Revolutionizing the Way People Experience Cancer Treatment With Kate Dilligan of Cooler Heads

Startups get the party. Startups get the party started. Startups get the party. Startups get the party started. You want tech and tacos? Tacos in tech you know we got tacos and tech is on smash border green guacamole keeper captains counting beans Contador Quentan frijoles found us trying to raise some queso la vida San Diego school of rappy rapping fire tortillas round jalapenos in these modern times a crappy my coding yoga posse fold the body origami we be surfing coronado eating tacos el gordo the tacos standing puesto lucha libre and sombrero Got a shout out to cost angels by the ocean watch the sunset La Jolla shores Entrepreneurs trying to get funded When San Diego Startup Week is popping in the summer Oceanside, the Tijuana Estee be full of hustlers from couch surfing to penthouses right on the beach Tech leaders believe stars are within reach we interview and founders who be shooting for the moon SD Tecos with your host, Neil Bloom. Startups get the party. Startups get the party started. Startups get the party. Startups get the party started.

Welcome to the Tacos and Tech Podcast. I'm your host, Neil Bloom, and I'm thrilled to have you here. On the Tacos and Tech Podcast, we interview builders of technologies, of companies, of communities, and we do it weekly, so thanks for tuning in. Every Tuesday, a new interview and on Fridays we talk about what's new in the San Diego tech ecosystem from a news perspective. So make sure you join us there as well too. We also have a tech newsletter that comes out every other week@freshbroodtech.com you can subscribe to listen to it without further ado. Enjoy this episode and welcome back to the Tacos and Tech Podcast. I'm your host, Neal Bloom, and I'm really thrilled to have Kate Dilligan on founder and CEO of Cooler Heads. Hey, Kate, thanks for joining the podcast.

Thanks so much for having me, Neal. It's awesome to be here.

It's really nice to sit down with you. I think for the first time in quite a while, if not maybe ever, I have been in the audience of seeing you pitch all the way back since 2018 during a. I think it was a Sunday afternoon that Arlen Hamilton came to town. Yep.

Down in Little Italy.

That's right. Well, I've been a fan from afar ever since. I was grateful that you joined us at Startup Week this year as well too, and I'm really excited to get to Know your story a little bit and what you're working on here at Cooler Heads. You want to give us an overview?

Sure. So Cooler Heads is using technology to help cancer patients and survivors manage the daunting side effects of of treatment. And this all comes from my experience as a cancer patient. And there's just this huge hole in the care continuum because patients get really outstanding care from their oncology team when it comes to their disease. But when it comes to side effect management, you're really on your own. And that's what we're pioneering at Cooler Head. So we're building the evidence based products, content and services that cancer patients and survivors need to feel like themselves on a day to day basis.

Wow. Well, one inspiring just to have gone through cancer and beat it. And we're all fortunate because of that. And now to build a whole company around that. I got to hear some of the story that led to this because obviously you did not grow up knowing you're going to build a cancer ecosystem company.

Not at all. Not at all.

Where did it all start? Where are you from?

So I'm originally from Los Angeles, which, you know, I know I'm not supposed to say now that I'm in San Diegan and I'm a San Diegan homeowner, so please don't make me sell my house and move back, but grew up in the South Bay of la, went to college on the east coast and then got into politics actually. And so worked as a political fundraiser for about six years. Broke a lot of fundraising records as a Democratic political operative. And I worked for a woman named Lord of Sanchez who was the first member of the Hispanic Caucus to represent a non majority Hispanic seat. So 2022, we've had orange county go blue and now even though there are some Republican members, there's a bunch of Democratic members. Loretta was the first Democrat to represent Orange county in Congress. And so I started working for her right after she was elected and then for her first term and then during her second term when she was a co chair of the dnc And I realized that politics was not a place I wanted to live for the rest of my life. It is really brutal. It is really demanding, kind of like a startup. So I decided, hey, let's go and not do law school. Because law school kind of seemed obvious. I have an undergraduate degree in history, so law school would have completely made sense. But this was around the time of, you know, the dot com boom and I was like, business school, what's this business school thing? So had the good fortune to go to Stanford to get my mba, learned a lot, totally changed my perspective on the way I think about things, and then connected up with somebody who'd been a mentor of mine in politics, a gentleman by the name of Dan golden, who'd been NASA administrator for a decade. So the longest serving NASA administrator had done over 64 manned space flights, had never had an accident. And he was really interested in the intersection of biology and engineering. So I joined up with him after business school and we built a company originally called Intelis. Moved into New Edge where we were building really early on. We were looking at, you know, the earliest versions of AI and doing like the earliest versions of semiconductors to, to focus on AI. And while the company ultimately wasn't successful, you know, Dan was a phenomenal mentor and I learned a lot, you know, on working with him, working on systems engineering.

So that would brought you to San Diego. Was New Edge founded in San Diego or what got you to town?

Yeah, no, it was originally, it was originally New Edge. And what we were doing is our first ip, we were licensing from an organization called the Neurosciences Institute on the Torrey Pines Mesa. And that IP turned out to be a little too young to be productizable, if that's a word nowadays. And so I was. But we developed our own suite of IP and I wound up leading a business unit where we were building digital signal processing solutions for the intelligence community. So basically understanding the different signals that are coming out of the battle space and disambiguating them in real time to provide the war fighter with real time information. And so we were really growing a business in that space. So I was working in the IC and back and forth to dc sometimes twice a week, which is crazy. I know all about the direct flights. Dulles San Diego did them a lot. But, you know, everything really changed for me when I was diagnosed in 2016. All of a sudden for me it was breast cancer. I found that lump, I followed up and I got the news that I had cancer with no family history. And all of a sudden just sort of everything changed on its head and, you know, back to that. So the germ for cooler heads comes from my first meeting with a nurse navigator. So at that point I've talked to the medical oncologist, I've talked to the radiation oncologist, I've talked to the surgeon. Like, I know that I'm in for surgery, I'm in for chemo, I'm in for radiation. Like what I was hoping was just going to be Cut it out. Cancer was really going to turn my life upside down for a year, basically. And so I'm sitting there with the nurse navigator and my dear friend who was an Assistant U.S. attorney at the time. And I recommend if you have to be diagnosed with cancer, bring in a attorney with you because they will take copious notes and ask great follow up questions when you're just completely floored and you can't think straight. But we were talking about what my care path was going to be and you know, I was going to start chemo within the next 10 days. And Sarah asked my nurse navigator, she's like, hey, I heard about this thing called cold cap therapy so Kate doesn't have to lose her hair. Is that a thing? And Terri said, oh, yeah, yeah, no, we've had patients do it, we just don't talk about it because most people have to spend at least $6,000 out of pocket. Well, I wound up spending $8,000 instead of $6,000. But you know, it really goes back to that kind of kernel of sitting there, being overwhelmed, not knowing what to do, not knowing what I'm in for and my medical team, who was outstanding and I'm well today because of them, but not handing me a roadmap, not handing me a guidebook about this is what you're in for and that's what I want to do for patients.

Wow. Got it. So you built your own playbook, navigated it, thankfully survived, which you know, is its own fight, and obviously is a bit of a luck of the draw too, on the kind of cancer you get.

You are absolutely right. And I want to emphasize that when people say, oh, congratulations on beating cancer. My best friend from business school died of metastatic breast cancer in 2018. And another one of my classmates is living with metastatic disease. So that is exactly true. I feel like I got lucky that I didn't fight cancer. I submitted to it, I did what I was told, and I'm very fortunate that I had a really good outcome.

Wow. So going through it yourself, you're obviously taking notes and play and thinking about the playbook that, well, you weren't thinking about a startup at the time, I'm guessing, like, when, at what point did you think this needs to be different? I want to be a part of the change for people in the future.

This is a great story. So, you know, our first product is addressing a therapy called scalp cooling. So scalp cooling is what allows chemotherapy patients to keep their hair. I used a very rudimentary version of this called cold Caps, because basically, and I'm going to just take a minute, explain what the therapy is, because this is why we're really different in, you know, this, our success in the market. And it also gets to why I started this company. So to do this therapy to keep a chemotherapy patient's hair, you bring the scalp temperature down to 65 degrees before, during and several hours following chemotherapy. Because chemotherapy, it's a blunt force instrument. It is designed to attack every single fast growing cell in your body, which is why your hair falls out. But you get mouth sores, you have nerve, and you have digestive distress. Because our bodies are rapidly regenerating and by constricting the hair follicles, they don't absorb the chemo. And that allows the patients to keep their hair. Well, my solution was cold cap therapy, which literally are gel caps that are cool to dry ice that you switch off the patient every 20 to 30 minutes. And I was paying somebody to administer them because I did eight cycles of chemo. So for me to have a family or friend do it, they would have to take off eight days of work, which is like two weeks. That's your two week vacation, basically. Right? So I was paying for the white glove service because I was in a position to do that. So the day before my third chemo infusion, I get a call from the white glove service people and they're like, the person who is supposed to do this for you tomorrow quit. So sorry. And that meant that I was going to lose all my hair.

Oh, sorry.

Like, sorry, like you've already spent a couple thousand dollars, but like, you're out of luck. Sorry about that. And the service was run up in Los Angeles. And so being the proactive person I am, I wound up swearing a blue streak at the person. I said, look, here's what you're going to do. You are going to call me back in two hours and you're going to identify somebody in Los Angeles who will accept, you know, $1,000 to do this. Because normally I was paying about 400. So I'll pay them more than twice what they make. And I will put them up in a hotel and they will come here tomorrow and they will do this for me and you will call me back and you would tell me who that person business. And that's a total example of being able to throw money at the problem. I was making a lot of money at the time, so I was able to do that. I wound up having to do that twice. And so that's the moment when I started Thinking, why is this so hard? This is medically induced hypothermia. This isn't magic. But why can't patients do this successfully on their own and use technology to address this situation? So, no, I wasn't thinking of a startup at the time, but after I got through treatment, you know, fast forward roughly a year later, I decided to separate from New Edge because part of the Cooler Heads origin story is both my parents had died. They'd been chronically ill and had died in the three years before I got sick. So I basically had a really bad four years. And cancer makes you think about what you want to do with your life. And so I took a break. I negotiated an exit from New Edge, wished them all well, took some time off, traveled, but I just kept coming back to this idea of, why isn't this patient administered and portable? Why can't patients do this treatment successfully on their own? And I'm fortunate enough that I had friends that really encouraged me. And so there was. I went to go see the Killers up in LA with my friend Tracy, and we were staying at my other friend Kevin's house. In the morning after the concert, we were hanging out on his deck drinking coffee, and they were talking about, so what are you going to do? And I told them about this idea, and I was like, and I want to name the company Cooler Heads. Get it. Ha ha ha. And. And they were like, no, you should do that. No, really, Kate, you should do that. You should do that. We would invest. You should do that. And then I was like, maybe I really should do that. And that's really where, you know, it was an idea, it was a huge pain point that I had. And then just being surrounded by a community of people who said, you can go do that is how this got started.

Wow. I mean, yes, how it got started, but starting is still. Many people think of the idea and sit on it for a long time too, and, you know, maybe work at it for a little bit as a side thing until you rip off the band and say, I'm all in. That's a big leap of faith. Uh, now, luckily, obviously, you'd worked at an early stage startup as an early employee, so you knew the craziness of all the plates in the air at the same time. But still, what was it like in the early days? Because it's not an industry, you knew, besides being a customer, how did you get educated and learn the industry and kind of do the customer development to say, this is a business idea?

So I, you know, like, I Think the superpower that any entrepreneur has has to be networking. And so, you know, I learned how to network back in my political days. And if you like, the through line in my career, whether it was politics or the intelligence community, are now med devices is these are actually really structured fields because in politics if you take a wrong step, I mean then your boss is all over the newspaper and you can get into all kinds of trouble. And so like how do you operate in these complex environments where there's a lot of oversight and regulation? So I networked around, I used, you know, my Stanford network asking people to talk to me about what it was like to build med devices, getting educated on the 510 process on how to get a device cleared. And you know, one of the things that Dan had been really good about doing in New Edge is I engaged a firm with a bunch of ex ideo engineers. And so we, I originally spent about $40,000 of my own money with a design thinking, engineering exercise around what would we want the experience around scalp cooling to be? Want it to be portable. We want it to be fully patient administered. We want patients to know that they're using it correctly. It can't be too heavy. It has to be like able to be wheeled because patients, some patients will just had surgery and can't lift anything heavy. And so we spent the first four to five months of the company and this around the time where, you know, I got into San Diego startup, was exposed to San Diego Startup Week and then, you know, got into Ad Astra where it figured out the technology exists to get this down to a unit price and a usability level. And now it's really time to dig in and build the business case. Because I really wanted to understand can we use best in class tech from other industries to build this product? Like is is the technology available? And it was. And so once I knew that, then I was off to the races.

So Ad Astra, which I think you were in one of the first classes, is that correct?

Correct, yeah. The second cohort that was like life sciences based. Even though I'm, you know, med tech, but life science is adjacent.

Yeah, yeah. And I remember just, you know, so Alison was an investor in my first startup and just seeing, wow, they're really bringing in a diverse group of founders, even obviously all women, but diverse skill set and diverse backgrounds and industries all coming together and learning, I thought that was pretty cool. And then to see your pitch come out of it, like, what was the experience of going through Ad Astra for you and Kind of where did it set you up for?

I mean, it just, it really gave me ad Astra. You know, Allison, Vidya, Sylvia really helped me develop the playbook as to what the resources were in San Diego and who's who and how to do this. And one of the most valuable things that was a part of that program was they would have us do pitches and they would bring in subject matter experts that are, you know, entrepreneurs or investors or stakeholders in the community to come and listen to us pitch and then sit down and do mock investor meetings. And then the last five minutes of those half hour mock investor meetings would be honest feedback. And it would be like, you know what, your answer about customer acquisition cost was incredible, or I don't think you have your manufacturing story down, or you need a couple more data points on how you're going to talk about your regulatory process and being able to get that unvarnished feedback in a safe environment where it is people who are wishing you well and they're going to tell you what parts of your baby are ugly so you can address them and be more successful. And they would always encourage us, mix up your pitch. Don't just perfect it, but try it differently. And if something flops, it flops. That's great. It flopped here, so we know you're not going to do that again. So it was really transformational and also giving me the confidence of, to how to ask questions of investors and how to answer questions in a succinct and compelling way.

Yeah, yeah, that's awesome. I mean, I've seen it over time just in your own pitch, because I've been lucky enough to see you pitch a few times. But, you know, it also takes the person as well too to be able to jump into this. And as an entrepreneur, there's like two iterations, two pivots in a day sometimes, right, where you, you have to have the confidence to know, look, I am not going to tear down everything I've built, but I'm going to follow a bit of a North Star of what the customer wants. Like what's the. How is the product or at least the company iterated from then to now based on, you know, what you're going to market with.

Yeah, our biggest pivot has been because of just like really good timing. So startups are a ton of hard work and some good luck along the way. So Medicare started reimbursing for scalp cooling in January of this year, and also now all the major medical societies, both oncology focused and like the American Medical Association Are now recommending that scalp cooling should become the standard of care. And our big differentiator from the legacy systems that have been cleared by the FDA is amit, which is the name of our product, is portable, so it allows. Because, you know, you have to do this therapy before, during, and for several hours following chemo. Well, because we use this magical new technology called a battery. When the patient is done with chemo, they unplug it from the wall, and they continue to do their therapy when they leave. So they can go finish their cooling in the waiting room or in the atrium or in the cafe, because the infusion center needs that chair back. Because it's like the restaurant problem. Once you're done with dinner and you've paid the bill, they want you to go because they want somebody else to sit down and start ordering drinks. And so scalp cooling with the previous iterations would double the amount of time a patient was in the infusion chair. So even though medicare is reimbursing, the opportunity cost of not being able to sit down another patient was just too great for many infusion centers to integrate this into their practice. Well, we've been commercial for four months. We have a pipeline of $3 million already. We're about to sign some major distribution deals that I wish I could announce, but I just can't yet. But, you know, documents are going back and forth because we're the first solution for this therapy that doesn't change patient workflows, which in healthcare is the big winner. Right. Like, how do you. And we're now also, with our pricing, we're now able to offer infusion centers. Incremental revenue like this can now actually not only not change their workflows, but it can be. They can make money off of it and use it to market to patients, Because a chemotherapy patient is worth about a quarter of a million dollars in profit. And so that's why the battle, if you will, between Scripps MD Anderson, UCSD, and Sharp in town, like, how are you going to provide. How are you going to differentiate your oncology services? How do you get that patient to come to you if your scripts versus going across the street to that beautiful new cancer center that they just built at ucsd? And so that's one of the things that we're able to do with, you know, helping our customers create real symptom management programs. So it's really the shift from having, you know. So your first question is, how is this different? Well, originally, we were building the systems to rent them directly to patients, and it would be cash pay. Now we have this razor razor blade model where we're selling the machine to the infusion center and then we're selling them the cap systems which are on a per patient basis in a way that's profitable for them. And venture likes this business model a whole heck of a lot more, I gotta tell you.

Sure, totally. Which I think eventually did. New fund slash techos angels came in and invested.

Correct, correct. Really proud to have them on our cap table.

Oh, well then I guess then I'm in through that since I'm a new fund member.

So thank you, thank you for being an investor, Neil.

Absolutely. Good to find out here on the podcast. Um, no, it's exciting to see what you're building. What is, I mean, I'm guessing the cancer. What is this? Is it the cancer tech market? Is that a term that's used for kind of sub industry you're in?

Okay, yeah, yeah. I mean it's med tech, but like ultimately, you know, we are focused on oncology and I mean we are addressing cancer side effect management. And if you think of there's been so many trends now where we're seeing like the consumerization of healthcare that was really pioneered by like hims and row about, you know, well, let's create telepharmacies for these very specific conditions that people are kind of awkward about talking to their doctors about. But then here's this whole suite of complimentary products around those things, whether it's male pattern baldness or sexual health. But now you're seeing like Neurx doing it with birth control. And there's a bunch of other startups, whether it's focused on, you know, your reproductive health or periods or menopause or all these different lifestyle lives and certainly pregnancy and maternity and all these other things. And so there's all these companies that are really focused on these different stages of people's lives. And what we're using, you know, AMA as the foundation to build this much larger platform around cancer side effect management. Because there's not a cancer aisle at Walgreens. And when you get the diagnosis, you have no idea what you're in for. I certainly didn't. And so where can you go? You know, as I said, evidence based products, content and services like who will tell you what is safe to use and what will actually work? Because I got to tell you, Dr. Google, Dr. Facebook and Dr. Amazon are not reliable sources of information.

Totally. So what are you learning about the patient itself? Are they getting smarter in this regard or is it kind of everyone's starting from scratch every time they get that first diagnosis.

People are starting to ask about scalp cooling. So what we are hearing from our accounts is that because there's increased demand for it, if we don't offer that, you know, if we fill in the blank medical center, if we don't offer it but some guy across town does, they're going to go to that other site. And so it's been in the past with the legacy systems, they would have one or two machines available for scalp cooling with the chair throughput challenges, et cetera, et cetera. So they could say yes if somebody asks for it. And we're kind of switching that on its head to create a proactive program. So it's not just the patients that are coming in that are doing, you know, doing their own research. Right. We're learning a lot about that and patients want to be empowered, but we're actually seeing it as being a real discriminator and something that our accounts are very excited to have. You know, not only with ama, but with our next generation, which is building an app on top of that where it'll be symptom tracking and then being able to push to patients the other products that they need in app. Because you don't know if you're going to get mouth sores, you don't know if your fingernails are going to fall out. And when all this stuff happens, how do you get in front of it as quickly as possible?

Really interesting. So where, where are you headed? What's the bigger ecosystem that you're building out?

Yeah. So depending on how you look at it, we spend about $140 billion b with a B on cancer in the United States every year. And so conservatively, cancer side effect management is a $6 billion opportunity. Once you start adding in digital health services, it's more than a $20 billion opportunity. So we're really using AMA to build relations with arguably the sickest patients, because if you're really sick, then you're getting the kind of chemo that makes your hair fall out and building a relationship with them. But really our vision is to be essentially the one stop shop. And we're not only going to be with that patient while they're going through treatment. And you know, for me, it was about. It wound up being about 18 months of active treatment. And now I'm on, I mean, just survivorship, but there's also a bunch of health challenges that come with that. So really building a relationship with the patient right after diagnosis and helping Them along the way, essentially, like giving them that roadmap that I didn't have.

Wow. Well, really important work, obviously for how many people are going through this. And pretty compelling that you did it from your own use case and others you've seen around you who didn't have that, unfortunately, as well too. It's gotta feel fulfilling now, though, that you're looking back and saying this has been a five plus year journey that started with cancer and has turned into helping so many thousands of people. It's got to fit that.

Yeah, it feels great. So, like, today, the day that we're recording this is November 8th, November 10th, 2016, was my first day of chemo. And because those are the sort of days that you remember. But today, Caitlin, our director of commercialization, she is doing our first patients at our first paid site. So our first account is now officially up and running. Will be installed at 12 paying infusion centers by the end of this year. By the end of 2022, we've done a soft launch that was successful, but Caitlin was with these patients, two patients this morning at this first site, which is in the Chicago area. And these two patients were chatting with one another. And one of the. And this kind of gets to like this larger idea of community that we want to build. One of the. The patients were just chatting with each other and one of them said, hey, just come in here and do your chemo with me. We need each other right now. And Caitlin was texting me. She's like, I get it, I get it. Like, these two people have immediately bonded and they're going to support each other. And like, I see what this larger vision can become, which is really exciting. Like, we're getting thank you notes from patients who are part of our soft launch. And so the exciting thing about cooler heads is we're an opportunity to make a lot of money doing the right thing.

Yeah, yeah. And I think that's. Honestly, there's a San Diego thread that goes through a lot of that. Like, we work on, I don't know, companies that matter or are going to have an impact. Maybe it's because we have a little bit of the choice to. Because of the lifestyle we have. But man, it feels like the companies we build here we want to work at, not that we have to, and we see the impact. I don't know if you feel that within the ecosystem.

Definitely, definitely. Like, this is definitely a community that cares a lot about what used to be known as the double bottom line. And I think that is something that the investors In San Diego also really encourage, you know, obviously you have to show it's a big market. You have to show that there's a way for this to be profitable. Like for us, like demonstrating there's a way for us to make money for we can help infusion centers make money and that's good for us to make money. That is obviously very compelling. But when you're out there raising money and startup land, like, how do you discriminate and how is this something that investors are going to want to tell their friends about when they go to dinner on Friday night? And cooler heads. I think we've had that impact.

Absolutely. Well, we know San Diego is building impactful companies and we therefore are making impactful food decisions as well too, including our taco scene. Do you have a favorite or go to taco spot when you've ended the day on a good note.

So I live in south park, right on the edge of Golden Hill, and there's a place called Benny's which is on 30th and A. And it is, you know, your Mexican greasy spoon that does like awesome breakfast burritos. But if I've either had like a great day and I'm riding high or I'm just super stressed out, I was like, I want some chicken tacos and a cheese quesadilla from Benny's. And it is, it is a three minute walk out my door. And like their homemade like salsas and hot sauces are amazing. Their tomatillo salsa is amazing. And so it's just this like random hole in the wall place. But it's like our neighborhood joy. And like once people go to Benny's, why people that come into town that stay at my place and they're like, I'm just excited to get Benny's breakfast burritos. But like, I've got to say, like the Benny's chicken tacos for me and I always get a cheese quesadilla too. Like that is both my reward and my comfort food.

Okay, you heard it here first. That's the smart order at Benny's over in South Park. I love that. I don't think it's been mentioned before. So new one addition to the taco database?

Yeah, absolutely. No, I want to represent local man. Like local. We like to do local. We like our entrepreneurs.

For sure. Yeah, for sure. Well, we're incredibly proud of you, Kate. So keep up the great work and excited for obviously, you know, these feels like you've been at it a while. It's still early days and excited for the continued journey. So let's have you back on and hear the impact over the next few years as well too.

Looking forward to it. Thanks Neil.

Thanks Kate. Thanks for tuning in Tacos and Tech Podcasts. You can find all of our episodes on freshbreadtech.com as well as on Twitter at Tacos and Tech Pod. Also follow Fresh bretech on all of our social platforms and make sure to share and give a review on Apple Podcast, Spotify or Google Play. Thanks again.

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