Dr. John L. Marshall is the Director of the Otto J. Ruesch Center for the Cure of Gastrointenstinal Cancers at the Lombardi Comprehensive Cancer Center at Georgetown University. That’s a mouthful of a title, but he wrote an op-ed in The Washington Post last month with a call to action for cancer research dollars to go more towards clinical trials (since fewer than 5% of patients right now are on clinical trials) and less money towards “evidence-based medicine” – meaning offering only those therapies that have been proven to help patients live longer, or at least live better. I know that my wife, Sharon Rapoport, is alive today because she was on a clinical trial for Herceptin in which early-staged breast cancer was treated with this drug. Here’s an interesting section of Marshall’s piece to think about in which Dr. Marshall believes the cure lies at the molecular, and not the generic level…in other words, “”personalized medicine:
In this country, the highest hurdle we must leap is our patients’ expectations. Cancer patients facing death want treatment; they want hope that they will be cured, even if they have been told that they cannot be cured. They will try toxic treatments over and over, hoping to extend their lives. We physicians are co-conspirators. Of course, we also want to believe that the next treatment will help more than the last, even though we know that is rarely the case. What if we had to pay for all this out of our pockets? Would we pay that much for some possible hope?
I believe we can invest more in actual hope. To do so, we must further explore the genetic makeup of patients and their cancers. We can no longer diagnose cancers using only a microscope. We must profile them at a molecular level to determine precise treatments, instead of using our current trial-and-error approach.
To assess a patient’s specific genetic problem, we must understand all the possible permutations and patterns. This will come only from a comprehensive clinical database — a high priority of the administration’s reform plans. For example, we know there are at least four different types of breast cancer; they look exactly the same under a microscope but are very different diseases. The repeated biopsies and blood tests that are needed, none of which is covered by most health insurance plans, will become critical to finding our answers.
The future of cancer care will rely on personalized medicine. To read the entire piece, click below: