Page 60 - BusinessWest November 9, 2020

What’s Next in Cancer Care
Researchers Continue to Make Advances in Treatment Options
CBy John Sheldon, M.D.
ancer is the second-leading cause of
death in the U.S., but we continue to
make significant advances in reducing its toll.
Key developments have included targeted drug therapies resulting from genomic profiling of tumor samples, which determines the molec- ular ‘fingerprint’ of the tumor; immunotherapy, which allows the body’s own natural immune system to better attack tumors; more sophis- ticated radiation-delivery technologies, which allow for more precise targeting of tumors and better sparing of adjacent normal tissues from radiation dose; and newer combination or ‘multi-modality’ treatment regimens, taking advantage of a combination benefit effect of dif- ferent ways of attacking and killing tumor cells. In lung-cancer treatment, for example, we now have drugs to target a variety of specific mutations that may be present, such as EGFR, ALK, ROS1, MET, RET, BRAF, or NTRK. Immu- notherapy has been shown to provide a survival improvement in both stage-3 and stage-4 lung cancer. For earlier and smaller lung cancers, highly targeted radiation treatment can be delivered in a short regimen of just three to five sessions, as an alternative to surgery for patients who are not good surgical candidates. And for other patients, combination regimens of radio- therapy and chemotherapy followed by immu- notherapy may be the preferred approach.
Even newer types of drugs are now avail- able called antibody-drug conjugates, or ADCs, which target with high affinity a particular pro- tein expressed on the surface of tumor
cells, attach to the target, and then deliv-
er a toxic payload to kill those particular tumor cells. This type of treatment was
just approved by the FDA in April for metastatic ‘triple-negative’ breast cancer
(a more aggressive type of breast can-
cer), and another drug in this category
was approved last December for locally advanced or metastatic bladder cancer.
Molecularly targeted radiation deliv-
ery is another category of treatment that is advancing. Also known as peptide-receptor radiotherapy (PRRT), it consists of a radioactive particle, or radionuclide, linked to a protein, and this protein seeks out and targets its intend- ed receptor, which is overexpressed on certain tumor cells. Once the protein-receptor binding takes place, the radionuclide is internalized into the tumor cell — and destroys the tumor cell. This treatment is currently being utilized for neuroendocrine tumors of the abdomen (the type of cancer that afflicted both Steve Jobs and Aretha Franklin), and it is being investigated for the treatment of metastatic prostate cancer.
Quality of life is an ongoing focus of cancer care, and while we always aim to increase sur- vival, we simultaneously aim to optimize quality
of life for patients under our care. In the realm of radiation treatment, shorter course regimens are more frequently being used (supported by
“Cancer is the second-leading cause of death in the U.S., but we continue to make significant advances in reducing its toll.”
evidence from clinical trials) in order to increase convenience for patients. Such regimens are now commonly used in the treatment of breast cancer, for early-stage lung cancer (as men- tioned above), for some brain-tumor patients, and for some patients with prostate cancer. For the latter, radioactive seed implants into the prostate gland may be an option for a one-visit outpatient treatment.
In short, we continue to push forward strongly in the treatment of a broad range of cancers. u
Dr. John Sheldon is medical director, Radiation Oncology at the Mass General Cancer Center at Cooley Dickinson Hospital.
What’s Next in Health Education
Pandemic Has Accelerated Inevitable Technological Progress
By Marie Meckel, Kathleen Menard, Susan McDiarmid, and Theresa Riethle
Despite the complexities that COVID-19 has brought to healthcare education, the trajectory from traditional models
to hybrid or virtual experiences was inevi- table. Today’s technology allows healthcare educators to transcend geography, which widens access to health education in all seg- ments of the population despite location, economic status, and race. The pandemic also revealed the vulnerabilities of underrep- resented minorities.
These challenges caused many educators
to pause to re-evaluate and readapt to how we teach and develop medical curriculum. Incor- porating technology through virtual learn-
ing experiences while focusing on how social determinants of health impact patient care and outcomes are two areas of focus in the future of healthcare education.
Health programs can integrate in-person and remote simulation experiences; these include the traditional simulation lab consisting of real- istic mannequins where learners can develop clinical skills in a safe setting without patient
harm. Additional virtual experiences include
a wide array of interactive patient-encounter portals where learners can conduct histories, perform physical examinations, order and inter- pret diagnostic tests, develop assessments and treatment plans, all while documenting patient records and receiving coaching and feedback every step of the way.
Live rounding with certified medical pro- viders has also enabled learners to experience traditional hospital rounding from wherever they are in an interactive manner. Even surgical experiences can be supplemented with high- definition surgical videos and medical lectures from subject-matter experts.
While none of these experiences will replace the need for traditional hands-on learning, they can provide learners with unique education experiences that directly correlate to what is seen in clinical practice. With the increase in tele- health visits, medical learners are now equipped to adapt to these visits, delivering care in a better and more effective manner.
Technology is intertwined into healthcare
today as seen with diagnostic imaging, robotic surgery, and electronic health records. By incor- porating technology into healthcare education, medical learners will be better prepared for clinical practice. The virtual experiences will
“By incorporating technology into healthcare education, medical learners will
be better prepared for clinical practice.
also develop independent and critical thinking, thus making it easier to adapt to innovations and changing patterns of illness and health systems.
In order to provide equitable, high-quality healthcare to all patients, we must include
Education
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HEALTHCARE
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