Digital health and oncology: a growing world of personalisation, diagnosis and prognosis2020-04-03
In an increasingly digital world, we’ve come to accept that computational approaches have not only bettered our understanding of health issues, but contributed to the diagnoses of diseases, their prevention and, oftentimes, cures. The treatment of cancer of any type is notorious for being unique to every individual patient, even if all aspects of the condition are identical – which means that with cancer specifically, the personalisation of medical treatment is crucial. It therefore comes as no surprise that in the oncological world, digital health has played a pivotal role in tailoring prescriptions to specific needs (as well as predicting drug responses), improving cancer diagnostics and treatment, and facilitating general patient care.
Although the science of digital pathology dates back to the early 1960s, it wasn’t until the principle of virtual microscopy was enabled in the 1990s that rapid advancements in radiological developments for cancer were able to be achieved through mass-research and analysis, facilitated by this early form of digital health. With the growth of scanning, storage and networks, along with more powerful and affordable technology (which was still in significant deficit until the early 2000s), the field of radiology was able to undergo the transformation needed for mass cloud storage to appear on the market. This allowed for a smoother transmission of digital data over larger distances, access to past case studies from either the same patient or similar cases for assessment and research, comparison of different oncological areas of multiple cases simultaneously, and a generally higher efficiency with which researchers are now able to conduct their work and annotate their findings.
Empowering patients with the right tools
Today we find ourselves in an even better position: as the all-encompassing universe of startups evolves and finds new avenues for progress, so too does cancer treatment. From tech giants like Microsoft and Apple, to smaller startups like Medicalchain, and everything in between, specialised software is developed for targeting specific conditions, improving communication, and aiding patients in managing their health.
Since the Scottish Funding Council (SFC) launched its Cancer Innovation Challenge in March of 2017, much has changed in the way cancer is regarded clinically, encouraging startups to develop innovations in diagnosis and treatment. In this scheme, each participating startup business was awarded between £35,000 and £100,000 in 2018 to make advancements in new approaches in diagnosis and treatment of blood, kidney and tissue cancers. Among these, is an app developed by Px HealthCare, which aims to encourage breast cancer patients to notify the Cancer Treatment Helpline when they encounter particular symptoms. Professionals are then provided with a real-time view of patients and their reported conditions, after which the NHS in Scotland is able to weigh in.
My Clinical Outcomes (MCO) is another web platform that encourages patients to take regular assessments to evaluate their conditions in a guided format, opening up a gateway for patient-reported data to enable regular, remote monitoring and analysis for patients and medical professionals alike. Currently spearheaded at NHS Ayrshire and Arran, it’s tailored to Scottish patients with any type of cancer, on the basis of which experts are able to assess the effectiveness of treatments and make adjustments.
The UK-based equivalent to MCO uses similar methods with machine-learning to predict outcomes for patients. This project was launched with modelling for the prognosis of patients with renal cell carcinoma, using regularly-collected statistics in sources such as the Scottish Cancer Registry. With the incorporation of these additional variables, accuracy of diagnoses has comparatively skyrocketed. Simply by sharing symptoms in a timely manner as they occur, helping clinicians to better personalise treatment, digital tools such as these have been able to extend the lives of patients by up to five months.
The rise of smart technology
Commercially-available technologies such as wearables have started to play a crucial role in helping patients manage their cancer. Research by the American Society of Clinical Oncology (ASCO) in several US cancer centres concluded that incorporating general fitness data using a Microsoft Band is a very realistic way to reduce unplanned hospitalisations. Oftentimes, chemotherapy treatments combined with the disease itself causes nausea in patients – an issue which can be tackled with a simple fitness regime, easily monitored by wearables connected to smartphone apps for data logging.
Other smart technology such as iPhones are also becoming surprisingly effective tools for oncology, for example, with the detection of tumours. A medical imaging company – Butterfly Network – has now received FDA clearance for its ground-breaking ultrasound-based imaging system, which comes with a probe that connects to an iPhone, paving the way for ultrasound detection to someday become entirely portable, widely accessible, generally affordable, and diagnostically versatile. The app allows for a head-to-toe scan of the body to be carried out for under $2,000. This, in combination with the learning-based artificial intelligence applications that work in tandem with the hardware, can better assist experts with the interpretation of the diagnoses, and therefore prescriptions.
Although the technologies for cancer prevention, detection, diagnosis and prognosis are all still far from being readily available to the general public, and far from acting as standalone treatment technologies, the oncological advancements in digital health have progressed significantly since the inception of oncology as a science. With digital health technology starting to offer more affordable and less invasive cancer management solutions, the potential to create a holistic and effective model of tackling cancer seems progressively more likely every day in the digital age.
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