with being a patient who was diagnosed with Stage IIA breast cancer informed your work with the Patient Advisory Panel?

Karen Fancher: That's a complicated question. I think the short answer is: I can give perspectives from both sides, right? I've been a patient, obviously, but I also have a hopefully good working knowledge of the system, the health care system, that cancer journey system. So I hope that the opinions that I'm giving are reflective of both sides of that, like what the patient might be thinking, but also how the pharmacist might be thinking as they approach that patient.

Alana Hippensteele: Right? Absolutely. What led you to pursue your career as an oncology pharmacy specialist initially?

Karen Fancher: So, yeah, that's going back a while. I think there's this sense that I'm going to say something like, my grandfather had cancer, and it changed my whole life, and I knew this was the path I wanted to take—and that just was not my experience. I didn't have a real passion for any area of pharmacy until my last year of school. When we got to the oncology module, I really liked the way those drugs worked. I understood the way they function better than drugs for cardiology or other things like that.

Then I took a couple rotations with the same professors that had taught me in class, and I had the best experiences, and they became my mentors. I kind of just went down that path because that's what I liked best at the time. I don't regret that for a second. I absolutely love my experiences with my patients that I have to practice at a high level every day. I also really kind of like that I get to be part of decisions without having to do anything gross, like touch patients, body parts, or anything like that.

Alana Hippensteele: I totally get that. How has your experience being both a patient with cancer and an oncology pharmacy specialist help to inform your perspective when working with patients?

Karen Fancher: If you asked me before I got diagnosed with cancer, if I understand what my patients are going through? I would have said, yes. I would have been like, ‘Yeah, I understand.’ I did not understand.

I think what I have learned the most is that it's okay for a patient to be angry. I got real swept up in that whole, ‘You're a fighter, and you're a warrior and good vibes only.’ All that like that kind of rhetoric if you will. Then when it was my turn, I was just pretty angry. At least at first, I was pretty angry at the whole situation. So I think now I appreciate and I'm a little more forgiving, and I'm a little more understanding, when my patients aren't always bright and happy and like girl power about breast cancer, and that sort of thing. I hope I'm more sympathetic towards their anger, because sometimes it does suck, and it's okay to say that.

Alana Hippensteele: Absolutely. Yeah, that's really powerful. What are some points you'd recommend other oncology pharmacist keep in mind regarding the patient experience when working with patients with cancer?

Karen Fancher: So maybe first and foremost, just that patients are getting so much information from everybody who's trying to help an oncology pharmacist, and I still had people trying to tell me what drugs I should take, and what exercises I should do. And, as if I didn't know my own disease state well enough, everybody wanted to help. But I got some really questionable advice. So I would just tell oncology pharmacists, patients are getting information from all sources, all angles, and you're here to help them sort that out. But also, just appreciate the sheer amount of information that's coming from all directions. I would also say that I was really surprised at the number of people that advised me to do something alternative to take something herbal. Again, I was aware of that when I thought about counseling my patients, but now I'm definitely asking like point blank, ‘Are you doing any herbal medications that I should be aware of? It's okay, I just need to know about that.’ I think I'm more conscious of that now.

Alana Hippensteele: On that note, are there some common herbal remedies that you've heard patients with cancer pursue that might be something that oncology professionals or oncology pharmacist should note or be sure to ask about?

Karen Fancher: Yes. So unfortunately, the selection of herbal and complementary products is so large, it's hard to identify 1 or 2 single products that the patient might be taking. In my experience, the patients usually come with a bottle that has like 7 ingredients in it. So I guess number one, being really vigilant that you've looked at every single one of those ingredients, because again, this proprietary blend of something could contain an ingredient that's not compatible with that patient's chemo, or increases their bleeding risk, or what have you.

I think I'm always surprised by the number of breast cancer patients that are advised to take some type of estrogen product. Repeatedly, I see patients that have shown me a bottle that says my holistic prescriber recommended this, and there's an estrogen derivative in there, and they don't always go by the same names. So unfortunately, I can't always spot it without checking a reputable source.

Alana Hippensteele: Right. What is on the horizon in your work on HOPA’s Patient Advisory Panel?

Karen Fancher: So we actually just had a meeting yesterday. As I mentioned, we're doing the HOPA on the Hill Day in September. There's a couple of us that are going to do interviews as a recap of the HOPA conference that we just attended. HOPA was so generous to invite all of the panel members to come as their guests.

So several of us are being interviewed for promotional materials with HOPA. Several of us are going to give interviews for Joe Biden's Cancer Moonshot Initiative, and against that there's been several other ad hoc requests that we're hoping to fulfill in the next couple of weeks.

Alana Hippensteele: Right. That's exciting. Any closing thoughts?

Karen Fancher: Well, thank you for asking. I appreciate the chance to kind of show off what we're doing and what we're hoping to accomplish. Number 1, ladies, get your mammograms. Number 2, you know I guess I really thought that I would be somehow immune or special and these kinds of things wouldn't happen to me and my family because that's what I've dedicated my life to. And that just wasn't true. So, even if you're not a lady, you need to get screened for whatever kind of cancer you might be at risk for whatever age-appropriate screening. But also, it's going to be okay. It's going to be okay. I'm always happy to speak to anybody who's interested or needs a second backup or just vent.