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Cancer care in America isn’t just about breakthrough drugs or advanced surgeries. It’s also about what happens when patients end up in the hospital, often at their sickest. Every year, cancer-related hospitalizations cost the U.S. upwards of $50 billion, a figure that highlights the impact for both patients and the healthcare system. Dr. Geneva Guarin, MD, MBA, sees this reality play out every day at a major university hospital. She’s not only treating patients in their most critical moments but also digging into research that could reshape cancer care for the people it impacts the most.
Dr. Guarin has a unique perspective since she’s at the bedside when chemotherapy side effects spiral, when stem cell transplant patients need urgent care, or when complications from treatment put lives on the line. “Similar to other patients, patients with cancer navigate through the complexities of medical insurance in our healthcare system,” she said. “Most of their imaging studies, procedures, and medications require prior authorizations which can cause delay in delivery of care.” For families already navigating a cancer diagnosis, those delays can feel frustrating and become dangerous.
She’s also working on ways to bring costs down without cutting corners. Many hospital admissions stem from secondary issues like infections, dehydration, or poorly managed chronic conditions. Dr. Guarin believes better coordination between oncologists and primary care providers could prevent some of these hospitalizations in the first place. She points to solutions as simple as timely IV fluid infusions in outpatient clinics or more consistent vaccinations against preventable illnesses like flu and pneumonia. These steps may sound small, but multiplied across the country, they could keep thousands of patients out of hospital beds.
Her research also examines the ripple effects of new treatments. Immune checkpoint inhibitors, for example, have transformed survival prospects for many cancer patients. But they come with risks. “In our current research analyzing a national database, I have learned that among patients receiving immune checkpoint inhibitors, the rate of ICU admission within 90 days of receiving this medication is significant,” she said. That kind of data is critical for physicians and patients weighing the benefits and risks of these therapies.
Sepsis is another challenge at the top of her list. Patients with cancer often have compromised immune systems, leaving them vulnerable to infections that can quickly turn deadly. Delays in treatment can derail chemotherapy schedules and worsen long-term outcomes. “Patients with cancer often have compromised immune system and depending on where they are at in their cancer treatment, may or may not be in the best shape to combat infection,” Dr. Guarin explained. Her ongoing research aims to better understand how sepsis affects patients receiving newer therapies and how hospitals can improve outcomes.
Preventing readmissions is another area where she sees opportunity. In her own institution, dedicated cancer urgent care clinics allow patients to bypass the emergency room for common issues like nausea or transfusions. Nurse coordinators also play a vital role in bridging the gap between inpatient and outpatient care, ensuring patients aren’t lost in the shuffle after discharge. Medication reconciliation, she added, is one overlooked but critical safeguard. This includes confirming patients are on the right drugs after leaving the hospital. These strategies, if adopted more widely, could reduce stress for patients and their families.
The barriers to progress are real and include physician shortages, burnout, and the maze of insurance regulations. Yet Dr. Guarin’s dual training in medicine and business gives her a broader perspective on how to move the needle. She sees a need for policy-level changes that involve not just doctors and patients, but government leaders and insurers too.
Her vision is a system where hospitalizations are rarer, outcomes are stronger, and the financial burden is lighter for families. “I hope that through my research, we can reinforce our knowledge on the potential effects of immune checkpoint inhibitor in the setting of sepsis and determine ways to improve outcomes of hospitalizations of patients with cancer,” she said.
Cancer remains one of America’s most costly and complex diseases. But with leaders like Dr. Guarin pushing for smarter and more compassionate systems, we have a chance to bend the curve. Reducing unnecessary hospitalizations and improving inpatient outcomes can help patients and their families while easing the burden on the entire U.S. health system.
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This content is brought to you by Melissa Moraes.
Photo provided by the author.
