A digital companion for breast cancer patients– Part 1

eHealth from the emotional side of things

It is 3:06 PM and Mrs. Laudner is finally called into the doctor’s office. The lab test results have finally arrived. “Mrs. Laudner I am afraid I don’t have very good news for you. There is no easy way to say this, so I am just gonna go ahead and say it. Our suspicions were right, you have breast cancer.”

There is a long silence…

From this point on, Mrs. Laudner can see the doctor’s mouth is moving, but she doesn’t listen anymore. Too big of a shock. She is completely stunned, not even able to utter any emotion. She feels like someone just pulled the rug from under her feet.

Just like Mrs. Laudner, there are about 81,000 other women in the DACH region experiencing a very similar situation every year. In the USA, the number grows up to 230,000 cases. The World Health Organization estimates about 1.8 million cases worldwide every year. Breast cancer is a malicious disease affecting women around the world in developed and underdeveloped countries. The median age of breast cancer diagnosis for women is around 62 with a growing high-risk after the age of 40.

Luckily, the survival rate has increased in the last few years due to the proliferation of early detection methods, new medical procedures, treatments, and medication. Most startups operating in the eHealth sector, have concentrated their efforts in screenings and early detection which is key in the prevention of breast cancer. In contrast, eHealth has not done much in addressing the emotional well-being and health management of the patients. In part because the adoption of technology by the average patient over 60 is rather low.

There are currently thousands of women suffering from breast cancer, learning how to cope and adapt to their new and painful reality. One of the toughest challenges at the beginning of their treatment is finding a guiding hand that can help them manage uncertainty and anxiety. Where do I find the right information about specific topics? How do I tell to my children? How will the treatment be like? Am I going to die? These are just a few of the questions that are answered by their physicians but restricted to specific appointments during the treatment. Information on the topic is widely available, but it is scattered, too generic, unfiltered and in often cases just overwhelming.

Newly diagnosed patients are challenged with making fast decisions and learning about the disease as they go along. Usually, the first information would come from the physician or the breast cancer center where they are treated. This quick pace leaves little room to deal with the emotional aspect of the disease (uncertainty and anxiety) and getting a proper overview about breast cancer and the journey ahead. After the first emotional rollercoaster ride, the number one priority becomes trying to regain some sense of control back into their lives. We believe the biggest challenges facing the new breast cancer patients could be addressed by having a digital companion.

A brief history of digital companions

For many people, the notion of a digital companion seems like something taken out of a Science Fiction film. We’ve seen many different variations on the big screen, from the psychopathic HAL 9000 in the movie 2001: A Space Odyssey (1968) to the loving and caring operating system SAMANTHA from the movie HER (2013).

Since a few years, similar systems such as SIRI, CORTANA, ALEXA, OK GOOGLE and a few others are unnoticeably becoming part of the everyday life to a lot of people. We are not even talking about nerds and early adopters, but mainstream consumers. These systems are trying to position themselves as reliable and useful digital companions.

Professor Sherry Turkle from M.I.T. questions: “Are there some tasks, such as providing care and companionship, that only befit living creatures?” bringing back fundamental philosophical questions about life and consciousness, but also the relational authenticity between human-machine interaction.

The late computer scientist Joseph Weizenbaum brought some of these issues to attention back in the sixties when introducing a computer program called ELIZA, explicitly designed to engage a user in a relationship and one of the first examples of relational artifacts. This engagement came through mirroring users’ thoughts to appear supportive. Professor Turkle describes an interaction between a person and ELIZA: “My mother is making me angry,” ELIZA might respond, “Tell me more about your family,” or “Why do you feel so negatively about your mother?” This seemingly simple interaction had a strong emotional effect on many people. Some wanted even to be alone with ELIZA and felt that they could open up to many other topics. However, this is still a simulation and should be taken with a grain of salt. Today’s available systems (ALEXA, SIRI and the likes) are good at taking orders and fulfilling them with the help of verbal commands but offer very little in terms of companionship. With real companions (human, software, canine or other) there is an implicit sense of trust and mutuality which is still very hard to emulate.

With that in mind, we question ourselves: How could a breast cancer patient develop a relationship with an artifact? One based trust and intimacy. What would be the long-term effects of doing so? Scientific evidence shows that lifestyle changes such as exercise, nutrition, sleep, and mindfulness have a rather positive impact on the patient’s quality of life, and in some cases, directly in the outcome of their treatment. But with the hurdle of low adoption and poor affinity to technology, how do we go about creating a companion for breast cancer patients?