Metastatic breast cancer, also known as stage 4 breast cancer, is an advanced form of the disease that spreads beyond the breast to other parts of the body. Despite the severity of the illness, nearly one in three patients in the United States miss, delay, or discontinue treatment altogether. Factors such as financial strain, limited insurance coverage, transportation challenges, and social isolation often contribute to these gaps in care.
“Some people have to make a choice between maybe feeding their children and filling a prescription for their cancer treatment,” said Jamie Myers, Ph.D., FAAN, research associate professor at the University of Kansas School of Nursing. “There are also costs related to time away from work, unreliable transportation, or dependence on public transit, which has its limitations. These barriers can significantly impact care.”
Missing treatment appointments or struggling to adhere to a care plan can increase the risk of disease progression and mortality for patients with metastatic breast cancer.
To address this issue, Myers is leading a project at KU Medical Center aimed at improving treatment adherence among patients experiencing financial and social hardships. The initiative is funded by a grant from the National Comprehensive Cancer Network Oncology Research Program, supported by Pfizer External Research and Grants.
The project focuses on integrating services from Gateway to Hope, a nonprofit organization that provides community navigation for breast cancer patients. The organization offers financial assistance, connects patients to resources such as transportation and food banks, and provides social support to help patients maintain their treatment schedules.
During the first year, Myers and her team will analyze current referral processes for financial and support services, identifying gaps and measuring treatment adherence through electronic medical records of metastatic breast cancer patients at KU Cancer Center.
“Our vision is to see if there’s a way to systematically identify patients who are likely eligible for Gateway to Hope services using information in the electronic medical record,” Myers explained.
The researchers will explore “automatic triggers” within patient records, such as Medicaid coverage or responses on social determinants of health screenings, to flag individuals at risk of missing treatment. These triggers would prompt referrals to Gateway to Hope.
In the second year, the team will implement the referral system at KU Cancer Center’s Westwood location for eligible metastatic breast cancer patients. They will track outcomes for 40 patients, including adherence to appointments and medication, quality of life, and satisfaction with the community navigation services provided by Gateway to Hope.
If successful, the program could expand to other KU Cancer Center sites and eventually to facilities within the Masonic Cancer Alliance. “This model of care could be something that other cancer centers might be interested in replicating,” Myers said.
