The Sequoia Regional Cancer Center is part of the Kaweah Delta Health Care District. It is located in Visalia, in the heart of California’s Central Valley. The cancer center offers a multidisciplinary approach to cancer care with a team of specialists who collaborate on helping patients navigate their cancer journey through diagnosis, treatment, and recovery. The combined efforts of the multidisciplinary team allow for the treatment of cancer utilizing all oncology specialties, ensuring the best care possible is available for each patient.
The Oncology Pharmacist spoke with Clint Brown, PharmD, about his role as oncology and pain management pharmacist at the Kaweah Delta Health Care District. He provides oncology and pain management expertise for cancer and noncancer patients treated within the district.
Tell me about your role at Kaweah and the Cancer Center.
Clint Brown (CB): I wear 2 hats: I am the oncology pharmacist and 1 of 3 pain management pharmacists. The goal of cancer treatment is to focus on patient-specific outcomes and improve quality of life. I do that by trying to maximize the efficacy of chemotherapy and minimize its toxicity. This is done by tailoring doses and regimens to the individual patient and maximizing both prophylactic medications and supportive measures.
The same is true for pain control. We try to maximize efficacy and minimize toxicity by individualized dosing of pain medications utilizing a multimodal approach to limit pain.
How did you become an oncology pharmacist/pain management specialist?
CB: After completing a first-year pharmacy practice residency that focused on chronic pain management, I took a position with Kaweah as a clinical pharmacist, helping to provide pain management for acute palliation and hospice patients. At the same time, a position became available for an oncology pharmacist. Feeling that I could serve the pain needs of our cancer patients, I filled the position, and now I do both. About 9 months ago, we implemented a pharmacy-driven pain management service and expanded it throughout the entire hospital in an effort to better manage pain and prevent opioid-associated adverse events.
What is the main challenge of your job?
CB: My biggest challenge is seeing the emotional and physical struggles of the patients and their families as they undergo the treatment process for their cancer. We spend a great deal of time with them in an effort to help shoulder that burden by being an expert resource with regard to their medications, how they work, how to take them, what to expect, and how to mitigate any side effects.
What about your rewards?
CB: Being able to spend a lot of time with the patients. They are incredible. My main reward is getting to know that patient well and being able to help him/her overcome and beat cancer. That doesn’t happen for all patients, but when it does it is very rewarding.
What are you excited about in the field of oncology?
CB: The targeted therapies are now turning once-fatal cancers into chronic manageable disease states that patients live with rather than die from. Some examples are imatinib for gastrointestinal stromal tumor and trastuzumab for HER2-positive breast cancer. There are other examples too. I am hopeful that the newly identified metastasis-suppressor gene for prostate cancer will lead to better targeted treatments and improved outcomes.
What advice would you give to a person entering this field?
CB: Do not shy away from working as an oncology pharmacist. You get to meet the most incredible and courageous people in the world. Even though the regimens can be complex and outcomes may not always be ideal, oncology pharmacy provides the best opportunity to do what we are good at, which is educating doctors, nurses, the multidisciplinary team, and patients themselves about the medications they need to take. We can help promote adherence, maximize benefits, and mitigate toxicity.
What would you be doing if you won the lottery?
CB: I would stay in the field of oncology. I love the interaction with patients and being able to help them. Outside of that, I would compete in triathlons and spend more time outdoors with my wife and my 5-year-old and 3-year-old sons.
