Technology and Cancer Care: Still a Dark Genome

Are we treating cancer better because we can diagnose it faster? Would the base pairing between AI and cancer care get stronger ahead? Would more technology hamper affordability and repeat the classical paradox?

In this deep scan of some interstitial tissues of technology and oncology, Dr. Kinjal Jani, Director & Head- Radiation Oncology, HCG Cancer Centre, Ahmedabad explains why technology is helping immensely on personalization and speed; and why some stubborn tumors like affordability, social stigma and human factors continue to envelope cancer-care.

From CRISPR to various gene-sequencing and editing advancements, technology seems to have a bigger role in the area of cancer research and treatment. Does that help in what you do?

There are three types of oncologists – surgical, radiology and medical. There has been a lot of progress in all areas. Especially in understanding specific mutations and a particular genome. Earlier, treatment was given as per broad parameters and stages. Now treatment is getting extremely targeted due to a better understanding of details. With precision, the chances of cure also increase manifold.

Is this personalization scalable?

Yes, it is advancing in a big way. In the next ten years, every patient will get a different pill – that would not be a thing of wonder. The side effects go down considerably when the focus is sharpened with personalization.

HCG has various tech tools and platforms like Vital Beam, Versa HD, Elekta Harmony Pro and CyberKnife. Are you also aiming to tap personalization in a bigger way?

There have been a lot of advancements in radio-therapy. Earlier one radiation was given on the anterior side and one on the posterior side. But in that approach, normal tissues would also get radiation. These new techniques enable targeted radiation which helps us to spare normal tissue and attack the tumor with a targeted dose. Earlier a lot of work in this area was done through X-Rays. Now - We are also working on Proton Therapy on similar lines. It is available in only two places in India and it helps to improve the focus of radio-therapy massively.

AI can do so many things in 5 minutes which, otherwise, would take half an hour. It can be so useful in diagnosis, planning, dosage decisions, and cancer targeting.

Can wearables or interfaces like Neuralink or sensors help in this area? In studying vitals? Can we ever reach a stage where the body can heal cancer with bio-engineering interventions?

In cancer, more than vitals, knowing the stages is more important. So, for us, scans carry more weight than the data that wearables can show. The body cannot heal something as intricate as cancer on its own - although having a strong immunity does help a lot in reducing complications and hastening recovery.

Does having a better compute muscle accelerate diagnosis/treatment? We have seen how AIIMS and CDAC have partnered in some areas. And how HCG has accomplished genomic profiling of over 1000 patients. How much can better computing, especially AI, help, and where?

Yes, better computing muscle can help a lot. AI can do so many things in 5 minutes which, otherwise, would take half an hour. It can be so useful in diagnosis, planning, dosage decisions, and cancer targeting. It can reduce working hours for healthcare people in a significant way. The role of humans would stay critical but we are also learning to use technology in many areas – like in control stations, targeting decisions, in radiation areas, and so on.

That works in surgical oncology and imaging too?

Yes. Robotic surgery enables bloodless surgeries with less damage to tissues and less time taken. There is better control and lesser complications too. For instance in Radiosurgery- CyberKnife wields a combination of real-time imaging and pre-treatment planning to target the tumor. The pre-treatment planning helps the specialists to determine the ideal position of the tumor and the radiation beams. We also use real-time imaging to track the tumor’s movement and adjust the radiation beams accordingly. This enables the radiologists to deliver high-dose radiation to the target area in less time.

What’s the biggest obstacle in fighting cancer today? Can technology help to democratize healthcare and make it affordable?

Financial issues and social stigma – are top challenges today. A lot of patients still hesitate in sharing their conditions for fear of social reactions. The visual impact of treatments also leaves them isolated and feeling inferior. That’s why it is crucial to use counseling and empathy that back discretion in cancer treatment. Healthcare can be made free but, then, it can lead to long waiting time-windows and that’s always a disadvantage in cancer treatment. Many technology platforms cost crores in investments and their ROI does not exactly spur affordability. Technology is great. But it can also make a lot of areas expensive. Robotic surgeries can be painless and faster than open surgeries - but they cost so much more.

How can collaboration and research be enhanced while confronting data privacy and security issues?

We label data for analytics purposes and not as identifiable information. I can find out how many patients of a certain stage came in what period – I can do a lot of analysis without knowing any other details.

HCG is also opening up a lot of consolidation opportunities. Can you share anything on that?

It started from a small set-up in Bangalore in the early 90s and has grown to its current state with the idea of touching tier-2 and 3 cities in India. Now we cover cities like Hubli, Vijayawada, Nasik and Baroda. HCG is a global leader now and is eyeing new frontiers of growth. HCG Cancer Centre, Ahmedabad, is the first dedicated, private, and comprehensive cancer center in Gujarat. The idea is to provide high-quality, result-oriented cancer care by adopting global innovations. We work towards quality cancer care treatment through Surgical, Radiation & Medical Oncology, all under one roof with a full range of diagnostics.

Dr. Kinjal Jani

Director & Head- Radiation Oncology, HCG Cancer Centre

By Pratima H

pratimah@cybermedia.co.in