The Unscripted Pharmacist Podcast With Lenora Casey, OCN, BSN-RN

Oncology Data Advisor: Welcome to Oncology Data Advisor. Today, I'm here at ONS Congress, and I'm joined by Lenora Casey. Thank you so much for coming on today.

Lenora Casey, OCN, BSN-RN: Thank you for having me. Of course, as you introduce me, I'm Lenora Casey. I work in San Andreas, California at Mark Twain Cancer Center. I am the current President of our local chapter ONS, which is the Northern Valley Lode, and we had started a podcast called the Unscripted Pharmacist. I have a partner—he's the actual pharmacist—his name's Kyle Rootsaert, and we wanted to really touch the diabetic aspect more, kind of have them starting a better low-carb, high-fat diet, try to get them off of their medications, try to make their quality of life better. It's more for that, but also for, my thing is I'm more preventive medicine where I want to see if we can make a difference with metabolic syndrome and, kind of, go into how we can prevent cancer from forming.

Oncology Data Advisor: So, how'd you go about getting involved in the podcast?

Ms. Casey: Well, my husband actually has been on this low-carb, high-fat diet for a number of years. I met Kyle, our pharmacist. He was very passionate about it. He's been doing this for 10 years. He's a pharmacist, of course. I do work with him. Let's see. We started chatting and then it just developed. He, and of course my other colleague Chris, he's also an RN, he produces us, he helps us. He does the TV aspect, and I just do the podcast aspect, which is probably better for me. I'm a little nervous when I get on TV. But we talk about like CGMs, continuous glucose monitoring. We definitely promote that. We want people to look at what are you eating? Are you going out every day for fast food? How many carbs are you taking in? What do you think about your diet overall? How's your weight? Do you have other problems? Maybe you're retaining fluid. Maybe you're have weight gain. Maybe you have high blood pressure. How can we help you decrease all of those things into where the normal ranges are? And of course, right now we're on this lipid profile. I'm just learning about all of this, of course. But Kyle's been doing it for years, so he's like our main resource.

Oncology Data Advisor: That's awesome. Are these things that are commonly talked about in oncology?

Ms. Casey: No, it's actually not talked about in oncology, especially because in my role, I'm a clinic RN where I'm more of a navigator and I'm also with the physician and doing more of the clinical aspect. So, patients get diagnosed with cancer. Then I step in as a kind of a nurse navigator. I do a lot of mental health. I do oral chemotherapy compliance. Now there's a lot of targeted therapy that are all gone oral. So I actually make sure that they're refilling their medications and I talk to them about their side effects. I get them appointments. I also navigate, which let's say a patient comes in brand new diagnosis, they've had a biopsy, they have head and neck cancer. I make sure that we go over the chart before the patient gets an appointment, and I ask the physician, "Okay, what do you need? What do you need to make this visit the best visit that this patient can have?"

And then they'll let me know, okay, well, they need some next generation sequencing, especially if they're more metastatic or even if they're locally advanced. And then I make sure that we start with whatever company that does the pathology—I can't always say every company because there's so many—but I start off there and then make sure that that gets done. If they need any additional scans, if they need to see any other physicians like the radiation doctor, then I get all of that connected. Also, if they've just only seen their primary care, then I make sure that the primary care doctor knows what we're doing. So that way we work as a team. I'm all about communication with everyone.

And then, let's see what else? So if they're on oral medications, I make sure that can they afford it? What can we do to get those oral drugs to them? I talk to them about the financial toxicity that might be happening. I also talk to them about trying to get them patient assistance. Do they need copay assistance for anything? We're now more active in getting gas cards for our patients. We do have a foundation with Mark Twain Cancer Center. Actually with the hospital. We're connected with them. And our foundation does have money set aside for the cancer center. The paperwork's horrendous, but if you can get through five pages of filling out everything, our patients can get gas cards. I think for Christmas-time, we're going to work on getting some grocery cards. I live in Calaveras County. We're kind of a small rural area in Central California, kind of in like, I call it little mountainous, foothill mountains. But we don't have a lot of resources. So trying to figure out how to get people places is sometimes difficult.

Oncology Data Advisor: Definitely. That's great that so many things are offered for the patients.

Ms. Casey: Yeah. Well, we're trying. We're trying to put things together.

Oncology Data Advisor: Great. So, what are some of the future topics you have planned for the podcast?

Ms. Casey: So, I think in the future, I know we're talking about the lipid profile. We'd like to explain every aspect of it, what each thing does, how it works. Because a lot of people are going to their physicians. They're saying, okay, you have high cholesterol. You have to be on this drug. But really, I don't think everybody knows what high-density lipoproteins (HDL) does in the body, low-density lipoproteins (LDL) does in the body, our triglycerides. How all those aspects affect our metabolic health. I think that's one of the things.

The other thing is prevention. Let's get some screening. So how do we screen, what should you screen for? Those types of things, because that's where I come in. We need to start talking about preventive health before we really start. Okay, so now you're diagnosed. So let's talk about prevention first. How can we become the healthiest humans that we can be? And that's kind of where I think our podcast is going to go. I always hope for suggestions. They do put it on YouTube. We are on YouTube under Calaveras Community TV (CCTV). But I would really, really like it if people would say, Hey, what do you want to listen to as far as prevention? Bring that to me and we can research it and then get those topics out there. I think that's one of the most important things. Let's prevent diseases in general before they start happening.

Oncology Data Advisor: Definitely. How can people reach out to you if they have any ideas?

Ms. Casey: If you have any ideas, you can reach me at This email address is being protected from spambots. You need JavaScript enabled to view it., and please reach out to me if you want to hear something of interest to you that you think, like if you want to do exercise, Kyle is a very passionate paddle boarder, if you want to talk about that too. So we have all these things. Chris, he's a runner and I bike, so we all have different aspects. So, hopefully, I don't know, reach out to us. We'll try to do our best.

Oncology Data Advisor:

Awesome. Well, thanks for talking to me today. It was great to hear about the podcast.

Ms. Casey:

No, thank you so much for having me.

About Ms. Casey

Lenora Casey is an Oncology Certified Registered Nurse at the Mark Twain Cancer Center in San Andreas, California. Currently, she serves as her local ONS Chapter President and recently started a podcast called the Unscripted Pharmacist. Ms. Casey is passionate researching and helping patients, as well as her colleagues, find a healthier way to live and improved quality of life.

Transcript edited for clarity. Any views expressed above are the speaker's own and do not necessarily reflect those of Oncology Data Advisor.