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Veena Shankaran, MD, MS, co-director of the Hutchinson Institute for Cancer Outcomes Research (HICOR) at Fred Hutch Cancer Center, has been awarded the newly established Lert Family Endowed Chair. A gastrointestinal cancer specialist, she is also a professor at Fred Hutch and UW Medicine.
Randy Lert, a patient in Shankaran’s care, and his wife, Joyce, established the chair to accelerate her nationally recognized research connecting financial hardship and patient outcomes.
With such gifts, visionary donors empower scientists to pursue transformative ideas. Generous supporters have endowed more than 60 chairs at Fred Hutch to date, honoring faculty members and giving them flexible funding for innovative research. Endowment gifts are critical to long-term sustainability and a cornerstone of the Campaign for Fred Hutch, which is bringing the community together to increase the pace and scale of discovery. This endowed chair is one of 25 supported by matching funds through the Anniversary Challenge.
"Dr. Shankaran has been a leading force at Fred Hutch and nationally for decades," said Fred Hutch President and Director Thomas J. Lynch Jr., MD, who holds the Raisbeck Endowed Chair. “Her focus on the economics of care is crucial, helping to maximize the impact of scientific discovery by improving what happens when new treatments meet the realities of patients’ lives.”
This impact is rooted in Shankaran’s relationships with her patients.
“Caring for Randy and getting to know him and Joyce over the years has been deeply meaningful to me, and I’m incredibly grateful for their partnership,” Shankaran said. “Through the ups and downs of treatment, they have been curious about my research and motivated to help remove barriers that so many patients face.”
Treating cancer and its financial toll
One aspect of Shankaran’s leadership expands therapeutic options in gastroesophageal cancers by bringing new treatments from the bench to the bedside through clinical trials. Randy Lert, who has esophageal cancer, chose to participate in one such trial, contributing to knowledge that will benefit future patients.
Shankaran’s focus on the financial complications of cancer combines her clinical experience with a background in philosophy and stems from an early-career moment when one of her patients was not responding to treatment as expected. The care team eventually found out that he was rationing his medications because he couldn’t afford them. Ever since that realization, Shankaran sees these challenges everywhere.
In her role as co-director of HICOR, Shankaran and her colleagues link cancer registry records, financial records and health care claims to paint a clearer economic picture of care. They hold annual summits with patients, researchers, clinicians, insurance executives and policymakers to identify cancer care inefficiencies and set benchmarks. Examples include reducing patient bankruptcies, hospitalizations, and genetic testing gaps, and increasing the number of patients who follow therapy recommendations.
The Shankaran research group in Fred Hutch’s Public Health Sciences Division published a study in November exploring whether analyzing cancer patients’ credit report data can identify financial hardship earlier than patient surveys. The hope is that by predicting treatment delays and long-term financial strain for people with multiple myeloma, issues can be addressed earlier in ways that improve patient outcomes.
Shankaran also leads the largest multi-site study to assess financial outcomes in patients with cancer through the SWOG Cancer Research Network, one of the world’s leading publicly funded cancer clinical trial networks. She was stunned by one of the recent findings: About 75% of patients with colon cancer have some kind of major financial hardship.
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“It’s not 5% or 10%, it’s almost everybody,” she said. “And there are many stories like this if you just ask, from food insecurity to childcare costs to trouble getting into the clinic because of transportation issues.”
This endowed chair will help Shankaran translate more findings into solutions. Possibilities include supporting insurance navigation or a current study that tests whether providing direct cash payments to patients helps improve adherence to therapy. She also wants findings to inform broader health care policy decisions.
“A gift like this allows us to take risks, think creatively, pilot work here that can lead to national studies, and speed up the timeline from conception to results, something that is especially difficult in today’s funding climate,” Shankaran said. “It also gives us more opportunities to train the next generation of clinicians who are especially interested in health services research — a tremendous legacy into the future from Randy and Joyce.”
A patient experience inspires giving
The Lerts have generously supported causes they’ve cared about for many years. "Even when we didn't have much money, we gave small amounts to organizations that needed it," Joyce Lert said. Then, when they had more resources, they increased their giving. Their first gift to Fred Hutch went to HICOR after Randy Lert became a patient.
“I've been in treatment for nearly five years and I've been very grateful for the quality of care we've received," he said. Both he and his wife noted the holistic nature of his care, focusing on him as a person rather than just the specific treatment of the moment. And they appreciated how honest the team — led by Shankaran — was about potential outcomes and how things were going.
Their experience also opened their eyes to the challenges others might face when navigating a cancer diagnosis.
"I was retired and had meaningful financial resources," Randy Lert said. "I wondered what you would do without those resources or if you were working while in treatment."
A legacy built on process, grounded in values
During his career in finance, Randy Lert learned to value process over results.
“Randy has told me many times that the process matters as much as the outcome,” Shankaran said. “And I think that mantra applies well to research. We don't know results in advance, but meaningful progress comes from our steadfast commitment to rigor, expertise and integrity along the way."
Still, Randy Lert knows where he wants that iterative approach to lead.
"I hope these funds will improve the quality of health care delivery broadly. With respect to my cancer, I hope that 20 years from now, someone with a similar disease will have a better outcome than I will," he said.
In the meantime, a celebration of the endowed chair’s creation, attended by Shankaran and other Fred Hutch leaders, offered an opportunity for the Lerts to gather as a family. Their children and spouses came, some visiting from afar and bringing along beloved grandchildren.
"The first thing I hear when our grandchildren come or call is, 'Where's Papa?'" Joyce Lert said. She and her husband are savoring the chance to see them, glad for the message this gift sends to their children and grandchildren about their values and who they are.
“Randy and Joyce are such kind-hearted people who care about others,” Shankaran said. “I’m exceedingly honored by their trust and generosity, and the sense that we’re in this together.”
