Through that process, you know, I've watched as you have
tirelessly,
you know, visited many NCI centers,
federally qualified health centers, you know,
having the chance to highlight innovations in cancer prevention,
screening new therapies, how we do survivorship.
Now, two years ago, you bestowed the honor on us
when I was the director in San Antonio
of visiting us at the Mays Cancer Center in San
Antonio,
where we discuss advancing the science of cancer and Latinos
and the needs of South Texas.
So I'm so thrilled to really welcome you to this
Cancer Center.
The Atrium Healthway Forest Baptist Comprehensive Cancer Center celebrates this
year,
50 years as an NCI designated center
and two years integrating with the Levine Cancer Institute.
The Levine Cancer Institute brought
much newer but brought innovation,
strength in clinical trials and expertise to a shared mission
as one center.
Together last year we saw over
37,000 new patients and over 20,000 newly diagnosed cancer patients
and bringing together innovations in clinical trials
in discovery science and cancer control
and care according to what we like to call the
loved one standard.
Where we seek whether it's through trials,
our science or our care
to care for individuals as we would want our own
family members to be careful.
And today's visit really will highlight two aspects
of what we're working on that very much is in
alignment with that aspiration.
The 1st is in cancer patient navigation.
Cancer patient navigators are are the glue
in, in the difficult journey that cancer patients follow.
It's very complicated. Many doctors,
many specialties, many, many facilities,
very complicated. They really provide that blue
that improve outcomes, decrease anxiety,
really help patients navigate that.
Again, huge thanks to both yourself,
the President and the administration for how many advanced was
really a transformational piece,
which is for cancer navigation to now be
reimbursable by Medicare and that's huge.
It is huge. You know it's absolutely huge because in
the past we largely had to by hook or by
crook philanthropy other things support these programs.
But now this coverage will allow this to really flourish
across the United States
even in our center that has a robust program will
be able to really expand that across our regional sites
and take that to a whole nother level.
The second piece is really around financial toxicity.
You know and just have patients can have nausea or
vomiting
as a side effect of their treatment.
Certainly there are many financial side effects.
So, so my predecessor and friend who's in the audience
factor,
Derek Rogerman had the innovative idea
with the teams here to bring the same expertise that
we normally do
to treatment planning around tumor board.
Someone has a cancer, we bring experts around the table,
they all kind of give their two cents.
We come up with a treatment plan
in the same way different expertise
around an individual's financial challenge is that transportation is that
lodging,
is that co-pay for medications
or some other burden. So two really innovative programs
and really excited for you to hear about them.
Yeah, but we're here about them in just a moment.
Let me hand it over to you for for some
thoughts.
So actually, I know exactly
exactly what you're talking about because,
like you,
both my parents died from cancer and then my sister
had a stem cell transplant not very many years ago.
And I know when people hear that word cancer,
that's the last thing you hear.
You hear nothing else because you're so in shock
from, you know, like where do I go,
what doctors do I take?
How am I going to pay for this?
And so having someone walk you through that process every
step of the way to not only provide emotional support,
but really to help you
walk through, you know, your medicines,
what time your appointments are,
make sure that you have,
like you're saying someone to drive you there because honestly,
you're so shaken or, you know,
I mean, how many times have I gone with
members of my family? I mean,
certainly when my son was diagnosed with cancer,
I was the one who went with him to his
chemotherapy
appointments. And so all of that
and you know the diet,
just all of it, it's,
it's overwhelming. And I'm sure everybody here,
like you're saying everybody here in this room understands that.
And because I'm sure you know,
of someone who at this very moment
has has been diagnosed with cancer or some or you've
known someone who has
maybe died of cancer or has maybe hopefully become the
survivor of cancer.
So I understand everything you're saying.
I'm so grateful actually to,
you know, when we started the cancer moon shot in
the Obama Biden administration,
you know, I'm so thankful that we had the opportunity
that we could take it forward
and do what we're doing today because yes,
you know, Joe and I were very lucky.
I mean, we had access to really good care and
we could afford the care and we had private insurance,
but so many people do not and it just depletes
their bank accounts because who is going to say
if you're if they're saying to you,
you can try this medicine,
but it's $1000 a week or a month
and it's for your mom.
Who's going to say mom,
I'm sorry, but we can't buy that for you.
Who's going to say that?
So it's so important that we find a way to
help families afford
their cancer treatments and and everything else that is involved.
I mean, you know, the parking at the hospitals,
I mean, things are really expensive.
The meals that you have to eat because you're there,
you know, you're not like dropping in just to see
your mom for an hour.
You're there the whole day.
So I'm so thankful for what you're doing here.
And I have to say I'm so thankful to Joe
that you know after our son died,
I mean we had to find purpose because you
and you probably know this yourself and that's why we're
here,
that that's the only way you can sort of take
something that's so horrible and so devastating and turn it
into something good.
And that's what you've done.
So I thank you for this and
and I thank the press for getting out the
the word because otherwise the people here in this state
they need to know that there is help available that
they are not
alone. So I want to thank all of you for
being here.
Thank you wonderful the director.
So, so first, we're delighted that you're our new NCI
Cancer Center director that you're visiting here or early on
in your tenure.
You know, perhaps we'll become one of your favorite Cancer
Center.
Any thoughts you'd like to share?
Yeah, thank you.
I'm really proud that this is my first
NCI designated Cancer Center visit and that it's,
it doesn't have to be a favorite.
And you know, on your 50th anniversary year and in
a state that I I used to call home and
both of my children call home today.
So
I wanted to say though,
I've also been a medical oncologist taking care of patients
with complex cancers for 20 some years and can see
first hand how navigation can help get the right patient
to the right place and the right treatment most effectively
and make a real difference.
So to me it's a huge
honor to have the chance to see this now move
into something that's available for every patient because every patient
really deserves and opportunity.
I think the other piece the the tumor board that
you all have done,
we've all known about for a long time.
It's really a hallmark in in the in the field
for
managing the very complicated parts of of paying for healthcare.
We
we can, we can point to some direct effects of
the moon shot
both for navigation. I'll give you one example which is
the
accelerating colorectal cancer screening and and follow up initiative that
has
made a real difference but also
funding to support understanding that financial burden and how we
can best manage it.
A lot of it we've learned here as well.
So thank you very much.
I'm really happy to be here.
Yeah, wonderful
mayor Lyles are are Charlotte mayor of the of the
great Queen city.
I do have a thought.
I have many thoughts about this because
First Lady, I would like to say Doctor Biden,
Atrium health and advocate health.
They bring a new dimension to the city
that's going to make a real difference.
But I also have to recognize Sandra Levine who has
stood by this committee,
this community, with her philanthropy,
with her family's, for that philanthropy.
And we so much appreciate this.
And I, you know, I what I want to say
is that,
you know, I'm a cancer survivor,
a breast cancer survivor. And during this time I can
see the changes in the way that you speak about
cancer,
the way that we act as we're going to work
with patients.
And I'm just so grateful that our residents has they
have the possibility to come to some place where they
do have the support system,
the services that are necessary to,
you know, just lift themselves up and hopefully survive.
So I'm grateful for all of the kind of research
that you do,
all the efforts that you put into it.
And I just want to say thank you to each
of you on this team to being here in our
community,
working for our people. It makes all the difference in
the world.
Thank you, wonderful.
And the vice chair of our wonderful Mecklenburg County,
Mr. Jarrell, please. Well, thank you so much.
Doctor Biden. Thank you for being here.
I also want to say welcome and thank you to
Advocate Health and Miss Levine and and just everyone Doctor
Mesa referenced earlier that,
you know, cancer has robbed so many families.
We've all been touched by it.
My family is no exception.
When I was nine years old,
my father lost that battle
to cancer and our family did.
But as I stand here today,
I'm just so heartened because
I think about,
I know we lost that battle,
but I feel like we're going to win the war.
And I just want to thank you for your advocacy
and what you're doing and the resources that each and
every one of you are providing.
And I'm so proud of our community for coming together
and bringing all the stakeholders together.
So thank you so much.
Thank you. Wonderful. So let's pivot to to to these
these two programs.
In many ways they have important connections.
But first, Chris Blackley does a superlative job at
leading our wonderful cancer navigation problem.
Why don't you share with them
a little bit about the the great program?
Yeah, sure. I don't know if I can describe navigation
any better than the first Lady did.
I'll let you know when we have another opening.
Hopefully I won't need a job soon.
Hopefully I agree.
But again, on a serious note,
when when someone is diagnosed with cancer,
it's terrifying.
And it's not only terrifying for the patient,
but it's terrifying for their family.
And like you said, as soon as the patient hears
those words,
everything else just blacks out
and they don't remember, you know,
what they were told. And again,
it's such a shock, like you said.
But then when when people go home
and the shock starts to wear off,
they have questions that that they didn't get answered when
they saw the doctor,
You know, what is this going to mean for me
and my family?
Will I be able to work?
Can I afford this? Do I have someone who can
watch my kids while I go to treatment?
So those are things that the Navigators really work
towards providing for our patients.
Navigation got its start actually because it was working to
overcome barriers that patients had as they were going through
their treatment.
Like we've talked about financial food insecurity,
housing insecurity, you know other things
you know that that are very difficult to deal with
especially with the cancer diagnosis.
And then we've also been able to do some exciting
research here
and so be able to show some improved patient outcomes.
Patients who have a navigator have fewer visits to the
emergency room.
They're less dependent on that.
They have fewer readmissions after they've been in the hospital
and of course they they miss fewer appointments.
All of those you know and more are something that
that helps in saving healthcare costs as well
and resources that are, you know,
valuable right now. She's looking
at me what she's saying,
yeah,
we've been very fortunate here
at our Cancer Center. We have
65 navigators right now. Wow.
And good for you. Yes,
it's very unusual and last year we navigated over 10,000
new patients,
new patients.
It's been so robust because our leadership here understands the
value,
but this is a benefit that we provide our patients
free of charge.
So as you know, you know that is difficult to
sustain over a long period of time especially as we
grow.
And then we have to send out Doctor Mesa and
Doctor Woods to go try and round up some money
to try and support our program that we think is
so important. So that's why I'm so grateful for everything
that you've done
and the Cancer Moon shot because as long as I've
been in this position,
this is what we have been working for
is to get it recognized
for what it can do for all of our patients,
for all
and and to be able to
provide that support that those patients need.
So I just can't thank you enough and really it's
going to add to the sustainability of navigation for the
long term.
So that's good to hear.
That's good to hear, you know and it's such a
critical program because we both bring together disease specific navigation.
But then we also have as part of our office
for cancer HealthEquity as part of our NCI comprehensive Cancer
Center population navigators that have different
complementary expertise that really are trying to overcome challenges with,
with language, with culture or other aspects of HealthEquity.
Now clearly something that is frequently found during the process
of navigation is financial taxes.
Yep. So Doctor Greg Knight,
one of our wonderful colleagues,
he's a hematologist, but he along with Doctor Derek Raghavan
and
Caitlin Henso who was then able to be here today,
many others involved in really putting together this innovative program.
Greg, why don't you share some of those details?
Sure. So as we had mentioned financial toxicity.
So this is something that we're
now learning more about and and from a research perspective
realizes incredibly crucial.
So we always think about the physical toxicities,
the nausea, the vomiting, the loss of hair,
but the financial toxicity is devastating for patients.
That's right. And we now know that it also decreases
quality of life,
but it also increases chance of death if you're experiencing
this.
So here at this institution we decided to try to
take to tackle this problem and we created this thing
called the Financial Toxicity Tumor Board.
As Doctor Mesa mentioned, we
tried to go at like a disease focused tumor board
where you bring in all these experts into a room
and you go,
let's figure out a solution to this.
However, when you're starting to talk about things like financial
toxicity that is a very complex problem.
We need to go for the entire Cancer Center and
use all of the resource we have.
So not just medical people,
but we need billing, we need administrative,
we need nurse navigation, we need social work,
We need all of these people in the same room
to bring their expertise to the problem.
So just a quick example just to kind of show
you how this works.
So we had
a case recently, a young person,
they have a GI cancer
and they lost their job and this is because they
have cancer.
They put, you know the the treatments and not being
and so you know it's devastating.
They've lost their income. Well,
they've also lost their insurance because their insurance was from
their employer.
And so this person is just in dire straits.
And their physician presents some of the tumor board and
says they don't know how they're going to pay for
their cancer.
They don't know how they're going to be able to
get here,
if even if they could pay for cancer,
how they're going to get here.
And they don't know if they're going to be able
to food on the table.
And so what's amazing is when you're in that meeting,
then all of these peoples with all this expertise can
jump in and say,
Oh no, we have all these things we can offer.
So we immediately got grants from both internal and from
foundation to for for food,
transportation and cost of living.
We had the financial people immediately look at the case
and be able to say,
OK, we can get them COBRA,
get the insurance back. Now for those that know about
COBRA,
they know that getting it is not the problem.
Sometimes paying for it is the problem sometimes.
And we were immediately able to do that within the
confines of the meeting.
And then we were able to connect them with financial
navigation and in financial navigation they were able to make
a plan in an offering.
So eventually, maybe going to an ACA plan,
maybe doing these things where you're everything is covered.
The advantage of this is when this person is cured
from their cancer,
they're not going to have crippling debt.
They're going to be able to live their lives and
live a normal life post cancer.
That's right.
The the last part of that case that that I
found so
exciting was that for our center was that we realized
that we we missed this,
right? Like as a center,
we should have picked this up.
We should be screening more,
we should be doing these things.
And this is when you have all these people in
the room,
you start to figure out the system problem.
And what we've realized is we need to do a
better job and that's what we started to do.
And so the hope is now
thousands of patients because we discussed this one case that
the tumor board will be screened and maybe never get
into that situation.
Now I would be remiss if I didn't mention one
other part of the tumor board and this is this
thing we call
the patient assistance program. Now this is designed to be
the kind of the front door because we know
that there are common things that are going to be
problems for patients like co-pays,
medication costs, right. Almost everyone is going to have these
issues.
So we want to take that away,
right. We want when you're getting treated for cancer,
we don't want you to be thinking about these things.
We want to assist if you need the assistance.
So in the past two years,
we have had 6000 patients served by our co-pay assistants
for a value to the patient of over $6 million
for our free drug program.
10,000 patients have gotten free drug for a value of
over $200 million.
And we think these programs work together so well because
now we can take care of the common things,
the co-pays the drug costs and then if it's complex
or there's other issues we need to bring the cancer
turn to bear,
then that goes to our tumor board and we're able
to fulfill our mission which is to be able to
treat everyone regardless of circumstance.
We are so excited to have you here.
We are, we are really excited to,
you know, this is work we've been really proud of.
I'm really proud of our entire team with us and
I and I think that I'm hopeful.
I am hopeful to doctor athmall that you know this
will be a cancer,
this will be adopted by other cancer centers and we
can really start to finally make a dent in this
issue with financial toxicity.
Wonderful. Well, thank you. You're doing a great job.
So we know that you know we're making great progress
in cancer,
but we know that that progress really has
it not been for all.
One of the reasons I'm proud of working here is
again it's a truly a strong for all mission and
and part of that is creativity,
but part of it is also innovation of how do
we really accomplish that.
So very excited to introduce our Dean of the Wake
Forest University School of Medicine Doctor Ebony Bowar who
again through her leadership and the the model of the
School of Medicine as the academic core for our system
helps bring innovation to HealthEquity
in Bowar. Thank you so much and somebody who spent
my entire career focused on health and HealthEquity.
I'm so honored to be here with Doctor Biden and
Dr.
Rathmel as we focus on cancer HealthEquity.
These models have talked about how and Doctor Biden you
really talked about how everybody needs to have access to
this care.
And at our school HealthEquity is fundamental to our mission.
And and and we're thrilled to train the next generation
of cancer doctors,
the next generation of cancer researchers to support the research
that will find the cures and to help support these
innovative models around HealthEquity.
We just want to thank you for your support of
this mission.
What you're doing in cancer effects millions of people who
will or in the future or have cancer now.
But it's also a model for the rest of the
nation as well.
The models that are happening coming out of the cancer
field are also we're we're adapting those navigation models,
financial toxicity boards in cardiovascular disease,
neurosciences, all the conditions that are important to to our
Americans.
So we're just very grateful for your focus.
Thank you. Thanks.
Wonderful. Well, we're just so thrilled to have had you
here any any final questions that you have for our
wonderful team.
I think they covered it,
don't you.
I think really I think our questions are answered and
I think we feel so much better about
where we're going and what we're trying to achieve in
the future and
you know you're leading us.
So thank you so much.
We are. We are excited to work in partnership with
yourself,
with our fellow centers across the the the NCI,
you know, defeating cancer as a team sport.
And we're we're just excited to be a member of
that team.
OK, why don't we do a group?
Oh, sure.