EVIDENCE-BASED TREATMENT- WHY DOES IT MATTER FOR CANCER PATIENTS?

A significant problem that confronts healthcare is the ability to correctly diagnose and treat cancer of all kinds. Both the rising burden of cancer and the fact that cancer is not one disease, but a set of complex conditions ensures that the problem remains of high importance.

Besides this, a staggering 5.2 million number of cases of medical errors and adverse drug reactions were reported in India by the Harvard School of Public Health. Most of these errors were preventable and occurred only due to the lack of clinical expertise and medical facilities.

Therefore, there is a dire need for clinical decisions to become even more efficient through evidence-based, accurate diagnostics. Not only will this lead to uniformity and reduction of errors, but it will also allow patients the ability to access the right treatment suitable for them.

Role of diagnostic evidence in cancer management

There are numerous forms of cancer, out of which a majority are treatable and can be managed for some years if diagnosed early. However, there is no standard treatment that will work for all types of cancers or all patients. With changes in disease patterns, medical professionals need to find the appropriate diagnosis by studying the patient’s genetics and medical history, size and nature of cancer cells, etc. and share a tailored line of treatment based on these factors.

In the area of personalized medicine, genomic testing will most likely become a standard practice in cancer care to provide access to the most effective treatment option. In the future, diagnosis based on the patient’s tumor profile, their response to treatment, and benefit from a specific treatment or therapy (targeted drugs, radiation, hormone-based medicine, surgery, etc.) will guide the direction of treatment.

The majority of the deaths related to the disease take place when cancer metastasizes and spreads into the bloodstream and other parts of the body. Today, there are innovative tests that help oncologists detect cancer cells in the blood and determine whether the treatment is working post the start of the therapy. Such tests are today beneficial in evaluating the prognosis of metastatic breast, colorectal, prostate, and lung cancers. These liquid biopsies are useful to identify tumor development, impact of treatment, or as a surveillance method for people who have a high risk of cancer reoccurrence after being treated.

Need for accuracy and targeted treatment

Cancer treatment is a highly intensive process requiring very specialized clinical and diagnostic skills. However, there are concerns related to the substantial overuse of aggressive care for cancer patients. Incorrect or delayed diagnosis by undertrained doctors or misunderstood protocols can cause a delay in treatment, which can further aggravate the disease and hence, push the patient to opt for more aggressive treatment.

The focal point of cancer research today is to make genomic testing a critical component of cancer treatment, which will help predict the mutation in the disease and its vulnerabilities to drugs.

Gene testing diagnosis has become a core part of personalized medicine as medical practitioners are looking for different ways to enhance treatment according to individual needs. For example, if a test can suggest accurately that the risk of cancer relapse is low in a patient, the patient can avoid more rigorous treatment. However, precision and accuracy remain the key.

In today’s age, diagnosis and treatment go hand in hand right from the detection to disease progression to monitor the treatment success. In India, as many as 50,000 small pathology labs cannot afford to offer high-end diagnostics. Therefore, there is a pressing need to develop and bring advanced diagnostic testing techniques and expertise in India.

Digital library

CORE was the first laboratory in India to use Digital Pathology, and we built a Laboratory Information Management System (LIMS) bespoke, to make digital pathology easy to use. In essence, we did to pathology what PACS and RIS systems did to Radiology. This helps our partner hospital systems across the country, by streamlining pathology workflow – and both improving efficiency and accuracy of diagnostics.

As a by-product, this has also led to the largest repository globally for data pertaining to Cancer Patients of Indian origin. This has significant implications for Drug Development, Therapy Selection, and many other use cases.

Having such a repository is a starting point for understanding the disease patterns and specific variations for Indian cancer patients. Of course, pharma can then use this to develop targeted drugs for our population.

In a nutshell!

The critical challenge is to bring an attitudinal change within the industry on how clinical performance is linked to the accuracy of diagnostic evidence. The focus should shift from reactive to proactive diagnosis and treatment with greater collaboration between the best scientific minds and various healthcare stakeholders.

About the Author

Zoya Brar, Founder, and CEO, CORE Diagnostics is a first generation entrepreneur. CORE’s service philosophy revolves around providing definitive diagnostics & therapy selection in shortest possible turnaround time with second opinion on every test.