April 13, 2024

Advancing cancer care with emerging technology: A fine balance

The breakthroughs in cutting-edge medical technologies for cancer care are remarkable. It seems like every day we are reading about ground-breaking progress that can change the fundamental premise of medical care delivery. Wearable technology, molecular testing and point-of-care devices promise hospital-level care at home, but established technologies like robotic surgery and immuno-therapy are still unaffordable for many. Historically, integrating these innovations into clinical practice poses challenges due to the traditionally slow adoption rates in healthcare systems. This lag in implementation can delay the benefits these technologies offer to patients and oncology programs, with data showing disruptive technologies can often take decades to enter routine patient care.

In light of the rapid growth of data and the influx of novel technologies, there is a pressing question: are cancer care programs equipped to keep up with these advancements? Is the conventional approach to improving care (a lengthy validation process and clinical trials to ensure safety) appropriate? Across the world, clinicians across the world are keen to address the elephant in the room: how do we give patients the benefit of these new technologies without compromising on safety and driving up already spiraling healthcare costs?

When clinicians embark on implementing new technologies in their healthcare settings, it’s crucial to follow a strategic approach. For clinicians, it is crucial to start with a clear clinical objective, evaluating technology’s impact on workflows, understanding the context of the solution, maintaining the doctor-patient relationship as a priority, and rigorously testing and validating the technology to build patient trust.

The rise of artificial intelligence and machine learning, particularly in the realm of radiomics, presents an immense opportunity for oncology. Radiomics employs machine learning to extract and analyze features from medical imaging data, aiding in diagnostic, prognostic, and treatment planning endeavors. By leveraging deep learning algorithms, providers can enhance accuracy, sensitivity, and precision in identifying and treating various cancers, such as brain tumors, through AI-aided pathology. This helps identify imaging features too subtle for the human eye to capture, to help clinch a crucial diagnosis. With the rise of automation, the concern is that radiologists may be replaced by algorithms; it is important to realize the focus has been and should continue to be augmentation of human radiologists. Our aim should be reduce the learning curve for radiologists, and prevent human-fatigue related error.

Another innovative technology making strides in cancer care is 3D printing, facilitating the creation of patient-specific implants and surgical tools. This advancement streamlines surgical planning, improves precision, and enables customized treatments for patients, demonstrating significant potential in enhancing outcomes across oncological procedures. Previously prohibitively expensive, the expansion of this technology has allowed 3D printers to become household items and offer this to patients who could never have afforded it a decade ago.

Genetic and molecular testing have also become foundational in modern oncology, leading to more targeted and personalized treatment approaches based on individual genetic profiles. Molecular testing plays a pivotal role in tailoring cancer therapy and predicting disease risk, allowing for proactive and personalized interventions, as highlighted by recent studies identifying biomarkers for lung cancer risk prediction.
In embracing these technologies as enhancers of established healthcare practices, clinicians can leverage technology as a force multiplier to elevate the standard of cancer care while maintaining a patient-centered approach.

When we consider cost it is important to realize that every technology we now use was once considered to be affordable for the general public: television, mobile phones, and internet to name a few. As doctors practicing in this exciting phase of scientific progress, we have a role to serve as the guardrails for emerging technologies entering medical practice; we need to ensure that they are patient-centric, affordable and add definitive value to the patient journey. Additionally, the cost-benefit ratio for emerging technologies has to be addressed. Whether governmental or non-governmental insurance or out-of-pocket coverage, we as a society always have to foot the bill for healthcare, so financial prudence is crucial. India is uniquely positioned to achieve this balance: we have a massive underserved population, in many instances overburdened hospitals, deep technology expertise and a reasonably nimble healthcare system. The time has come for us to build technological capacity for ourselves rather than for the world; this will help us bridge social, demographic and logistic gaps and deliver more accessible, appropriate, high-quality, affordable, patient-centric care.


(Author: Dr. Narayana Subramaniam is Director of Head and Neck Surgery and Oncology and Director of Clinical Innovation, Sparsh Hospitals, Bengaluru, India)

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