You have cancer, now what? The tech version

Ask any cancer patient about their cancer journey, and they will likely begin with the moment they received their diagnosis. It is a stressful, frightening and overwhelming experience.

Nobody is prepared to hear the words “You have cancer”.

Cancer is more common than you think

1,000 people hear these words every single day in the UK.
500 in Canada.
5,000 in the USA.
10,000 throughout Europe.

Most of these cases are in the lung, breast, colon or prostate; stomach and liver cancer are also among the more common diagnoses globally. Beyond these and other types of cancer, there are literally hundreds of rare cancer types, which together account for 22% of cancer diagnoses.

This article aims to explain how technology can help anyone just diagnosed with cancer of any type.

And it all starts with knowing what the C word really stands for.

Technology to help understand a cancer diagnosis

In order to understand a cancer diagnosis, one needs to know what cancer really is: an extremely complicated condition, with many different types and sub-types. If that was not enough, metastatic disease (which describes a condition that has spread beyond the original location) adds even more complexity.

There is little doubt that most patients and caregivers turn to the web in order to find out more about their diagnosis. Unfortunately, not all online sources are reliable and accurate (some of them are even deceiving). Online health material must not induce fear or confusion. Instead, a brief and balanced explanation of the key cancer types, together with references for those who want to read more, can really make a big difference for someone who just received a diagnosis.

It is important for patients to understand that an exact cancer diagnosis may include a lot of information. For instance, compare between these two diagnoses:

1. “breast cancer”
2. “2cm, stage 2 grade 1 invasive ductal carcinoma in the left breast, with clear margins, 2 lymph nodes involved, estrogen-positive and progesterone-negative, with overexpression of the HER2 protein”.

Perhaps the centerpiece of the diagnosis is the Pathology Report. With technology’s help, patients should be able to decipher each piece of that report and compose a concrete and comprehensible view of their own diagnosis. The goal here is not to turn patients into pathologists, but to explain what is happening in their own body.

Making important decisions

Achieving a good understanding of the diagnosis helps to lay the foundation for the next steps. While technology cannot replace a doctor’s experience and clinical examination, it can be instrumental in highlighting specific decision points based on the exact diagnosis. These include:

• Fertility options: Depending on age, gender and family planning, some patients want to know their options for preserving their fertility after treatment. This is particularly important in some types of cancer, as well as for specific treatments. Digital health tools can highlight the key options and guide patients towards a fruitful discussion with an “onco-fertility” expert. It may seem obvious, but some reports have documented limited discussions around this important topic.
• Molecular Diagnostics: Some tumors are characterized by a genetic signature, which in turn can support diagnosis, prognosis as well as treatment decisions. Therefore, for those patients, it is very important to conduct molecular diagnostics on the tumor (generally via tissue or blood testing). This is, after all, the basis of personalized medicine in oncology. Technology applying basic rules on a cancer diagnosis can help patients understand whether they could benefit from such testing. Interestingly, even in the UK, many “eligible” patients seem to be missing out on these opportunities.
• Companion Diagnostics: Similarly to molecular diagnostics, companion diagnostics (often abbreviated CDx) help clinicians determine whether a specific treatment has higher likelihood to help the specific patient. These tests can be expensive, but are sometimes required in order for oncologists to prescribe these treatments, identifying which patients stand to benefit most is crucial — and digital health technology can help.

Getting a second opinion

There are many reasons it is hard to be a doctor: you cannot always be sure, and sometimes you may be wrong. When someone faces the intense emotions associated with a cancer diagnosis, the urge to confirm the diagnosis can be overwhelming. Therefore, getting a second opinion is the norm (and is often encouraged by experienced doctors).

Increasingly, a second opinion is being sought online. This may include sending pathology to an online service, and receiving a diagnosis based on the supplied information (usually for a fee). This can be particularly helpful when there are no designated and experienced cancer clinics nearby. While large hospitals have been providing such services for a few years, there is an growing number of independent providers offering second opinion services.

Finding the “best doctor for me”

A patient diagnosed with cancer needs to decide their next steps. Choosing the “right doctor” is one of them.

As already discussed in a previous article, there are plenty of online services helping patients identify the right doctor. A service can be more helpful to cancer patients if it can focus on the exact cancer type, and enable reviews and opinions from the community. However, it is important to realize that “the wisdom of crowds” can be misleading when it comes to choosing an oncologist. This is because no two cancers are the same, and the relationship can be quite personal and different for each of us.

Summary

Too many of us will hear the words “you have cancer” at some point. That will be a moment we will want to forget, but will never manage to.

There is no cure yet. There is no silver bullet either.

But one day, the first prescription given to someone with cancer will be a “healthy dose of digital health”.