Douglas Fair
· Associate Professor (Clinical)VerifiedUniversity of Utah · Hematology & Oncology
Active 2015–2026
About
Dr. Douglas Fair is an Associate Professor of Pediatrics in the Division of Hematology/Oncology at the University of Utah. He received his medical degree from Albany Medical College, completed his Pediatric residency at UT Southwestern in Austin at Dell Children’s Hospital, and his Pediatric Hematology/Oncology Fellowship at the University of Utah. He also received additional training in Clinical Research through the Masters of Science in Clinical Investigation Program at the University of Utah and holds a Utah Certificate of Palliative Education (UCoPE). Dr. Fair joined the university faculty in 2016 and serves as the Director of the Primary Children’s Hospital Solid Tumor Program. He is the Founder and Medical Director of the Childhood, Adolescent, and Young Adult (AYA) Cancer Survivorship Program at Primary Children’s Hospital, and he serves as the Director of the Huntsman Cancer Institute AYA Program and co-Medical Director of the Huntsman Intermountain Adolescent and Young Adult Program (HIAYA). His research interests include improving survival outcomes for children and AYAs diagnosed with solid tumors, clinical trial development for sarcomas and rare tumors, and investigating outcomes and care for survivors of pediatric and AYA cancer. Additionally, he focuses on gonadal and fertility function in cancer survivors, exploring gonadal toxic and protective agents in cancer therapy. Dr. Fair has contributed significantly to national committees and steering groups, including the Children’s Oncology Group and the NCCN AYA Guideline Committees, and is a leader in the Oncofertility Consortium. He has been active in advocacy efforts to address gaps in insurance coverage for cancer patients and plays a key role in policy change at both the insurance provider and legislative levels.
Research topics
- Family medicine
- Medicine
- Internal medicine
- Oncology
- Political Science
- Intensive care medicine
- Gerontology
- Medical education
- Demography
- Immunology
- Pathology
- Environmental health
- Medical physics
- Law
- Pediatrics
- Public relations
- Psychiatry
Selected publications
Adult embryonal rhabdomyosarcoma (botryoid subtype) of the ureter: A case report
Urology Case Reports · 2026-03-04
articleOpen accessEmbryonal rhabdomyosarcoma arising from the ureter is exceedingly rare. We report the case of a 20-year-old female who presented with flank pain and hematuria, initially attributed to ureteral stones. Subsequent evaluation revealed an embryonal rhabdomyosarcoma (botryoid subtype) of the ureter. Following surgical resection and chemotherapy, the patient achieved remission and experienced minor complications including neuropathy and bladder irritation. This case highlights the classification and management of ureteral rhabdomyosarcoma. While the prognosis for ureteral rhabdomyosarcoma appears favorable based on limited literature, long-term surveillance is crucial for monitoring recurrence and managing potential complications.
Journal of Adolescent and Young Adult Oncology · 2026-03-30
articleWe explored how sociodemographics and health insurance literacy (HIL) are associated with financial toxicity (FT) among adolescent and young adult (AYA) cancer patients using linear regression. Participants ( N = 86; ages: 18–39) diagnosed with cancer in the past year completed baseline surveys of an intervention trial assessing HIL (range: 4–36, lower scores = worse literacy) and the COmprehensive Score for financial Toxicity (COST; range: 0–44, lower scores = higher toxicity). Policyholders had higher FT (β = −5.24, p = 0.02). Among AYAs aged 26–39, each one-point HIL increase correlated with a 0.55 increase in COST score ( p = 0.05). Improving HIL could address FT among AYAs aged 26–39, suggesting a potential target for intervention.
Journal of Adolescent and Young Adult Oncology · 2025-02-06 · 4 citations
articleOpen accessPurpose: Cancer organizations recommend cost-of-care (CoC) information be provided to patients with cancer by their care teams. Little is known about the CoC conversation experiences and preferences of adolescents and young adults (AYAs) with cancer.
F&S Reports · 2025-01-29 · 2 citations
articleOpen accessObjective: To describe fertility preservation via ex vivo oocyte retrieval for an adolescent patient undergoing oophorectomy for recurrent ovarian dysgerminoma and to review the available literature regarding this technique. Design: Case report and literature review. Subjects: A 17-year-old female with a medical history of right ovarian dysgerminoma treated with oophorectomy 3 years prior, who presented with a retroperitoneal mass noted during surveillance. Biopsy of the mass and remaining ovary confirmed recurrent stage III ovarian dysgerminoma. The patient desired fertility preservation. Ovarian tissue cryopreservation and traditional transvaginal oocyte retrieval were contraindicated because of the ovarian malignancy. Exposure: The patient underwent controlled ovarian hyperstimulation with gonadotropins followed by laparotomy and left salpingo-oophorectomy 36 hours after ovulation trigger. An ex vivo retrieval of oocytes was performed under both direct visualization and ultrasound guidance in the operating room after excision of the ovary and isolated using a "mobile IVF" setup. Main Outcome Measures: Number of meiosis II oocytes cryopreserved. Results: A total of 12 meiosis II oocytes were retrieved from the ovary and were successfully cryopreserved. The patient tolerated the procedure well and has since completed chemotherapy. Conclusion: The combination of controlled ovarian hyperstimulation followed by ex vivo oocyte retrieval provides select patients with an opportunity for fertility preservation that may have otherwise faced a complete loss of fertility. In this case, the patient was able to preserve oocytes without jeopardizing her health status or delaying cancer therapy.
UNC Libraries · 2025-05-01
articleOpen accessCurrent Oncology · 2025-01-28 · 2 citations
articleOpen accessWe adapted CHAT, a four-session virtual program to help individuals affected by cancer manage insurance and medical costs for caregivers of pediatric cancer patients (called CHAT-C); we then pilot-tested CHAT-C. Eligible caregivers were ages 18+ and the primary caregiver to a pediatric cancer patient (≤25 years old) diagnosed in the past five years and treated at Primary Children’s Hospital. We conducted engagement studios to adapt the program. Feedback was evaluated using a rapid qualitative analysis framework and included content preferences, navigator preferences, logistics/structure, timing of delivery, and feasibility/acceptability. A small pilot test of CHAT-C was conducted; feasibility, acceptability, and preliminary efficacy were evaluated based on enrollment rates, qualitative feedback, and baseline/follow-up surveys. Participants in the pilot (n = 14) were primarily white (93%), married (93%), female (86%), ages 40–49 (50%), and college-educated (57%). Most participants (64%) completed all four sessions of CHAT-C. Those who did not complete the sessions cited a lack of time, a child’s disease progression, and a perceived lack of benefit. Health insurance literacy (measured by nine items) improved by 10.8 points on average (SD = 6.0, range: 9–36) after CHAT-C. Caregivers of childhood cancer patients are willing to participate in a health insurance program, but some caregivers need less time-intensive options.
Preventive Oncology & Epidemiology · 2025-02-06 · 3 citations
articleOpen accessBackground: Health insurance education could mitigate financial toxicity experienced by young adult (YA) cancer survivors by increasing confidence when navigating cancer care costs. This paper describes the protocol in a randomized controlled trial (RCT) to test a virtual patient navigation program designed to help YA cancer survivors understand their health insurance. Methods: This is a two-arm, multi-site (Huntsman Cancer Institute, Intermountain Health) RCT wherein intervention participants receive four sessions with a patient navigator (PN) and a booklet on insurance; usual care receives the booklet. We will enroll 300 YA cancer survivors (n=200 intervention; n=100 usual care) diagnosed with breast, testicular, lymphoma, sarcoma, colorectal, melanoma, or thyroid cancer between the ages of 26 and 39, who have completed treatment in the past two years. All participants will complete three surveys: enrollment, 6 months, and 12 months; medical records/insurance claims data will be collected out to 18-month follow-up. Recruitment began in the fall of 2023 and is expected to last approximately 2.5 years. The primary efficacy outcomes include improvement in health insurance literacy and financial toxicity at 6 months. Secondary outcomes include adherence to cancer surveillance guidelines at 18 months. We will also conduct cost-effectiveness and budget impact analyses. Discussion: Anticipated results from this trial could identify key information that YA cancer survivors need to improve health insurance literacy and survivorship care.
UNC Libraries · 2025-03-14
articleOpen access<strong><em>Background:</em></strong> Financial burden is a major concern for survivors of adolescent and young adult (AYA) cancers. We identified if employment disruptions during the COVID-19 pandemic affected AYA survivors' financial burden. <strong><em>Methods:</em></strong> AYAs who were enrolled in a cancer patient navigation program were e-mailed a survey in fall 2020. Survey items included sociodemographics, employment disruption, and two measures of financial burden: COmprehensive Score for Financial Toxicity (COST) and material and behavioral financial hardship items (for any reason, COVID-19 induced, cancer induced). Financial burden outcomes were dichotomized at the median (COST = 21; financial hardship = 3). The association of employment disruptions and sociodemographics with financial burden was assessed using multivariable logistic regression models. <strong><em>Results:</em></strong> Reduced hours/job loss was reported by 24.0% of 341 participants. Survivors with a high school education or less (odds ratio [OR]: 2.70; 95% confidence interval [CI]: 1.21-6.03) or who had decreased hours or job loss (OR: 3.97; 95% CI: 2.01-7.84) had greater odds for high financial toxicity. Reduced hours/job loss was the only factor associated with high material and behavioral financial hardship for both any reason (OR: 2.75; 95% CI: 1.41-5.33) and owing to COVID-19 (OR: 4.98; 95% CI: 2.28-10.92). Cancer treatment since March 2020 was associated with cancer-induced high material and behavioral financial hardship (OR: 3.31; 95% CI: 1.96-5.58). <strong><em>Conclusion:</em></strong> Employment disruptions owing to the COVID-19 pandemic, lower education levels, and cancer treatment were associated with high financial burden among AYA cancer survivors. Our findings suggest the need for multilevel interventions to identify and address financial burden among vulnerable cancer survivors.
Wilms Tumor, Version 2.2025, NCCN Clinical Practice Guidelines In Oncology
Journal of the National Comprehensive Cancer Network · 2025-08-01 · 3 citations
articleThe NCCN Clinical Practice Guidelines (NCCN Guidelines) for Wilms Tumor (WT; nephroblastoma) cover strategies for the screening, diagnosis, and treatment of WT, which is the most frequent primary kidney tumor in children. WT can generally be separated into 2 histology types: favorable histology WT and anaplastic WT. Five-year survival is high for children with favorable histology WT who receive appropriate treatment; however, survival rates are much lower for patients who present with higher stage diffuse anaplastic WT. Treatment of WT can range from surgery alone to surgery plus intensive chemotherapy and radiation depending on whether the tumor is unilateral or bilateral, histology, and local stage. The goal of therapy is to maximize cure while minimizing long-term toxicities. The content featured in this issue covers the NCCN panel's recommendations for overall management of both favorable histology WT and anaplastic WT.
UNC Libraries · 2025-02-14
articleOpen accessBackground: Health insurance education could mitigate financial toxicity experienced by young adult (YA) cancer survivors by increasing confidence when navigating cancer care costs. This paper describes the protocol in a randomized controlled trial (RCT) to test a virtual patient navigation program designed to help YA cancer survivors understand their health insurance. Methods: This is a two-arm, multi-site (Huntsman Cancer Institute, Intermountain Health) RCT wherein intervention participants receive four sessions with a patient navigator and a booklet on insurance; usual care receives the booklet. We will enroll 300 YA cancer survivors (n = 200 intervention; n = 100 usual care) diagnosed with breast, testicular, lymphoma, sarcoma, colorectal, melanoma, or thyroid cancer between the ages of 26 and 39, who have completed treatment in the past two years. All participants will complete three surveys: enrollment, 6 months, and 12 months; medical records/insurance claims data will be collected out to 18-month follow-up. The primary outcomes include improvement in health insurance literacy and financial toxicity at 6 months. Secondary outcomes include adherence to cancer surveillance guidelines at 18 months. We will also conduct cost-effectiveness and budget impact analyses. Discussion: Anticipated results from this trial could identify key information that YA cancer survivors need to improve health insurance literacy and survivorship care. Trial registration: ClinicalTrials.gov identifier: NCT05829070. Registered on April 25, 2023.
Frequent coauthors
- 96 shared
Anne C. Kirchhoff
- 71 shared
Echo L. Warner
University of Utah
- 69 shared
Heydon K. Kaddas
- 43 shared
Austin R. Waters
University of Utah
- 39 shared
Perla L. Vaca Lopez
University of Utah
- 39 shared
Judy Y. Ou
University of Utah
- 38 shared
Nicole Ray
University of Utah
- 33 shared
Joemy M. Ramsay
University of Utah
Education
M.D.
Albany Medical College
Other, Pediatric Hematology/Oncology
University of Utah
M.S., Clinical Investigation
University of Utah
Other, Palliative Education (UCoPE)
Utah
Awards & honors
- Utah Certificate of Palliative Education (UCoPE)
- Fellow of the American Academy of Pediatrics (FAAP)
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