There are many specialties within the profession of pharmacy. If oncology is a specialty you are considering, this post can help you. Learn from the experience of a board-certified oncology pharmacist here.
Authored By: Laura R. Bobolts, Pharm.D., BCOP
I knew I wanted to help treat cancer at a very young age. I was just a kid when my grandfather died of kidney cancer. That was my first introduction to death and I wanted to wring cancer’s ugly neck. From that day forward I knew I wanted to be a part of the battle against cancer.
I entered pharmacy school with a clear plan to become an oncology pharmacist and I’ve learned a lot along my journey. Here are some expectations of the oncology pharmacy profession I had while in school, versus reality…
1. I thought a PGY2 in oncology was absolutely necessary or my career was over!
Don’t get me wrong, I recommend post-graduate year 2 (PGY2) oncology pharmacy residency training to all my students interested. Let’s just be honest though—things don’t all always go as planned with the pharmacy residency match process.
I put all my eggs in one basket and only ranked one PGY2 in oncology for the pharmacy residency match process. I was not lucky enough to the one program and as it goes, the scramble for an open residency spot or clinical pharmacist position began. Fortunately, I was offered a PGY2 post-match, but simultaneously the cancer center that held all my eggs and didn’t match me offered me an oncology pharmacist position.
It was a really hard decision, but I took the job offer instead of the PGY-2 oncology residency offer. I had to teach myself everything I now know about the treatment of cancers – everything! I would arrive at work two hours early just to read and learn about cancer treatments. Eventually, it payed off! I became a Board Certified in Oncology Pharmacist (BCOP) and have excelled in my career – even without a PGY2 in oncology.
2. I expected to deal with cancer drugs only, not the disease itself
You’re a pharmacist, so you just deal with the drugs right? Very wrong!
Oncology pharmacy is a great profession for those that like disease management. In order to find the best treatment option for a cancer patient, I have to be able to interpret imaging results and pathology reports, identify what specific cells a cancer is arising from, understand how the cancer behaves in the body (including) where it might spread next, and also determine if any molecular biomarkers are expressed by the tumor.
You need to know how the mechanics of the cancer to be able to identify the best treatment to combat it. It’s not just about the drugs.
3. I thought Oncology Pharmacists only worked in hospitals
Indeed, most oncology pharmacists practice in a hospital setting, but not all of us.
I was the first pharmacist at a prior institution to establish the role of a full-time pharmacist in a solid tumor clinic. I worked out of the doctor’s office developing treatment plans for patients and counselling them on their new therapy.
Fast forward to my current position, I now work for a private company performing oncology pharmacy benefits management solutions. I am now an oncology pharmacist that works from an office or even my home, aiding in the management of cancer patients across the U.S. and Puerto Rico.
4. I thought everyone practices evidence-based medicine
I started my career very naive, practicing at a National Cancer Institute-designated cancer center where only treatments supported by evidence were administered. Now entering the business world of oncology pharmacy benefits management, I see much clearer. In the real world, treatments are ordered for cancer patients at times without safety or efficacy data to support them.
Many oncologist may not have the resources of a multidisciplinary team including an oncology pharmacist to help them identify further treatment options supported by evidence. That’s not an excuse though, to add cancer drugs together and see if it works. I see this daily across the nation and I use my brain to determine alternative treatment options to steer therapy back on an evidence-based medicine track.
5. Cancer drugs are VERY expensive! I never thought someone would use a more expensive drug to make a higher profit.
It’s sad – cancer drugs are a huge multi-billion dollar industry and some treating oncologist take advantage of that. The more money a drug costs to purchase, the higher the reimbursement is, period.
We have a huge spectrum from old and very effective chemotherapy drugs that can cost $100 per treatment to brand new cancer drugs costing anywhere from $10k to over $50k per treatment. Say a doctor makes $6 profit off the $100 cancer drug but $600 profit off the $10k drug. Which drug would a for-profit cancer center or physician’s group prescribe if both drugs were appropriate? The reality is cancer drugs can be real money makers, some with huge profit margins.
If I ever develop cancer, I am going to a large non-profit institution. I do not want my oncologist influenced to order drugs for my body due to the amount of money they can make off my treatment.
I love what I do as an oncology pharmacist but my eyes are now wide open! The patient has me as an oncology pharmacist in their corner to make sure their cancer treatment is in their best interest, supported by evidence that the therapy is safe and effective.
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