Report: Addressing the toxicity of cancer treatment costs

DETROIT – Lauren Hamel, Ph.D., assistant professor and member of the Population Studies and Disparities Research Program at Karmanos Cancer Institute and the Wayne State University School of Medicine, was awarded a Research Scholar Grant by the American Cancer Society. She will use the grant to test the effectiveness of a patient-focused intervention to improve patient-provider treatment cost discussions and other patient outcomes related to the financial consequences of cancer treatment.

Dr. Hamel and her team responded to the growing problem of financial toxicity, or the severe material and psychological burden of the cost of cancer treatment. Financial toxicity affects an estimated 30% to 50% of patients with cancer, especially patients who are racial/ethnic minorities, have lower incomes or are under 65. However, well-timed and effective patient-oncologist treatment cost discussions could help.

Dr. Hamel and her team designed, built and pilot tested the DISCO App (Discussions of Cost), which is presented to patients on an iPad and includes a brief educational video on treatment costs patients may incur and ways to manage costs. The app then advises patients that having a discussion with their oncologist is a good way to start managing costs. Patients respond to questions related to their financial situation (e.g., employment, insurance). Based on their responses, DISCO presents them with an individualized list of cost-related questions to ask their oncologist or other providers.

The five-year grant for $844,000 will fund a randomized controlled trial of the DISCO app’s effectiveness using video-recorded interactions between patients and their oncologists, and longitudinal self-report data from patients.

Dr. Hamel’s team includes Karmanos and WSU School of Medicine investigators Susan Eggly, Ph.D., professor of Oncology; Elisabeth Heath, M.D., professor of Oncology, and Seongho Kim, Ph.D., associate professor of Oncology; as well as David Dougherty, M.D., M.B.A., of the Dana-Farber Cancer Institute in Boston.


Wayne State University is one of the nation’s pre-eminent public research institutions in an urban setting. Through its multidisciplinary approach to research and education, and its ongoing collaboration with government, industry and other institutions, the university seeks to enhance economic growth and improve the quality of life in the city of Detroit, the state of Michigan and throughout the world. For more information about research at Wayne State University, visit



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