Know Thy Enemy: Side Effect Warfare in Oncology

In all the ways in which digital health elevates care delivery and the patient experience there is one area that seems to universally unite the cause: Oncology. Cancer affects 100% of Western populations, either directly or through a friend or family member. The near-ubiquitous nature of the disease has led to $4.6 billion in funding from the American Cancer Association alone. Breast cancer is the most commonly diagnosed followed by Lung and Colon. The chances of getting cancer hovers around 39% for men and 37% for women, and yet, the disease remains a mystery. While curing cancer is the dream, many of us would settle for learning how to manage cancer the way one might manage a chronic disease, like diabetes. We are getting closer - but the journey is not without obstacles.
Each promising breakthrough also comes with unintended, sometimes unanticipated, side effects. Science and medical advancements have come a long way, but despite the most ardent efforts, chemotherapy is still known to obliterate the immune system, and surgery of any type has inherent risk. Androgen Deprivation Therapy, for instance, while being one of the most effective ways to treat Prostate Cancer, also causes cognitive impairment. Sometimes. And only in some patients. And medical experts don’t yet know enough about it and the aggravating factors to isolate for a course of treatment. And so, cognitive impairment, fatigue, and hair loss are all risks the patient accepts in favor of [hopefully] surviving cancer. Suddenly Oncologists are faced with treating multiple ailments in addition to the original diagnosis, all while monitoring how this collage of sickness impacts each other and the patient, all in real time. It’s like playing an unrelenting game of side effect whack-a-mole.

If only there were means to target only the cancerous cells, while leaving healthy cells intact. Precision medicine is the latest and greatest therapy, providing relief to old-school therapy protocols. Precision medicine’s hyper-targeted approach uses genetic profiling and biomarker analysis to provide the right treatment to the right person at precisely the right moment in time. Many are hopeful that it will be the silver bullet, able to treat more cancers for more patients in the very near future. In the meantime, folks like SEngine Precision Medicine are piggy-backing on precision medicine to accelerate drug development via the same methodology, while other digital health advancements are setting up shop in people's homes.

To manage symptoms and side effects, consumers have begun tracking their symptoms at home. The technology to do so is increasingly robust as the lines between consumer-grade and clinical-grade are blurring. Home is the preferred environment over the clinical, because as we all know, hospital visits beget more hospital visits. Likewise, a hospital visit is only a sliver of time that is not at all representative of how a patient is doing overall. Furthermore, when 20% of the oncology population lives in rural areas without direct access to clinical care, there is really no other option than to meet patients where they (geographically) are. Communication is made possible via telehealth capabilities. Mobile, wearable, and remote data sensors are not only cheaper than a hospital visit, but they are highly accurate, making the “hospital at home” model as viable as ever. Proteus’ ingestible sensor, for instance, is a huge leap forward in this area. It not only exists in the home, but in the patient's body in the home, generating real time data for doctors to react to, learning about medication efficacy and side effects within the patient's body. Their 2017 FDA approval made Proteus the first ingestible sensor to be paired with distributed therapy, paving the way for a new frontier in cancer management.

Cancer treatment generates an unprecedented amount of data. And every branch of the healthcare ecosystem is helping to ship it, store it, digest it, make meaning of it, utilize it, and more. This is a huge commitment across the entire ecosystem of care. Information is power. We need more money, more research, and more data. Because the more we know, the better chance we have at making cancer an affliction of the past.