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Dr. Emamekhoo on discussing the drug shortage with GU cancer patients


Hamid Emamekhoo, MD, explains his approach to discussing the ongoing cancer drug shortage with his patients with genitourinary cancers.

Hamid Emamekhoo, MD, explains how he discusses the ongoing cancer drug shortage with his patients with genitourinary cancers. Emamekhoo is a medical oncologist with a clinical and research focus on genitourinary malignancies at the University of Wisconsin-Madison School of Medicine and Public Health.


Communication with patients is very important for us. Every single patient’s treatment is important. When we get into this type of decision making, there are a lot of emotions and ethical considerations involved from both the patient’s side and the provider and treatment team’s side. So it is really hard when a treatment is working for someone to then have to tell them that we have to adjust the plan and not continue with that specific treatment. We have developed some talking points for physicians to provide clear communication and transparency about what is causing this shortage issue and how we are trying our best to come up with ways to provide alternative treatment options for our patients should the situation arise. Some of the discussions are easier than others, such as when we have a specific alternative treatment regimen and we can explain to the patient thatwe can get prior authorization from their insurance provider to use this alternativetreatment. Again, we operate with complete transparency and explain that as soon as we gain supply and if it is appropriate to go back on, for example, a platinum-based regimen, we can make that transition and switch back. For some of our patients, such as those with prostate cancer receiving carboplatin plus cabazitaxel, we continued treatment with single-agent cabazitaxel at the time when carboplatin was in very short supply. We decided that at least for a cycle, we could go with single-agent cabazitaxel, and then later on we can consider adding the carboplatin back into the treatment when supply allows. So, discussion with the patient about the shortage is going to be on a case-by-base individual level explaining the situation with the shortage and what the potential alternative treatments might be.

Transcript has been edited for clarity.

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