Victoria K. Marshall, PhD ’18, is transforming how patients receiving oral anti-cancer medications manage their treatments and symptoms from home.
Oral anti-cancer treatments can improve patients’ quality of life because they spend less time at the doctor’s office compared to other forms of treatment, Marshall said. However, it is imperative that patients and their caregivers maintain consistent routines for taking the medication and have resources to manage symptoms and side effects – including knowing when it is time to call a doctor. The necessity of technology-based tools has only grown more significant as the number of Food and Drug Administration-approved oral anti-cancer treatments has more than quadrupled since Marshall began her research in 2013.
Marshall was part of the committee that wrote the national guidelines to support patient adherence to oral anti-cancer medications published by the Oncology Nursing Forum, which has a widespread impact.
“It was an invitation as a content expert to write a national guideline that impacts practice,” said Marshall. “Nurses all over the United States -- and maybe beyond -- are reading these practice guidelines to support patient adherence to oral anti-cancer medications.”
Marshall is also working to provide more accessible resources for patients receiving cancer treatment at home. Marshall is developing a web-based program, currently in the prototype stage, called Geriatric Oncology Adherence Link: A Program Supporting Older Adults Prescribed Oral Anticancer Medications (GOALHealth) to provide geriatric oncology patients a comprehensive tool to help them maintain consistency in taking medication and to manage their symptoms. GOALHealth will include information sheets and symptom management toolkits for the 33 most commonly prescribed anti-cancer medications as well as medication calendars and pill reminders
Currently, there are no web-based programs available to help manage oral anti-cancer treatments across multiple technology devices (smartphones, tablets, and computers) and that target the specific needs of adults over 65 years of age. Marshall is challenging the misconception that older adults are not utilizing technology to support them in their cancer treatment journey. Based on her findings older patients are not only using smartphones regularly, but nearly 60% of their smartphone usage is for health-related purposes to manage their cancer care
“[GOALHealth] is really, you know, one of the first technology-based interventions that is very specific to the older adult,” said Marshall.
Accessibility is at the forefront of Marshall’s work. The web program will have read-aloud options, content written at the 6th-grade reading level and larger text options. GOALHealth is theoretically driven and rooted in behavior change theory to promote healthy self-management behaviors. Patients can customize and utilize features such as calendars, pill reminders, and evidence-based symptom management toolkits based on their needs. Marshall also intends to have the program translated into Spanish and to develop a model to support caregivers, following her work with Latina breast cancer survivors and their partners.
Marshall’s path to oral anti-cancer research began after working as a floor nurse and hospital administrator for nearly 20 years. She set her eyes on earning her PhD with the encouragement of her husband, David Marshall, who is also PhD-prepared. Michigan State University’s program was the right fit for her interest in chronic disease and symptom management.
“The best decision I’ve ever made in my life was to attend Michigan State,” said Marshall, adding, “It has been life-changing for me, and Drs. Barbara Given and Bill Given have been such amazing mentors… [They] systematically set me up for success at every point.”
Marshall became a fellow in the biobehavioral oncology group and was a graduate research assistant on the team of Barbara Given, MSU distinguished professor emeritus, working on a randomized controlled trial funded by the National Cancer Institute.
“I really fell in love with [biobehavioral oncology] when I was interviewing patients and caregivers that had gone through the cancer journey,” stated Marshall, reflecting on her time at MSU. “I think that just kind of lit a fire and really fueled my desire to continue research and find out more about how to support these patients and caregivers moving forward.”
Marshall continues to apply what she learned at MSU in both her research and in leadership roles, such as at the University of Southern Florida (USF) where she is a tenured faculty.
Marshall mentors several doctoral students in their research and serves as chair of the PhD Curriculum Committee at USF. She has also recently been appointed to the Board of Directors of the Southern Nursing Research Society, serving as the director of Career Development and Awards. Marshall is also the past program chair of the Oncology Nursing Society of Greater Tampa.
Marshall has celebrated many achievements since earning her PhD from MSU seven years ago; however, in the end, Marshall describes herself as “just a Spartan Nurse for life.”