Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Is cancer truly the enemy? 

Ken Dixon, MD
Conditions
October 26, 2018
Share
Tweet
Share

Cancer is the enemy.   So, our immediate desire is to get rid of it, throw it away, and never hear from it again.  Current therapies that require living tissue are proving that false.   We know that your living tumor tissue is like your fingerprint, unique to each individual patient.  It contains information specific to you, your genetic make-up, your cancer and ultimately the thought is, your treatment.  If kept alive, instead of being thrown away as medical waste in the operating room, it can unlock treatment options that might not otherwise be considered and save patients from side-effects of ineffective treatments.

In today’s world of chemotherapy and targeted cancer therapies, therapy is administered without checking to see what would happen first.  After the pathologist cuts the cancer into chunks, those pieces, though dead, are preserved within blocks of wax.  A fancy meat cutter then slices off very thin pieces of the tumor so that the pathologist can examine it under the microscope.  From that analysis, and from information about what happened to other patients with similar, but certainly not identical, problems in the past, the physician then decides how to treat the cancer of that individual patient.

This treatment method works about half the time.  Well, to be specific, in cases in which drug therapies are the mainstay, such as for cancers of the lymph nodes and the blood — the lymphomas and leukemias — they really do provide significant benefit.  On the other hand, most of the benefit from modern cancer care for solid tumors comes from the surgical and/or radiation oncologic interventions.  The actual additional incremental survival benefit from chemotherapies or targeted therapies in solid tumors over that provided by surgery or radiation is generally in the single percentage point ranges.

But if instead, the cancerous tissue is kept alive we can test tissues outside the patient’s body against the same therapy that we plan to use against the cancer within the patient.   And only then would we treat the patient with a toxic drug.  But, remarkably, we do not do that.  Instead of keeping cancer tissue alive for further testing, we put it in formalin, which kills it.

Functional precision medicine is the alternative. It is the analysis of each patient’s living cancer tissue after treatment by drugs outside the body. And only then, does the patient receive treatment. This prevents injury to the patient by preventing ineffective cancer therapies from occurring, fostering effective therapies and potential patient benefit, and almost certainly saving costs for the patient.  While this concept is new, a new society has been formed to advance these ideas and create new trials around them.  This society is named the Society for Functional Precision Medicine.  And, a new industry is forming around it to save tissue, freeze it alive, then test it with many different medicines.

Just like freezing cord blood for newborns, the technologies exist.  The early supporting data is in.  Now we must shift our thought processes to embrace this change in the way we treat cancer.  The paradigm must shift to the study of an individual patient’s cancerous tissues, and, return that information to the cancer physician. This enables the care team to make better decisions and in effect, puts a person’s cancer to work for them.

Therefore I suggest, we must look further before we define precision medicine in cancer care as the genomic or other molecular characterization of dead tumor tissue.  Conceptually, it makes little sense, and, in actual fact, such analysis works in well under 10 percent of cases.

The real way forward for precision medicine is to keep the cancer tissue alive, then grow it in a culture, just as you would in another analogous situation such as growing a bacterium causing an infectious disease.  Then you test it with different medicines to see what kills it outside the body, just as you would decide which antibiotic to use for that bacterial infection.  This is what is called a co-clinical trial, in which you do the trial on the cancer in a setting in which you figure out whether the treatment works without potentially making the patient sick.

This isn’t rocket science.  This is pretty basic stuff but we seem to have closed our eyes to this reality.

Ken Dixon is a cancer surgeon and founder, SpeciCare.

Image credit: Shutterstock.com

Prev

The present moment as a refuge

October 26, 2018 Kevin 0
…
Next

What we can learn from the tragic deaths of CEOs

October 26, 2018 Kevin 0
…

Tagged as: Oncology/Hematology

Post navigation

< Previous Post
The present moment as a refuge
Next Post >
What we can learn from the tragic deaths of CEOs

ADVERTISEMENT

Related Posts

  • Cancer patients who want to take unproven supplements

    Marc Braunstein, MD, PhD
  • Hormone replacement therapy is still linked to cancer

    Martha Rosenberg
  • Can the Maternal CARE Act fail moms? 

    Sonal Patel, MD
  • We have a shot at preventing cervical cancer

    Lisa N. Abaid, MD, MPH
  • Our patients matter, but at what cost to our families? 

    James A. Quinn, PA-C
  • Obstruction of medical justice: How health care fails patients with cancer

    Miriam A. Knoll, MD

More in Conditions

  • What Elon Musk and Diddy reveal about the price of power

    Osmund Agbo, MD
  • Understanding depression beyond biology: the power of therapy and meaning

    Maire Daugharty, MD
  • Why medicine must stop worshipping burnout and start valuing humanity

    Sarah White, APRN
  • Why perinatal mental health is the top cause of maternal death in the U.S.

    Sheila Noon
  • A world without vaccines: What history teaches us about public health

    Drew Remignanti, MD, MPH
  • Unraveling the mystery behind one of the most dangerous pregnancy complications: preeclampsia

    Thomas McElrath, MD, PhD and Kara Rood, MD
  • Most Popular

  • Past Week

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • A world without vaccines: What history teaches us about public health

      Drew Remignanti, MD, MPH | Conditions
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • How the 10th Apple Effect is stealing your joy in medicine

      Neil Baum, MD | Physician
  • Recent Posts

    • From Founding Fathers to modern battles: physician activism in a politicized era [PODCAST]

      The Podcast by KevinMD | Podcast
    • From stigma to science: Rethinking the U.S. drug scheduling system

      Artin Asadipooya | Meds
    • The gift we keep giving: How medicine demands everything—even our holidays

      Tomi Mitchell, MD | Physician
    • The promise and perils of AI in health care: Why we need better testing standards

      Max Rollwage, PhD | Tech
    • From burnout to balance: a neurosurgeon’s bold career redesign

      Jessie Mahoney, MD | Physician
    • Healing the doctor-patient relationship by attacking administrative inefficiencies

      Allen Fredrickson | Policy

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • A world without vaccines: What history teaches us about public health

      Drew Remignanti, MD, MPH | Conditions
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • How the 10th Apple Effect is stealing your joy in medicine

      Neil Baum, MD | Physician
  • Recent Posts

    • From Founding Fathers to modern battles: physician activism in a politicized era [PODCAST]

      The Podcast by KevinMD | Podcast
    • From stigma to science: Rethinking the U.S. drug scheduling system

      Artin Asadipooya | Meds
    • The gift we keep giving: How medicine demands everything—even our holidays

      Tomi Mitchell, MD | Physician
    • The promise and perils of AI in health care: Why we need better testing standards

      Max Rollwage, PhD | Tech
    • From burnout to balance: a neurosurgeon’s bold career redesign

      Jessie Mahoney, MD | Physician
    • Healing the doctor-patient relationship by attacking administrative inefficiencies

      Allen Fredrickson | Policy

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...