Endocrinologist Afreen Shariff has spent her career working with cancer patients, and she’s seen firsthand how often side effects of cancer treatments are overlooked.
“Everyone’s so focused on just managing the cancer that side effects are pushed under the rug—and have been pushed under the rug for many, many, many decades now,” Shariff said.
Shariff teamed up with her husband Aabid, who has a PhD in machine learning, to create Citrus Oncology: a virtual multi-specialty clinic connecting cancer patients with specialty doctors to help manage side effects of treatments. The name Citrus is meant to denote a “fresh approach” to managing side effects.
Shariff is an associate professor at Duke University, where she works in onco-endocrinology, meaning she manages endocrine diseases—such as diabetes or thyroid disease—in cancer patients. Shariff said there have been many advancements in oncology that are helping cancer patients live longer, and her goal with Citrus Oncology is to bring together medical experts from various disciplines—like endocrinology, cardiology, dermatology, etc.—to help treat side effects.
By bringing all of these specialists to one virtual platform, Shariff said Citrus Oncology is removing access barriers to side effect care.
How Citrust Oncology improves care
Citrus Oncology employs a B2B2C model, facilitating doctor-to-doctor consultations. This means an oncologist will put in a request on the platform to connect their cancer patient with a side effect specialist.
Wait times for specialists can amount to several months, but through Citrus Oncology, the specialist will submit written recommendations to the oncologist within 72 hours. This allows the oncologist and patient to quickly move forward with expert-backed advice on testing and treatment.
Citrus Oncology also offers direct patient care through a virtual clinic. The patient’s oncologist will determine what specialist they need to see, and the patient will log in to the platform for a virtual meeting with a specialist.
Shariff said that in the coming months, Citrus Oncology will also move into messaging-based care whereby the oncologist can message a specialist to get testing and prescriptions ordered. The messaging feature will be piloted in North Carolina.
“Because it’s asynchronous, it allows a lot of flexibility for the patient and for the physicians on our side to answer at a convenient time, rather than being this very archaic brick-and-mortar practice where someone has to stay on the phone to get appointments scheduled,” Shariff said of the messaging option.
Spreading Citrus
Moving forward, Citrus Oncology plans to onboard physicians in all 50 states. In Florida, the platform is covered by multiple health insurance plans, and Shariff said they are working to expand insurance coverage. Otherwise, a direct cash pay option is available and can also be covered by Health Savings Account (HSA) eligible plans.
So far, the platform has been piloted in North Carolina and South Carolina; it will next be taken into Texas and Ohio.
Shariff said it can take up to six months for an insurance company to approve the platform in a new state. However, she hopes to use data from the pilot programs to show insurance companies that Citrus Oncology will save them money in the long run by preventing hospitalizations.
Each physician at Citrus Oncology is interviewed by other physicians, ensuring “high quality across the board,” Shariff said. Citrus Oncology currently has over 70 physicians and has interacted with close to 100 patients.
The AI component enables physicians to conduct up to eight consultations per hour, compared to an average of three per hour. Shariff noted that the AI eliminates some of the busy work that normally takes up physicians’ time, and they can fit consultations around their schedule due to the virtual format.
“Think of it as wearing an Iron Man suit,” Shariff said. “You got a physician inside, and you attach AI to the physician, and now you’ve suddenly augmented everything that they can do and amplified everything they can do.”
QUICK BITS
Startup: Citrus Oncology
Co-Founders: Afreen Shariff, MD and Aabid Shariff, PhD
Founded: 2023
Team size: 17
Location: Cary
Website: www.citrusoncology.com
Funding: Bootstrapped; pre-seed
Shariff has a core team of 17 people, including medical advisors from various fields as well as AI developers and programmers.
Citrus Oncology was a runner-up at the Triangle’s Big Launch Challenge in 2024, where they competed in a pitch competition and won $5k. The startup also pitched at CED’s Venture Connect and has been selected for this year’s CancerX Accelerator program in Nashville, Tennessee, which is a four-month program bringing together founders focused on improving cancer care.
