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In this episode, we are going to talk about toxicity. Sure, we are familiar with returning from a vacation and needing to quote “detox”, maybe it’s a week of smoothies and prepping healthy meals, or sweating it out at the gym to release toxins. When you are diagnosed with cancer, we also talk about toxicity. This is typically within the context of chemotherapy or radiation where the benefits of the treatment out weight the risk. Today we are going to take a deep dive into the financial burden of a breast cancer diagnosis. It’s the elephant in the room. We have amazing doctors who talk to us about treatment options, surgery options, what’s taking place in the most recent and cutting-edge studies as well as the outcomes and our prognosis. But who is talking to us about the cost of a cancer diagnosis? We know the cost of the therapies and treatments are outrageously high, but what about the unintended costs associated with your diagnosis? Are you financially prepared to take time off from work to make it to weekly chemo infusions, or pay for parking when you return the next day for a Neulasta shot? What about finding child care so you can attend your follow-up appointments? These additional costs can sneak up on you and really become a hardship. That is to ask, are we financially toxic? Are we living with financial toxicity? To help shed light on this topic we speak with Dr. Ryan Nipp who has studied this very topic. Dr. Ryan Nipp is a gastrointestinal oncologist and health services researcher at the Massachusetts General Hospital Cancer Center. He completed his medicine residency at Duke University and his oncology fellowship at Dana-Farber/Harvard Cancer Center. Dr. Nipp’s research focuses on optimizing the care delivered to patients with cancer. Specifically, his research platform consists of studies interfacing between palliative care, geriatric oncology, and health services research. His goal is to improve the quality of life and care for patients with cancer and their family. He is interested in developing models of healthcare delivery to improve patient’s quality of life, address their symptom burden, and promote patient-centered decision-making. 

Topics: 
-Financial Toxicity dating back to 2010-How to make it easier for patients (i.e., is there a pill they can take at home vs coming into the infusion center). 
-Working with vulnerable populations and being able to reimburse transportation for clinical trials.
-Can we engage with industry so that it is a win-win? 
-The Cost Measure instrument to assess financial toxicity 
-Palliative Care; people are living better and living longer with early intervention of palliative care. 

Tweetables:
"We're very good about describing the problem… what can we do about it?" 
"We now have the highest amount of evidence that palliative care works we now need to start implementing this."

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