Advancing cancer care with emerging technology: A fine balance

Breakthroughs in the most advanced medical technologies for cancer care are remarkable. It seems like every day we’re reading about groundbreaking progress that could change the fundamental premise of how medical care is delivered. Wearable technology, molecular testing, and point-of-care devices promise hospital-grade care at home, but established technologies like robotic surgery and immunotherapy are still unaffordable for many. Historically, integrating these innovations into clinical practice presents challenges due to traditionally slow adoption rates in health care systems. This delay in implementation can delay the benefits these technologies provide to patients and oncology programs, with data showing that disruptive technologies can often take decades to enter routine patient care.

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

When physicians begin implementing new technologies in their healthcare settings, it is essential to follow a strategic approach. For clinicians, it is essential to start with a clear clinical objective, assessing the impact of technology on workflows, understanding the context of the solution, keeping the doctor-patient relationship a priority, and rigorously testing and validating the technology to build trust. of the patient.

The rise of artificial intelligence and machine learning, particularly in the field of radiomics, presents a tremendous opportunity for oncology. Radiomics uses machine learning to extract and analyze features from medical imaging data, aiding in diagnostic, prognostic and treatment planning efforts. By leveraging deep learning algorithms, providers can increase accuracy, sensitivity, and precision in identifying and treating various cancers, such as brain tumors, through AI-assisted pathology. This helps identify image features too subtle for the human eye to pick up, to help make a decisive diagnosis. As automation increases, the concern is that radiologists may be replaced by algorithms; it is important to understand that the focus has been and should continue to be the addition of human radiologists. Our goal should be to reduce the learning curve for radiologists and prevent errors related to human fatigue.

Another innovative technology making advances in cancer care is 3D printing, facilitating the creation of patient-specific implants and surgical tools. This advance simplifies surgical planning, improves accuracy and enables personalized treatments for patients, demonstrating significant potential in improving outcomes in oncology procedures. Previously prohibitively expensive, the expansion of this technology has allowed 3D printers to become household items and provide this to patients who could never afford it a decade ago.

Genetic and molecular testing have also become fundamental in modern oncology, leading to more targeted and personalized treatment approaches based on individual genetic profiles. Molecular testing plays a key 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.
By embracing these technologies as reinforcers of established health care practices, clinicians can use technology as a force multiplier to raise the standard of cancer care while maintaining a patient-centered approach.

When we consider cost, it’s important to understand that every technology we use now was once considered affordable for the general public: television, cell phones, and the Internet to name a few. As physicians practicing in this exciting phase of scientific advancement, we have a role to serve as a gatekeeper for new technologies entering medical practice; we need to ensure they are patient-centric, affordable and add ultimate value to the patient journey. Furthermore, the cost-benefit ratio for emerging technologies must be addressed. Whether it’s government or non-government insurance or out-of-pocket coverage, we as a society always have to foot the bill for health care, so financial care is essential. India is uniquely positioned to strike this balance: we have a massive underserved population, in many cases overburdened hospitals, deep technological expertise and a highly agile healthcare system. The time has come for us to build technological capacities for ourselves and not for the world; this will help us bridge social, demographic and logistical gaps and provide more accessible, appropriate, high-quality, affordable, patient-centred care.

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(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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