Each year in the United States we lose more than one out of every three patients who has cancer. That adds up to 600,000 lives ended too early in the U.S. every year. Standard therapies have evolved since modern cancer surgery got its start around 1880, radiation began around 1920, and medical oncology got its start around 1950. But now we have new, alternative therapies. I do not mean the herbs and health food supplements that are traditionally viewed as “alternative therapies” but have no scientific backing.
Today we have new alternative therapies that are making real progress. The ability to attack specific genetic mutations that lead to cancers with “targeted agents” is affecting the care of up to 20 percent of patients. Immunotherapies already have a bigger footprint than these targeted therapies and have a huge potential to improve our cancer cure rates. But these remarkable scientific advances are held back by a system run by institutions which see populations of patients for what they have in common – people with the same disease, rather than the one patient with a specific disease, a cancer unique to that single patient.
In this current world, “personalized medicine” is seen through the eyes of the institutions that run medical care. I speak of the governmental payers, regulatory bodies, major medical insurance companies, the geographically dominant medical systems, academic medical care, and the biopharmaceutical industry. These are the bulwarks of a system that provides access to solid and stable medical care to the individual through a well-trained physician and nurse community.
However, the core mission of each of these entities is to focus on populations of patients, not on the individual. Unfortunately, focus on the many takes the eye off of what is happening to the individual. In the case of the cancer patient, he or she may have a life threatening cancer that cannot be well addressed by current standard of care medicine. The cancer is unique to that individual and the individual’s personal medical situation is different from anyone else. But it is impossible for the government or Aetna or Cigna or the pharmaceutical company or the hospital system to focus on that individual because they each see many patients rather than the one patient. Personalized medicine, without the patient having a representative at the table, is only a shell of what it could be.
But a tide of change is now at hand. This change will be through the adoption of alternative cancer treatments by the individual who is willing to accept the risk of trying an innovative approach, rather than sticking with a standard therapy with known results, but results which often fail, leading to the patient’s premature death. A new world in which the patient has more control allows that individual to determine the level of risk he or she is willing to accept.
The day is not far off, though, in which personalized medicine really means that the individual cancer patient will have significant input into and control of his or her own medical care. In this new world, patients with poor current options of standard medical care will have the ability to take a risk through controlling some of the decisions that are now made for them by the above mentioned entities. In order to improve medical care, we have to accept that standard medical care often fails. We have to be willing to try alternative cancer treatments through further testing of the individual’s own tumor tissues and through research designed to benefit the individual rather than the population. This will happen. The winds are blowing and change is coming.
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