The Pharmacist as the CLL Communication Hub: Karen Fancher, PharmD, BCOP

Karen Fancher, PharmD, BCOP, associate professor of pharmacy practice at Duquesne University and clinical oncology specialist at University of Pittsburgh Medical Center Passavant Hospital, and her colleague Evan Slater, PharmD, pharmacy director at Rocky Mountain Cancer Centers, delivered a joint presentation on chronic lymphocytic leukemia (CLL) at the 2026 Community Oncology Conference from the Community Oncology Alliance. Fancher focused on the clinical side—disease progression, available treatments, and adverse effect management—while Slater addressed the operational and business considerations of delivering that care in a community oncology setting.

For Fancher, effective communication is the cornerstone of quality CLL management. She views the pharmacist as a valuable “middleman,” uniquely positioned to engage both patients and the broader medical team. This means establishing consistent touchpoints—whether through scheduled phone calls, patient portals, or e-mail—to ensure that symptoms and concerns are captured promptly and relayed to physicians.

One of her key insights is that patients themselves are often the first to detect toxicities. Symptoms such as headaches or an elevated heart rate will surface at home before they appear in a clinical report, making patient-reported feedback an essential early warning system. Fancher encourages pharmacists to probe those reports carefully and communicate findings to the care team. In some instances, toxicities may require referral to additional specialists, such as cardiologists or nephrologists, further reinforcing the pharmacist’s role as a communication hub.

Adherence is another persistent challenge in CLL, largely because most treatments are oral medications self-managed by patients at home. Although Fancher sees clear value in technology-based adherence tools—apps, alarms, and digital reminders—she cautions that these solutions may not suit all patients, particularly older adults in community settings. In those cases, she returns to a simpler approach: the phone call. A direct conversation, she argues, often yields the richest information and may be exactly what patients prefer.

Ultimately, Fancher believes pharmacists are ideally suited—as drug experts who speak the language of both patients and clinicians—to lead communication efforts in CLL care.