David Raubach: I want to thank you for joining us on today’s episode of The Cancer Project Podcast. We are really privileged to be joined by Rahul Mahadevan, who is the founder and CEO of a company called We Are In This Together, or WIT, which is a software platform that is connecting cancer patients with donors who can help provide financial and emotional support to those patients as they’re going through treatment. Rahul is a cancer survivor himself, and so we are going to hear his amazing story and learn a little bit more about this platform that he’s developed. So Rahul, thank you so much for joining us today.

David Raubach: Tell us just to give us a little bit of a background on you. Where are you from? Where do you live now? What should we know about Rahul before we dive into your cancer journey?

Rahul Mahadevan: I was born in India but I lived in 12 different countries growing up. I’ve been in California since 1987. I’ve been in healthcare since 2000 — I got into healthcare after having a heart surgery and lung surgery in 2000. I loved the industry and wanted to be part of an industry that could help my mother, father, brother, and sister-in-law go through treatment. I found a passion in making a difference to others, and then I started this company after my own diagnosis in 2021.

David Raubach: So let’s go ahead and dive in on that. The diagnosis in 2021 — you were working for Varian at the time. You have an interesting narrative about how that all occurred. It was almost a little bit of luck that the cancer was even discovered. Walk us through everything that happened leading up to that cancer diagnosis.

Rahul Mahadevan: I was working for Varian since 2018. In 2020, right after COVID hit, I wanted to go get an annual physical — I never go and get a physical. So I said, you know, with my heart condition and stuff I was dealing with, let me just go get tested and make sure I’m okay. In October I went to my primary care doctor and got all the usual tests done. As I was walking out the door, I said, “Hey, should I be tested for prostate and colon cancer? I just turned 50.” The response was, “No, the new guidelines are 55 — you’re okay.” And I said, “Well, what’s the test for prostate and colon?” She goes, “It’s a blood test.” I said, “Well, let’s just go ahead and get a blood test done anyway.”

Rahul Mahadevan: The PSA came back at 12, which was high. I was told it may not be a big deal because people of Indian origin have an enlarged prostate, so it may not be a big deal. I had no symptoms. I did a follow-up blood test at Stanford that came back high as well. The only way to determine if it was or wasn’t cancer was to do a biopsy. I ended up doing a biopsy in December of 2020, and then on January 4th, 2021, I was told I had been diagnosed with Stage 4 prostate cancer.

Rahul Mahadevan: The good thing is I worked for a cancer company, so I could leverage the team there to guide me in the best treatment options. I often say that if I hadn’t walked out and asked that question as I was leaving the doctor’s office — “Should I be tested?” — I don’t know if I’d be here, because I had no symptoms. I think about how many patients who see their physicians don’t ask that question and either find out too late or end up with negative outcomes because they don’t ask.

David Raubach: There’s a lesson there in just taking ownership of your own health and being your own advocate — initially with you just asking the doctor, hey, could we go ahead and do this PSA check?

Rahul Mahadevan: That was only because I’ve been in healthcare as long as I have and was working for a cancer company. If I had not been in the industry — if I had been in finance like I was before — I probably wouldn’t have known the question to ask. I think sometimes it’s just luck that you’re in the right place at the right time to ask the right questions.

David Raubach: So you get diagnosed, but you said it was Stage 4. It was serious.

Rahul Mahadevan: It was serious. It had breached. I was choosing between surgery and radiation, and I ended up not understanding the pros and cons until I talked to my team at Varian. I decided I’d rather go through a longer treatment process with more predictable outcomes than a shorter one with unknown outcomes in the event something went wrong with surgery. The hardest decision for me was to pick what I felt would give me the best quality of life — not the best longevity outcomes. Telling my mom that was not an easy conversation. I told her: I’m going to pick the treatment course that is going to allow me to live the best life I can — not the longest life I can.

David Raubach: That brings up a good point. When you’re diagnosed with cancer, you’re often presented with very difficult decisions, and there isn’t always a clear right or wrong answer. Different patients will make different decisions, and the whole process is overwhelming.

Rahul Mahadevan: Exactly. When you’re told you have cancer and this is what you have to do, you’re not thinking about what your life is going to be like — you’re thinking about what do I do? What does the next day look like? You start being more true to yourself about what the most important things are. There’s no right answer. Every single patient can have a different way of looking at it, and there’s no way for somebody to say what you decide is right or wrong. It is a personal decision.

David Raubach: Talk a little bit about your mental state at that point. It was 1:30 in the afternoon on January 4th, 2021. Just describe that scene and what you’re thinking and what you’re going through at that moment.

Rahul Mahadevan: I lost my dad when I was 12, so I’d gone through a period in my life where I realized life’s too short — take every day as if it’s your last. When I was diagnosed, the first moment was the “oh crap” moment. Okay, now what? But then I looked at it and said: you can’t change what you’ve been diagnosed with. You’ve been dealt these cards. You’re part of a club that you don’t want to be part of — but you are. Now put your practical hat on and figure out the best path forward. The doctor said to me, “I’ve told people they’ve had this before and you’re the first one who seems to be reacting with no emotion.” I said, “Well, I can’t change it.”

Rahul Mahadevan: My wife ended up having a two-hour shower because she needed to de-stress and process what was happening. I told my kids, who were 15 and 17 at the time: “Listen, until I panic, you guys don’t panic. I don’t want you to start treating me differently now that I’ve been diagnosed, because that’s going to exacerbate my situation. The sun comes up every morning and sets every night. When I start feeling I’m not myself, then you can start treating me differently. But until then, these are the cards we’ve been dealt — let’s go from there.”

Rahul Mahadevan: Even now, four years later, when I get sick or feel something coming on, there’s always that voice in the back of your mind saying: is it back? Is it spread? Has it gone somewhere else? You just have to work with that and process it.

David Raubach: There’s this concept we talk about called cancer survivorship — really what it entails is living with a cancer diagnosis. Cancer is one of those things that changes you permanently. It changes your perspective on life. A lot of times it just changes who you are as a person. But there’s also the reality of follow-up visits and the fear that it could come back. How have you tried to manage that survivorship period personally?

Rahul Mahadevan: For me, I can’t control it. If it comes back, it comes back. I try not to dwell on the fact that there’s nothing I can eat, nothing I can do proactively to ensure it doesn’t come back. I’ve accepted that if the cards are dealt where it comes back somewhere else, I’ll deal with it the same way I dealt with it the first time. But I can’t continue to worry about it. Although at the back of your mind it’s always there — when you get sick, when you have a bad cough, it’s like, is it COVID? Is it something else? Do I need to get checked? It does weigh on you. But you process it and say: don’t worry about it. If it comes back, deal with it, and play the best game you can play.

David Raubach: Walk us through the rest of the treatment journey. You mentioned brachytherapy and radiation.

Rahul Mahadevan: I had brachytherapy at UCSF and all my other treatment done at Stanford. Both great organizations, both great people. When you go through treatment, you meet a lot of patients with all types of cancers who are now part of your club. You start really looking out for each other. From a clinical perspective, I was never concerned about getting the best clinical care — I’ve always assumed that most physicians, hospitals, and organizations want to do the best for their patients. What really struck me was that I was one of the 5 or 10 percent of patients who came in with that healthcare background. Everybody else was dealing with this diagnosis without that context — facing not just the unknown of what their treatment would be like, but the unknown of what their life was going to be like. That combination is something else entirely.

Rahul Mahadevan: The machine I was treated on at Stanford was built by Varian. So when I went back to work, I held a conference call with all the engineers who built that machine — just to say thank you for saving my life. Most patients going through treatment are concerned about the clinical care they’re receiving and also how to deal with life. I was lucky to have at least one of those addressed. I can’t imagine going through this without a healthcare background. It’s a foreign language.

David Raubach: You’ve shared with me previously that there were aspects of the patient experience that caught you off guard — things you would never have imagined would be a challenge going through treatment.

Rahul Mahadevan: I met a lot of patients going through treatment who were voluntarily choosing to miss appointments or delay treatment because of life challenges. When you go through treatment for seven, eight, nine weeks in a row every day, you see the same people in the hospital every single day. When you start not seeing someone you expect to see and you ask them where they were, you hear things like: “I take the bus from my house to the hospital and the bus didn’t show up, so I ended up missing my appointment.” And you ask, “Why don’t you take an Uber?” And they say, “I can’t afford an Uber, or I don’t have a debit or credit card.” You start realizing that the privilege you live in is not what the majority of patients going through treatment are experiencing, especially rural populations and others struggling with life challenges.

Rahul Mahadevan: For me, I didn’t need financial support when I was going through treatment — I needed somebody to go for a walk with me, to go to the gym with me. I would wear my sweats to the hospital, drive by the gym on the way home, because I knew if I went home and changed I wasn’t leaving the house. And 70% of the time I sat in my car, not because I didn’t want to go into the gym, but because I just didn’t have the energy. I worked for a cancer company — I could have had 30 or 40 people who would have happily come with me if I’d asked. But I didn’t ask a single person. Not because I didn’t need it, but because I didn’t want to be a burden. And if I’m going through that — someone privileged, with resources, with friends in the industry — what are people without those resources going through?

Rahul Mahadevan: I’m a dog parent, and anybody who’s a dog parent knows they’re angels on earth. One of the things I didn’t realize when I was going through treatment was that pet care was a big issue for people my age. I asked my family if someone could walk him, and when the response was essentially “ah, he’s just a dog,” I understood for the first time what patients must feel when they have no one. I’ve met patients who refused treatment because they had a pet at home and nobody to watch it overnight. You hear about that and you think — why would someone not do treatment over a pet? But it happens more often than we realize. These are the life challenges that are just as important as any clinical piece of the cancer journey.

David Raubach: There’s a specific story you’ve told me that led to the formation of your company — and really the impetus for the name. Tell us that story.

Rahul Mahadevan: I’ll give the credit to my daughter, who turns 20 today. She and I were talking about a patient at Stanford who was going through treatment and was refusing it because his family would be at financial risk if he spent six months in the hospital. He had asked for housing for his family and the hospital couldn’t guarantee it. So he was struggling with whether to accept treatment, because he didn’t want to be in the hospital getting treated when his wife and two young kids might be evicted from their apartment. I was telling her this story and she said, “Listen, if you’re so concerned about patients, why don’t you quit your job and start a company to help them?” She was 15 at the time, and I wasn’t sure if she was just being a flipping teenager or if she was actually a genius. She’s actually smart.

Rahul Mahadevan: We were driving home and she said, “Why don’t you call the company WIT?” I thought it was spelled W-I-D and I said, “What’s funny about oncology?” She goes, “No, WIT — We’re In This Together.” I realized that your cancer journey is a journey not just of you, but of everyone around you who cares about you and wants to help you get through it. I will always take the company in any direction, but I will never change the name, because it is truly about the community supporting each other.

David Raubach: I want to make sure I capture the spirit of what you just described. You had this individual at Stanford who was literally having to make the decision: if I choose to get treatment that will hopefully save my life, I can’t work. If I can’t work, I can’t pay rent. If I don’t pay rent, my wife and two children are going to potentially be homeless. He’s literally having to make that decision.

Rahul Mahadevan: And I don’t think I was fully aware of it until my daughter said it — until I realized we are never going to have to make that decision. We’re never going to have to choose between food and a roof over our head. We have people we can stay with, we have a network. But there are more people like him out there than there are like us. And what bothered me was that home-versus-health decision. In this day and age, with all the resources we have, the fact that most people going through any chronic disease — especially cancer — have to choose between doing things for their family or taking care of themselves shouldn’t have to be something any patient deals with.

Rahul Mahadevan: I believe God gave me cancer for a reason. Starting the company was my way of saying: let’s take that experience and do something meaningful with it. Let’s work with organizations that can help make a difference to those who don’t have the resources we have. If you can change even 10% of people’s lives and make them a little better, you’ve done something meaningful.

David Raubach: Take us from that stage to where we are today with WIT. You had the idea — walk us through how you built it.

Rahul Mahadevan: That was probably May or June of 2021. I thought about it for a couple of months. Then I just started talking to patients at the hospital — what are you struggling with? I talked to about 200-plus patients. Almost every single one said, “I need help, but I don’t want to ask my friends and family. I don’t want to put more on their plate. I’ll suck it up and figure it out myself.” Or I’d hear: it’s against my culture to ask for help. You’d hear all these reasons why patients put the onus on themselves — not just dealing with cancer, but not wanting to burden somebody else with their non-cancer issues.

Rahul Mahadevan: I hired a friend who was a UX designer, and every Saturday and Sunday for four months from 6 a.m. to noon Pacific, we would just mock up designs and think through workflows — and I was in the middle of treatment. By August we had a mockup, which I showed to patients for feedback. September and October of 2021 I incorporated the company. I raised a two-million-dollar round from friends and family to get the idea off the ground, build a prototype, and run product design sessions — Zoom calls with 30 to 40 cancer patients at a time saying here’s what we’re designing, what do you think? The product we have today was designed by patients, for patients.

Rahul Mahadevan: We launched the product in May of 2022. Initially it was going to be B2C — let’s give this directly to patients. But as we went through that go-to-market pilot testing period in 2022, I realized the best way to have the biggest impact is not to build my own brand and go B2C, but to go to health systems and make this their product for their patients. Most hospitals have a brand that patients trust. If you build a product for them that they can use to help support their patients, patients are more likely to use it because it’s coming from an organization they already trust, and the community is more likely to get involved. I’m happy to be the Intel Inside. We started commercially selling in 2023. We’ve got about 10 health systems working with us now, served about 2,500 patients, and organically raised about $750,000 for patients. One of our sites has seen a 21% reduction in missed appointments by giving patients an average of just $400 per year.

David Raubach: I want to put those numbers in perspective. We have a foundation that’s a partner of Oklahoma Proton Center called the Proton PALS Foundation, and one of the most frequent requests they get is $50 or $75 to fill up somebody’s car with gas — because patients are driving 40, 50, 60 miles every single day for treatment. It’s amazing how much impact giving somebody $200 in gas gift cards can have. We have a tendency to think of charities and big donations — $100,000, $500,000 — but you’ve talked about how you and I can help a cancer patient by giving up a cup of coffee a month. Talk about that concept.

Rahul Mahadevan: We have a saying in the company: no patient should ever miss an appointment for a $20 problem. And that’s 90% of why patients miss appointments. I’m a big believer in building a local product for local patients — people by nature want to help others. The problem is we don’t know who needs help and we don’t know what they need help with. And on the flip side, patients are inherently uncomfortable asking. The whole idea was: if you can break that stigma where patients share what they need, and share that with people in the community — local church groups, neighbors — how do you tap into the person who says, yeah, I’ll give up a cup of coffee today? Instead of spending $8 on a venti cappuccino at Starbucks, let me give that to a patient who needs an Uber ride.

Rahul Mahadevan: My belief is if you can rally a local community where 50,000 people in Oklahoma City give $10 a month to the PALS Foundation, you can raise three, four, five million dollars a year to support patients in amounts that are not going to break anybody’s bank — but you get enough people doing it. And you know that all that money is going directly to patients in need who live in your community, whose kids go to the same schools as you, who buy coffee from the same shops, who shop at the same supermarkets — but are dealing with challenges you’re not dealing with. You can actually move the needle. I don’t ever want to go after big donors. They’ve got enough people hitting them. But I’ve met so many people who are more than happy to give $10 a month — they just want to know it’s going toward somebody who really needs it.

Rahul Mahadevan: Our whole philosophy is 100% of what somebody gives to a patient goes to a patient. We don’t want to take any money off the top. If someone says, “I need $25 for an Uber ride” — give them the $25, not $20. If they need money for food, give them whatever you give. By doing that you build trust in the community and you can really get the community involved. Financial toxicity is a real issue — more people go through bankruptcy after a cancer diagnosis because of all the non-clinical costs they weren’t planning for. If you can rally the community to support them even in a small way, you can make a big difference.

David Raubach: Nearly half of patients that go through cancer treatment are in medical debt once they get done. And specifically in Oklahoma, we have some of the worst cancer mortality rates in the country. The diagnosis rates are relatively average, but we don’t do a great job dealing with the diagnosis — not because we don’t have good treatments, but because patients literally can’t get to their appointments. We could tackle cancer mortality rates in Oklahoma in part just by having funding for patients to get there.

Rahul Mahadevan: For me there are three steps that have to happen to make that successful. First, patients need to be able to tell you what they want. To crack that, we said: think about a wedding registry. Nobody feels guilty asking for things on their wedding registry because they’re not asking David or Rahul to buy them something — they’re putting it on a list. What if you take that idea and apply it to patients? Let a patient create a support registry of whatever they want. Then combine that with the best of crowdsourcing — let them share it with friends, family, colleagues, people in the community, so people have visibility into not the macro needs of people but the micro needs — the $25 to $40 level. And then we realized a lot of our patients are underserved, marginalized patients who even if you give them money don’t have access to Uber, Lyft, DoorDash, or Instacart because they don’t have a debit or credit card. So we started issuing debit cards to patients.

Rahul Mahadevan: A combination of a wedding registry model, crowdsourcing, and debit cards — fintech together — gives patients the comfort to ask for what they need, and gives the community visibility into what local patients need help with. You bring the demand side and the supply side together and you can move the needle from an outcomes perspective for patients, and help health systems make more money on the business side because now you have fewer missed appointments, more people showing up. Everybody wins.

David Raubach: There’s also a practical element as it relates to working directly with the health system — you have a check-and-balance that doesn’t exist with something like GoFundMe, where fraud has been an issue. The health system goes in and validates that this is a real patient who is actually receiving treatment. That protects donors too.

Rahul Mahadevan: Exactly. If somebody wants to sign up and invite their friends and family to support them, that’s great — if you want to fool people who know you, that’s on you. But what I don’t want is for you to fool people who don’t know you. For us it’s really important that any patient a donor sees on the platform is actually a real patient in treatment. It gives donors comfort. And we don’t focus on how much income someone makes — I’ve had friends who made a lot of money whose kids were diagnosed with terminal cancer, and after two years of treatment costs, those parents ended up in financial debt. Financial need doesn’t discriminate by income level. The key is giving people the ability to help in a small way, because you get enough small amounts and you end up with a big impact.

David Raubach: Describe practically how everything works, maybe start to finish. We can use the Oklahoma Proton Center as an example because we’re about to launch the platform with you, and it’s going to be called Cancer PALS — Patients Are Loved and Supported. We took your daughter’s idea of having an acronym for the name. Describe what the patient does and what the donor does.

Rahul Mahadevan: Patients will be notified about Cancer PALS from someone at Oklahoma Proton — that this resource exists for them, and there’s no cost to use it. They sign up through the Oklahoma Proton website and complete a roughly five-minute onboarding process, then go and create their own registry of what they need help with. We focus on both financial and non-financial needs, because every patient will have friends who have money but not time, or time but not money. So asking for both allows your network and the community to help you in the way they can help you best. We will have a place within Oklahoma Proton’s website where donors can go in and say, “I want to support a patient directly” — maybe because they were diagnosed with the same disease, or their parent was diagnosed and they want to support a specific patient on the platform. Or they can give to the foundation as a general fund and receive a tax deduction, knowing that 100% goes to patients.

Rahul Mahadevan: Patients can choose to make their profiles public so the community can see what they need help with. Donors can search by zip code, disease type, or other criteria. You can support a patient with as little as $10 — and if somebody’s already given $10 toward a $50 request, the next donor only sees $40 remaining. You’re never giving more than what the person asked for. And we always tell patients: the smaller amounts you ask for, the easier it is for someone to give. Slice what you need into bite-sized chunks — $25 or $30 at a time — and more people will step up.

Rahul Mahadevan: On the back end, we generate a lot of data that will help Oklahoma Proton understand what patients actually need help with. If you see that people living in Norman, Oklahoma have a major child care need, maybe there’s an opportunity to work with a local daycare center to support patients coming from that area. You can really tease out the specific needs of specific patient populations and get the community more involved in removing that home-versus-health decision.

David Raubach: You touched on something important — there’s the money component, but also the in-kind donation, the time donation. Somebody could put on there that they need help walking their dog. Not everybody has kids or a wife who can step in.

Rahul Mahadevan: We don’t make in-kind needs visible to people the patient doesn’t know — one of the things that’s really important to us is that you don’t want some random person showing up at your house saying, “Hey, I’ll walk your dog” when you have no idea who that person is. So we only make in-kind needs visible to people the patient has selected as part of their network. But you have people who want to support a patient and don’t have funds to do it but have time — that’s exactly the kind of help that matters.

Rahul Mahadevan: That also speaks to what I’ve said a couple of times: sometimes it’s just hard for a patient to ask for help from a specific person. The one time I did that when I was going through treatment, I asked a friend who had said, “Whatever you need, happy to help.” I said, “I could use a ride to the hospital tomorrow — I’m just exhausted.” He paused, then said, “Ah, tomorrow’s bad. I take my daughter to the dentist. But I can do it Friday.” I didn’t need it Friday. I needed it Thursday. When you ask someone in real time, you put them in a tough position — they want to help but they can’t help in this particular way at this particular moment. If you just put your needs out there, you let people make the decision on when they can and cannot help. You remove that awkward conversation. Most people want to help — they just want to do it on their own terms, based on what they can do.

David Raubach: We’ll have a link to Cancer PALS on our website so donors and members of the public can go on and see what the needs are, give directly to a patient, or give to the 501(c)(3) foundation. We’ll be working with patients to help them create profiles, and we’re also partnering with the American Cancer Society — patients staying at the local Hope Lodge will also have the ability to get on the platform. We’re really excited to make this a community resource and partner with other health systems and cancer centers so that it becomes the one place locally where, if you want to help a cancer patient — wherever they’re being treated — a donor can go and do that.

Rahul Mahadevan: And we want to make the needs as visible as we can to anybody in the country who wants to support — knowing that 100% of what they give to a patient goes to the patient. My hope is that I can avoid wasting my diagnosis. I want to work with organizations like you, and people like you, to say: how do we really make a difference? If we do this right, maybe the whole conversation around home versus health goes away at some point. And it’s just about focusing on your health.

David Raubach: I really appreciate your time today, Rahul. Thank you for having us. It’s incredible to hear a story of somebody who was potentially weeks away from a diagnosis where it wouldn’t have even been treatable — you had an aggressive cancer and caught it just in time. And now here we are. We’re so grateful for what you’re doing, for giving back, and for enabling other people who want to give back to be able to do that as well. Thank you for coming on and sharing your story.

Rahul Mahadevan: Thank you for being part of my journey, my friend. I appreciate it.