Chemo 101: a web success story

Kristin Gustafson started marketing Chemo101 even before she launched the website that keeps chemotherapy patients, nurses, doctors and caregivers abreast of the latest information available about life in the Chemo Room.

Gustafson says her Denver-based site has grown like a blogger's dream over the last year, landing a $25,000 ad schedule from Whole Foods because of the marketing buzz she created within its target audience by competing for startup funding in the Pepsi Refresh Project.

That's a fund-raising program run by Pepsi which gives away grant money to make innovative ideas -- anyone's idea, really -- into reality by winning the funds to make it happen through a contest.

KG, as Gustafson calls herself, entered Pepsi Refresh last September at the $250,000 level, but lost out to a much larger organization, the animal protector ASPCA, which was able to marshal many more voters to its cause than Chemo 101.

But soliciting votes for her project from all the people who might use it essentially put Chemo 101 in the minds of its audience even before it was available. The site launched in December, and besides her Whole Foods advertising program, KG is now averaging 30,000 unique visitors to the site per month. Like I said: a blogger or website developer's dream.

And that's as much a reason for writing about her here as the nature of her cancer-related website. Gustafson has started a small business on the Internet in the booming health-care industry which never seems to shrink even as the nation's economy falters.

So KG's business lesson is valuable to many of the readers of this blog whether they come from the blogging world, the cancer world, the small-business world, or even the politics and policy world. Chemo 101 is an example of a successful, small-business startup in a booming industry fueled by the Internet.

And Gustafson has gone about starting that business in an instinctively entrepreneurial way.

Her professional background is in human resources, having worked with health-care, and specifically oncology-related, companies in Minnesota, before moving to Colorado to work briefly with a medical-device manufacturer. She found herself drawn back to oncology and the fight against cancer, however, and so decided to start Chemo 101 as an outgrowth of what started as an HR consultant's practice.

She didn't win the Pepsi contest, so her funding came from her own savings and investments, and she was helped by a friend who volunteered his expertise not only in programming but also in sales and marketing because he had been touched by the fight against cancer in his own life and wanted to "give back" while waiting a few months to take a new professional position.

Chemo 101 was borne of KG's experience with her target audience: patients, nurses, doctors and caregivers from mostly community-based cancer clinics. "Our site is really augmenting what they do in the clinic every day," she said.  "A lot of times from the day that someone is told there's cancer, they're just rushed through the process. And the oncology nurse has fifteen people that she's trying to get set up." So a lot of patients go home from a first treatment with dozens of unanswered questions.

KG's website has the answers to many of those questions. "My idea," KG says, "was build a website for cancer patients to understand their drugs and dollars, ... a resource to understand your chemotherapy drugs, understand the different food and drug interactions, and how co-pays work, and what type of insurance you're on; what questions to ask."

But while cancer consumers were the target audience, Gustafson knew her target market for monetizing the site was big pharma, the huge pharmaceutical companies that test, make and sell drugs that help millions of people fight cancer across the globe.

"My business models started with the thought of I'm going after the big pharmaceutical companies; they are the ones that have drugs in the data base that I have built. They have branded, marketed products that we see ... advertised on TV."

Those companies' oncology products, the chemotherapy drugs pumped into patients all over the world, are the mystery meat of the cancer-treatment industry. Millions of patients, nurses  and caregivers are constantly seeking the ever-changing, latest information about drugs and their side effects in order to ease the patient's struggle to stay alive.
 
And Gustafson, through the website, keeps the information up to date. She uses what are called Food and Drug Administration-approved "package inserts" to describe the chemicals patients receive during chemotherapy. The inserts are the printed material included with any medicine sold to consumers.

But she also has a "resources" section of the site she says will be used to offer information about alternative treatments ranging from use of medical marijuana for nausea to nutrition and diet information geared to the cancer patient. That portion of the site is not yet very developed, but like any site on the Internet, Chemo 101 is a work in progress.

Nurses' desire for more nutrition information, however, is what drove Gustafson to seek out advertising from Whole Foods Market. Surveys she collected at a national meeting of oncology nurses in Boston earlier this year showed nurses ranked a desire for more information on nutrition as high as their desire for information about clinical trials.

"Wow, nutrition is really something I never thought of, and here we've got 40 percent of the nurses saying they would want nutritional information for themselves and their patients," she said. So she contacted a Whole Foods sponsorship program in Boulder and quickly signed up for the first $25,000 of revenue Chemo 101 has generated for itself.

At a later annual  meeting of the American Society of Clinical Oncology in Chicago -- "Kind of the Big Dance in oncology," Gufstason said -- "we met with just about any pharmaceutical company that sells an oncology product that you can think of" and were "walking on air a little bit" with the Whole Foods ads already up on the site.

When you are talking with pharma "Goliaths" like Pfizer or Merck, Gufstason said, "David at Chemo 101 didn't seem so small when you had a partner like Whole Foods."

KG is still working to land other advertising and sponsorship deals that carry Chemo 101 into the future of the fight against all kinds of cancers.

But her one-year fight to start the company: the pre-launch marketing campaign through the national Pepsi Refresh program; her visits to national meetings to build traffic and credibility among professionals "critical" to the care of cancer patients, her primary audience; her widening of her advertising market beyond big pharma to businesses on the periphery of the cancer-care industry; all make for text-book examples of how to build an online small business.

So, even if you don't have cancer, Chemo 101 is a website to watch.

How does government money create jobs?

A question that has lingered through the debt-ceiling debate fiasco, specifically related to the need for stimulating a weak economy, is how can government money actually create jobs?

Gov. John Hickenlooper's administration is working hard to find an answer. It has applied to the Treasury Department for $17.2 million it wants to spend with lenders in Colorado to break their reluctance to fund small-business growth.

Small businesses grow by hiring people to produce and sell more of their product or service, increasing a firm's revenue and profits. The longest running complaint small businesses have had with state and federal policy makers has been that banks refuse to lend businesses money to achieve that growth.

Alice Kotrlik, a long-time valuable asset of the Office of Economic Development and International Trade and director of its Business Finance Division, is in charge of Colorado's application to the State Small Business Credit Initiative, and expects to hear a "favorable" response from Treasury very soon, perhaps within days.

She said the 2010 Small Business Jobs Act, signed last September and so far apparently in no danger from projected deficit-reducing budget cuts, requires the programs using the federal money to be started by states within 90 days of receiving a grant. All of Colorado's $17.2 million, if it gets it, will have to be deployed within two years. So the money will be going to businesses fairly quickly once the state gets its check.

That's good because business finance is a top-of-mind issue in Colorado not only because of political pledges to get people back to work -- create jobs -- but also because past efforts to fund small-business startups with government money have been dismally unsuccessful.

Kotrlic's office crafted her application for the small-business federal funding through Hickenlooper's "bottom-up" economic-development process, resulting in the release last month of the Colorado Blueprint, a document that amounts to a master plan for state governance.

The application calls for distribution of the $17 million through three programs: an existing loan-loss/reserve program run through the Colorado Housing and Finance Authority (CHAFA); an expanded pilot program started last summer that offers angel investors a tax credit for investing in Colorado small businesses; and an altogether new program designed to distribute $14.2 million of the funds by depositing cash certificates of deposit in banks that want to loan money to a small business but are hesitating because of a borrower's shortfall in the value of collateral being used to support the loan.

Kotrlic described the program for me in detail, and it sounds like the only kind of government effort a Colorado bank would be willing to sign up for to loosen up its lending to small business: direct cash infusions of government money they can take if a loan goes sour.

The banks aren't crazy. The reason a Small Business Administration emergency loan program failed in Colorado and around the country in 2008 and 2009 was because the loans -- $35,000 max -- weren't large enough for the bankers to bother with, and because the people who needed them, small businesses already in trouble and at risk of survival because of the economic collapse, were too risky to lend to.

Kotrlic's new program will provide up to 25 percent of loans from $75,000 to $1 million in a cash CD that can be deposited in the lending bank and dedicated as collateral for the loan. The small business owner then can use the full amount of the loan to grow his or her business by hiring new workers and increasing sales and revenues, and pay back the bank over a three-year term.

The state will provide a collateral shortfall for loans up to $5 million, but the percentage of state-supported collateral will drop for bigger loans to the amount needed to cover the borrower's shortfall up to about 10 percent of the loan. Kotrlic points out that 10 percent of a $5 million loan would still amount to a $500,000 cash CD, and she seemed to think that was plenty for the state to give a bank to cover the risk of an otherwise credit-worthy borrower.

That's how government money can create jobs and stimulate the nation's lagging economy. It's government at its best, helping private small businesses break through big-business bankers' reluctance to help Main Street get back on its feet.

In the Chemo Room: A guinea pig

Never did I imagine I would be walking through the Phil Anschutz-funded doors of the Anschutz Medical Campus in Aurora volunteering to be a guinea pig for cancer research.

But that's what I did on Monday, Tuesday and Wednesday when I went for my first screening and scan appointments to enter a clinical trial for a drug called MEHD7945A, sponsored by Genentech Inc. out of San Francisco, which I suppose wants to manufacture and sell the drug once it is cleared by the FDA.

The consent forms are pretty clear: "You are being asked to take part in this research study of an investigational drug called MEHD7945A. The study drug is being looked at to see if it could be a treatment for advanced cancer. "Investigational" means that the study drug has not been approved by the U.S. Food and  Drug Administration (FDA). The FDA is the U.S. government agency that reviews the results of research and decides if a drug can be sold in the U.S.

"You are being asked to be in this study because your tumor has grown or spread during or following chemotherapy or other treatment, or there is no standard therapy for your type of cancer.... The purpose of this research study is to determine the safety of the study drug and to determine the highest tolerated dose ... that can be given to subjects safely.... This is a Phase 1 study. This is the first time that MEHD7945A will be given to humans and is in a very early stage of development.... Please carefully read the sections on risk and benefits below."

The forms went on to describe known side effects, which so far have been mild in most subjects, but the forms don't rule out death or some lesser cataclysmic personal reaction to the drug and they schedule your first infusion (mine is on Wednesday) as a 10-hour day to make sure you don't have one.

The scans taken this week are done to establish a baseline for growth or reduction of the colorectal cancer growing in my lungs. The best results the researches will tell you about, however, is a possible stabilization of the growth and spread of the tumors. That's one reason entering the trial is considered one way a cancer patient who has gone through "standard" treatment and not defeated the disease can prolong his or her life beyond the time it would take for it to kill you if left unabated.

Dr. Wells Messersmith, the "study doctor" in charge of my treatment, told me July 8 that I don't look like someone who has cancer -- I've been gaining weight lately -- and my hope is that I keep up those appearances (and energy) while this new drug stabilizes my disease.

But none of all that is what amazed me most as I walked through the doors of the Anschutz cancer pavilion this week. What amazed me was the beehive of economic activity represented by the center during what has been the third of probably the three toughest economic years in the state's history.

Patients and employees alike hurried in and out of the pavilion; cars fueled by $3 gas, big buses and small carts ferried people in and out of jammed parking lots; hospital shops and cafeteria, information desks and check-in outposts were hustling with an assured, customer-service oriented dispatch.

I never thought I would have to be grateful to Phil Anschutz, but the marvel that has been created by The Anschutz Foundation -- which has contributed more than $100 million to building the center -- the University of Colorado, the city of Aurora, the state of Colorado and the federal government calls forth a deep sense of relief over having available to me the very best opportunities to beat my disease.

I don't mind feeling like a guinea pig.

Maybe my participation in this clinical trial, like all the work being done at the medical campus, will save a few lives down the road. 

Regis-based Capital Congress reaching out for small business

I just posted two ideas to a website being run by the Colorado Capital Congress, a new advocate for providing capital to small businesses that need it to survive in today's harsh economic climate.

That's a big chore to take on in Colorado, as Karl Dakin, executive director of the Sullivan Chair for Free Enterprise at Regis University, well knows.

He and "some other guys" tried to convince the legislature last session to create a public/private entity that could capitalize startup businesses to the tune of $25,000 to $250,000. They were turned down on a party-line vote in a House committee.

"They didn't want to see another government entity involved in funding" private business, Dakin told me in an interview Sunday. So Dakin took his ball and went home to Regis where last month he and Paul Alexander, director of the school's Institute on the Common Good, founded the Capital Congress.

On June 29, the pair held an organizational meeting with Denver-area business owners, some business financiers and at least one state legislator, Pete Lee, D-Manitou Springs, where they outlined a process for the congress to vet new ideas for accomplishing its cause: filling a shortfall of up to $10 billion a year in capital funding for Colorado small businesses.

The Colorado Capital Congress, www.ColoradoCapitalCongress.com, will collect, improve and then vote on ideas submitted from the general public, and then bring that agenda to next year's legislature with an assurance to elected officials the ideas have the backing of some of their constituents and represent a dire need for businesses in the state.

Capital, or cash, is always what most small-business owners lack if they can turn their attention from survival to actually strategizing about growth.

The growth of small businesses in Colorado is the largest single contributor to job growth in the state, so if politicians are sincere about finding jobs for Colorado's unemployed they will at least give a listen to Dakin and Alexander's suggestions when the next lawmaking festival rolls around in January.

"Business-friendly" is a descriptor many elected officials adopt for themselves when trying to persuade voters to support them. When the time comes to actually do something for voters who have believed in the descriptor, many state officials in Colorado do a free-market shuffle and beg off the issue.

I hope this Congress will hold some political cold feet close to the fire. 

Media Salad: Tossed into business

Christine Tatum was president of the Society of Professional Journalists for a year before she left the Denver Post to go into business, eventually for herself, as the founder of a Denver-based firm that provides competitive intelligence to other small and medium-sized companies.

She likes the fact she is taking journalism on a new route, that she is hiring fellow former journalists to provide her clients the information they seek, and that, while doing so, she and "the fellas" are still fulfilling the "calling" they answered when they became journalists.

"Which was to give people useful information," she said, information that can "enlighten" business decisions that are made every day. She calls the firm Media Salad Inc., and describes it on her website as: "a rapid-response research and reporting service that works on demand to deliver Market Intelligence so our clients can make informed strategic decisions faster.

"Our professional reporters and editors will work from around the globe to put independent findings in your team's hands for quick action."

Christine Tatum

Tatum, like many other reporters who have fallen out of the news business because the news/advertising model imploded, has created a new model for journalism based on the skills and craft she learned as a reporter, which she is now taking to market as a business owner.
Ironically, she believes what she has created could be taken inside a newspaper or other large news organization, providing a new client-driven revenue stream that puts a higher price on more targeted business information than what can be passed along in a general news story.

New revenue streams are what newspapers, magazines and most other media, including broadcast television, need to survive. Right now, traditional, general media has a hard time reaching the small niche audiences their once mass audiences have been broken into on the Internet.

"The information is not customized enough for these people," she says of her clients and the news industry. It's too generalized. "Sometimes a news story that is written raises more questions than it actually answers for you, and you can't call the reporter up and say, 'Hey, I'd like you to get rolling on that follow-up story.'" The newspaper reporter will "tell you where to get off," said Tatum.

But her "reporters" can start digging deeper at that point to "track competitors, vendors and donors; find and background potential partners; identify new market prospects; ... [and] track changes in regulation," she says on her website.

At the same time, Tatum says she hasn't forgotten how to tell someone where to get off.

"I make very clear at the outset," she said, "we give you the good, the bad and the ugly because we would not be doing our jobs for you if we didn't."

"And if they decide they can't swing it, and they find us obnoxious or all of a sudden we're telling them things ... or flagging things that they think: 'Oh my gosh, I just can't deal with this every day,' ... if they can't swing it, then I don't want to work with them. I just don't. I'm not interested in the money."

That sounds like the old technology reporter Tatum was when she worked for the Post or the Chicago Tribune before that. She's not afraid to tell stories of getting burned by the first business that hired her away from the Post, nor of her own dissatisfaction with the technology the Post was trying to use to build it's digital offerings at Denver Post.com.

Strangely, in terms of business, Tatum is not driven by a desire for great profit, which like many journalists, might disqualify her and them from the bruising, no-holds-barred world of free-market enterprise.

"I would be very, very happy if I just accomplished modest financial goals," she said, "as opposed to, 'Oh, we're going to be acquired by Google next week,' ... or, 'Oh, we're about to win like all of this massive investment.'"

Instead, she she'd rather know she helped a struggling fellow journalist feed his family, or make a tuition payment with the supplemental income she provides her independent contractors --her "reporters."

"Call me crazy, but I think that a lot of journalists have also answered a calling; it's not that you decided to go off and make lots and lots of tons and tons of money. You answered a calling, and in a weird way, I view what I am doing and continue to do professionally is answering that calling."

In other words, practicing a specialized, small-company journalism, independent of the big media dollars that no longer support as many journalists as once was before. It's the new journalism of the 21st century. Taking your writing craft into your own small business.

You may have heard that before on this blog. It's the pitch for my own small business.

Anti-tax pols should look to the Greeks

Any U.S. Republican or Democrat who believes we can cut the deficit and balance the budget without a tax increase should listen closely to Greek protesters who ask "Why me?" when their government insists on austerity measures.

The Greek poor have a good argument if they haven't benefited from the huge debt their society built up before going bust over the last decade.

On the other hand, the hypocrisy of anti-tax politicians in Washington resounds all the louder because they ignored and allowed the speculative practices of Wall Street bankers and traders who got America into the mess we all find ourselves in today.

President Barack Obama took to the White House press-conference podium yesterday to scold Congress when he said, "These are bills that Congress ran up. ... Now they are saying, 'Maybe we don't have to pay.'"

Instead, the congressmen and women who oppose raising taxes -- mostly Republicans but including some Democrats -- want to cut government spending to the bone, which means they want the burden of curing the deficit placed squarely on the backs of the middle class and the poor.

Not only did the poor draw no benefit at all from the wealth generated on Wall Street before 2008, but companies all across America whittled away at the middle class by eliminating jobs; cutting salaries; pushing people into part-time, no-benefits positions; increasing health-insurance co-pays and deductibles; and forcing employees out of defined-benefit pensions into 401ks where their retirements were put at risk by the same Wall Street traders who caused the 2008 crash.

But the "cut-spending-only-crowd" has yet another motive. Opposing increased revenues for government today essentially means the rich will escape paying the government back for Bush tax cuts that made them even more wealthy over the past 10 years. Anti-tax pols have but one constituency it seems: the people who fund their re-election campaigns year after year.

Because George W. Bush promoted a lack of dissent as the only true expression of patriotism in America while all that was happening, neither the poor nor the dwindling middle class took to the streets to protest their lot.

But the Greek rock-throwers offer a glimpse of what could happen in America as more of the poor get poorer; more of what's left of the middle class gets pushed into poverty; and the rich inexorably keep getting richer, as seems the goal of the current Republican majority in the House.

Revolutions get started in the back streets of any nation; and the middle class in the U.S. elected Obama to change things for the better, not worse. If anti-tax Republicans and Democrats believe the population of their country will remain somnolent forever they should look to Greece and the Arab Spring, then remember the anti-Vietnam-war demonstrations of the 1960s.

The people here are not afraid to peacefully stand up against their government. They just have to be pushed hard enough.

In the Chemo Room: Colon Cancer Alliance national meetup

I walked three miles today, more than I have been able to exercise since they but a bag on my belly and took a tumor and my rectum out of my bottom in September 2007. It felt good.

I was following some of the primary advice given colorectal cancer survivors -- about 60 of them -- attending the national conference of the Colon Cancer Alliance at the Marriott Denver City Center on Friday. The advice I heard most often was: Keep exercising. It will prolong your life.

Which is what all those survivors are looking to do. Some, like me, still have the cancer and are still fighting it. More than half of the 60 had survived the disease for more than five years, and some had passed the 10-year mark. Most of those looked pretty fit. And many of them walked in the Denver Undy 5000, a 5K and one-mile fun run and walk held this morning in City Park.

It didn't take long to be told on Friday that exercise was one of the best anti-cancer drugs. Dr. Tim Byers, a professor of preventive medicine at the University of Colorado Cancer Center in Aurora, opened the day-long conference with a keynote address packed full of statistics that showed declining death rates for both men and women treated for colorectal cancer.

Why?

"We don't really know," Byers said, striking a tone that held throughout the conference: a forthright realism about everything from ordinary doctors' lackadaisical endorsement of colonoscopy, the most effective preventive for colon cancer, to the lingering effects of "chemo brain," a loss of memory and other cognitive function after prolonged chemotherapy.

Another University of Colorado Cancer Center doc, Stephen Leong, lent credence to cancer survivors' complaints of "chemo brain," and suggested it was one of several persistent side effects doctors need to pay more attention to as increasing number of survivors live cancer free for longer than five years.

Other speakers noted lengthening survival times tend to make the magic five-year mark less meaningful. Cancer changes your life, many speakers agreed; but after-cancer realities are often magnified: money problems from long-term loss of income, relationship problems from a lack of a sex life, reassessment of career goals and capacities, all make surviving cancer a new life challenge.

Byers said at the outset that researchers believe all cancers, including colorectal cancer, like car crashes, are caused by a variety of factors -- genetic and cultural, environmental, behavioral, "What we run into in life" and simple "bad luck" -- that often combine in multiple and unpredictable ways.

Colorectal cancer, however, remains the second leading cause of cancer deaths in the United States after lung cancer, and part of the reason is that it strikes both men and women and most of it occurs sporadically, meaning the victim's cells mutate randomly.

Still risk factors for colorectal cancer are listed as:

•  Age, gender, race/ethnicity
• Family history
• Inflammatory bowel disease
• Diet
• Body weight
• Physical activity.

But an estimated 40 percent of colorectal cancer can be attributed to four specific risks: obesity, lack of physical activity, fruit and vegetable intake, and consumption of red meats.

"For colorectal cancer, brisk walking can take down the risk factor dramatically," Byers said.

So the next morning, I decided instead of standing around at the Undy 5000, where runners and walkers wear underwear over their exercise outfits to designate the geography of the colorectal problem, I would indeed walk the three miles to see if I could do it.

It seemed the best and cheapest therapy available.

I did, and it felt good.