Dawn Hershman, MD, MS

Improving outcomes by reducing the long-term side effects of breast cancer treatment.

Impact

While many new treatments, diagnostic tests, and procedures have been introduced for patients with breast cancer in the past decade, the quality of care remains a major focus of clinical research. Dr. Hershman is conducting interventional studies that aim to reduce adverse effects, control pain and improve treatment adherence, and improve quality of life for patients in all stages of breast cancer. Her current research focuses on understanding the long-term adherence to endocrine therapy among patients treated in phase III clinical trials, the evaluation of primary care use and cancer screening and imaging in survivors of metastatic breast cancer, and the development of secure devices to control the use of controlled substances, such as opioids, in patients after surgery.

Progress Thus Far

Dr. Hershman has previously shown that blood glucose levels are elevated (hyperglycemia) by chemotherapy treatment, and her results have suggested an association between hyperglycemia and chemotherapy-induced peripheral neuropathy. The team has accrued all patients to their clinical trial that will monitor glucose patterns over time to confirm this association.

What’s next

In addition to her work studying hyperglycemia after chemotherapy, Dr. Hershman and her team are continuing other research efforts directed towards improving quality of care, including the following studies:

• Care of patients living with metastatic breast cancer. Participants in an ongoing study will be evaluated for patterns in routine age-appropriate cancer and chronic disease screenings, vaccinations, and general primary care. For each of these cases, relationships between patient demographics (age, race, socioeconomic status), cancer types, and general health outcomes will be examined.
• Investigating the clinical efficacy of a password-protected pill-dispensing device to help manage opioid use for post-operative breast cancer patients. The device is linked to a mobile app that provides guidance based on pain levels and suggests tapering schedules as indicated by the physician.
• A new study to understand the long-term lack of adherence to endocrine therapy among patients treated in phase III clinical trials. The team will utilize a large clinical trials database linked to Medicare claims data, including long-term follow up treatment and healthcare information, which they will use to calculate endocrine therapy adherence by clinical trial.