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Dawn Hershman, MD, MS
Professor of Medicine and Epidemiology
Division of Medical Oncology
Columbia University Medical Center
New York, New York
Goal: To improve quality of care, reduce overuse of expensive drugs, and improve the quality of life for breast cancer survivors.
Impact: One major reason for early discontinuation of effective therapy for breast cancer is related to inadequate management of symptoms. Dr. Hershman is testing strategies to reduce side effects of cancer and cancer therapies that could improve adherence.
What’s next: She and her team will continue to focus on strategies to reduce side effects of cancer therapy. This year she will continue her work on chemotherapy-induced peripheral neuropathy—a common side effect of a class of drug called taxanes; test a pain medication for patients with metastatic breast cancer; and assess chemotherapy-induced hyperglycemia among patients with non-metastatic breast cancer.
While many new treatments, diagnostic tests, and procedures for breast cancer patients have been introduced in the past decade, the quality of cancer care remains a major national concern. Not all patients receive the most advanced treatments, and others receive costly treatments that may not help. Dr. Hershman is conducting a series of studies to improve adverse effects of treatment, manage pain, and improve treatment adherence and quality of life for breast cancer patients.
Full Research Summary
Research area: Identifying ways to improve cancer care delivery, quality of care, and quality of life for patients with breast cancer.
Impact: Delivering coordinated, high-quality cancer care remains a challenge. Not all breast cancer patients receive the most advanced treatments, while others receive costly treatments that may not be helpful. In addition, many patients live with the side effects of their diagnosis and treatment for a long time. Dr. Hershman is conducting interventional studies that would address these challenges and improve the lives of patients during and after breast cancer care.
Current investigation: She and her team are conducting several studies to assess the management of symptoms following a breast cancer diagnosis and treatment including hyperglycemia, neuropathy and chronic pain following chemotherapy. These studies include a clinical trial to reduce chemotherapy induced peripheral neuropathy.
What she’s learned so far: Dr. Hershman has reported the following key findings:
- Nearly one-quarter of early stage breast cancer patients stopped seeing an oncology provider within five years of diagnosis
- Non-adherence to cardiovascular medications is common and increases risk of a cardiovascular event
- Delays to initiate oral cancer treatment are often related to recent FDA approval of the drug, off-label use, and costs of the drug, as well as the need for financial assistance.
- Adherence to taking hormone medication is not improved by twice weekly reminders via text messaging. They have used this data to develop a predictive model for adherence.
What’s next: Dr. Hershman and her colleagues will evaluate the use and continued use of controlled substances for pain, anxiety and sleep following a breast cancer diagnosis. Her team will conduct several clinical trials: to reduce chemotherapy induced peripheral neuropathy, a common and debilitating side effect of many important therapies given to breast cancer patients; and, to address the issue of pain control in cancer survivors and test new electronic technology to improve patient-provider communication and enhance pain management. A third study will be focused on the development and management of diabetes, a side effect of therapy that may develop early in the treatment course or many years later.
Dr. Hershman is Professor of Medicine and Epidemiology at Columbia University and is Leader of the Breast Cancer Program of the Herbert Irving Comprehensive Cancer Center. She completed her medical degree at The Albert Einstein College of Medicine where she was Alpha Omega Alpha, and completed her internal medicine residency and oncology fellowship training at Columbia University Medical Center, where she served as Chief Resident. During that time, she completed a Master’s degree in Biostatistics/Patient Oriented Research at the Mailman School of Public Health.
She was appointed a faculty position at Columbia University in 2001 and since that time has developed an expertise in the areas of breast cancer treatment, prevention, survivorship, late-effects of cancer therapy, health outcomes and health disparities research. She has published over 250 scientific articles and has received numerous awards including the Ewig Award for Teaching Excellence, the AVON Foundation Medical Advancement Award, the American Society of Clinical Oncology’s Advanced Clinical Research Award and the ASCO/BCRF Comparative Effectiveness Professorship. She has national leadership positions in the Southwest Oncology Group, where she serves as co-chair of the Cancer Care Delivery Committee and Co-PI of the NCORP Research Base. She has served as primary mentor for numerous medical students, graduate students, fellows and junior faculty.
She has received grant funding from the National Cancer Institute, American Cancer Society, Department of Defense, Susan G. Komen Foundation, Lance Armstrong Foundation, the Breast Cancer Research Foundation, PCORI, the Irving Center for Clinical Research and the Avon Foundation for Women.
BCRF Investigator Since
The Ann Taylor and LOFT Award