As a Clinical pharmacist for Shields Health Solutions, I have had the privilege to focus on providing the best care for patients on specialty medications. With our care model, I can review each patient holistically, which means I can assess their labs, renal and hepatic function, allergies, med list and dosing, and other disease states that their specialty treatment could impact. These factors allow for individualized medication counseling and a trusting patient-pharmacist relationship, leading to empowered patients and improved outcomes.
In honor of October being breast cancer awareness month, I’m sharing a story of one of my patients with metastatic breast cancer that had been on several other treatments but continued to have disease progression. Her oncologist gave her the option to start new oral chemo for patients who have tried at least one other therapy. Before calling to review her new medication, I noticed that the dosing prescribed was 50% of the recommended dosing with no indications for dose reduction. I also saw a significant drug interaction with one of her other medications that could cause an increase in side effects and affect her quality of life. After talking with her oncologist, the dose and directions changed, and she was to stop taking her other medication during treatment. With an increasing number of available therapeutic options, it isn’t uncommon to see inappropriate dosing or dose adjustments needed based on individual patient factors.
When I called this patient to review her medication, she was upbeat and motivated despite everything she had been through. We had a wonderful conversation, and she felt better about starting her new chemotherapy. During a follow-up call, she mentioned that she had been taking her new medication an hour before her other one, which was challenging to remember. Luckily, both drugs can be taken simultaneously, which she was glad to hear. So far, she has been tolerating treatment well, and although it’s early in her treatment, there are no signs of progression.
With breast cancer being the most common cancer in women, it can be scary knowing that you or someone you love could be diagnosed at any time. However, this patient and this newer oral oncolytic agent shine a light on how amazing modern medicine truly is. Two years ago, additional treatments wouldn’t have been an option. Now there is this therapeutic option specific for her breast cancer to try, hopefully giving her and other patients more time until disease progression and more life to live.