Patient Experience and Collaborative Care in Metastatic Bladder Cancer
Shared patient perspectives and conversation centered around collaboration in clinical care for metastatic bladder cancer, including the oncology pharmacists’ role in treatment decisions.
Transcript:
Rohit Jain, MD, MPH: So, with this information, Jeffrey and Lauren, I'll ask you a few questions. So, what symptoms [did you have] that led [you] to get the medical care?
Jeffrey Ehas: I had first noticed that I had blood in my urine, and it was concerning. And we went to the doctor, got checked out, and turned out that I was diagnosed with bladder cancer. It was a terrifying moment.
Rohit Jain, MD, MPH: I totally understand. So, when you heard about the diagnosis, what concerns did you have about that?
Jeffrey Ehas: My concern was, am I going to die? How soon am I going to die? Next week? Next month? Before my birthday? Before Christmas? How long? What can we do? What kind of treatment can I get? Is it treatable?
Lauren Ehas: When he was first diagnosed, they weren't sure if he had a treatable [cancer] or not, if it was epithelial or not…He was still under anesthesia, and the doctor came and spoke to me about that. And I didn't even know if what he had was treatable. So, yes, it was very scary at the time.
Rohit Jain, MD, MPH: I absolutely understand the situation. It's always concerning when you hear this diagnosis. And how did you become educated about bladder cancer?
Jeffrey Ehas: My wife does research online, pamphlets, books from Moffitt, talking to the doctors at Moffitt.
Lauren Ehas: Learning as much as we could, wherever we could. Because… when you get a diagnosis like Jeffrey had, you want to do as much as possible to make a favorable outcome for as long as possible.
Jeffrey Ehas: Find out the facts. What is it? How does it work? What can you do?
Rohit Jain, MD, MPH: Absolutely. The more education, the better it is so that you can ask informed questions from your team. Absolutely agree with you. And Lauren, can you describe your role as Jeffrey's caregiver?
Lauren Ehas: I feel very fortunate that I might call myself his caregiver, but Jeffrey has done very well throughout this whole time…When someone's diagnosed with a stage IV cancer, you have no idea what you're looking at and how this procedure is going to go. How is he going to feel during the chemotherapy? Is he going to be sick? Is he going to be weak? Is he not going to be himself? But…we feel very fortunate that he did well with the chemo without acting [different]…he was tired, but not really any difference. I don't really feel like a caregiver. I feel like he's been taking good care of himself and I'm just supporting him.
Jeffrey Ehas: She is an excellent caregiver. She's everything to me.
Rohit Jain, MD, MPH: No, absolutely. Usually, it's the patient who's going through the treatment, but it's the emotional turmoil [that] the family is going through. So, it's very important that you have a very strong caregiver to support you through this journey. Amazing. So, moving forward, when we talk about this diagnosis and we talk about treatment, there is always…a multidisciplinary approach. We have in our team, pharmacists. We have nurse practitioners. So, Dr Shah, in your practice, what is the role of oncology pharmacists in the pharmacy and therapeutics committee for treatment of metastatic bladder?
Anand Shah, PharmD, BCOP: Thanks, Dr Jain. So … pharmacists are involved in so many different levels within the hospital, and pharmacy and therapeutics committee is certainly one of them. But I'm going to say that's not only where pharmacists function. So, P&T (pharmacy and therapeutics) committee is where drugs get approved. So, when we have so many novel therapies come through for oncology, these drugs get presented at the pharmacy and therapeutics committee by the clinical pharmacists typically. And the committee votes on it. And that's how these drugs get approved. Now, more on the clinical side, pharmacists are involved in all of our solid tumor clinics. And they're involved in a lot of different things. And we will talk about this a little bit more further down the road. But pharmacists are involved in patient education. As well as in the dispensing side, pharmacists are involved in taking care of reviewing orders, medications, dispensing the right medication for the right patient, and making sure that the chemotherapy is dosed appropriately and dosed correctly for our patients.
Rohit Jain, MD, MPH: Absolutely agree with you. It's a very integral part of our treatment.
Transcript is AI-generated and edited for clarity and readability.
