The idea of “patient-centered care” or “personalized medicine” strives to ensure that healthcare decisions, treatments, and plans are tailored to each patient’s unique circumstances and that patients are actively involved in the decision-making process. Dr. Rosen notes that while this is a nice sentiment, the actual care provided does not often fit what is practiced in medicine.
“From a historical perspective, until the 1980’s the only real treatment option for breast cancer was removal of the entire breast, a mastectomy. Then we began to see that survival rates were similar between mastectomies and lumpectomies, and the scale started to tip more toward a breast conservation strategy when clinically appropriate,” said Dr. Rosen. “The decision is not black and white, however – many factors are at play from both the doctor and patient perspectives.”
Such factors include the biology and growth pattern of the cancer, the anatomy and size of the breast, the level of training the surgeon has, and the patient’s personal preferences.
Surgeons’ decisions are heavily influenced by their level of training and resources – some feel comfortable offering breast conservation surgery when clinically appropriate, while others may not and default to mastectomy given their lack of training, experience, and tools to support them and their patients. For patients, their decision is often fueled by a sense of urgency and fear, with many opting for a mastectomy because they initially care more about getting rid of the cancer than saving a breast. In fact, the rate of double mastectomies has increased recently, with many thinking this may be their best option.
“While patients might not care much when they’re still processing their diagnosis, their view can change after surgery, and in recovery mode they might have a completely different view and come to regret their decision,” said Dr. Rosen. “In fact, many studies have shown that patient satisfaction outcomes are consistently higher for those women who chose breast conservation. That’s why, as their doctor, I think it’s important to have as many tools in our toolbelt as possible to help patients make the decision that works best for them in the long run. However, what we’re seeing is that the playing field is not level across hospitals and practices. Doctors often do not have the right tools or awareness to offer the best aesthetic option, and patients feel pressured to decide ASAP without thinking of long-term impact. That’s where I think tools like SimBioSys’ TumorSight Plan can be a real disruptor.”
TumorSight Plan is one of SimBioSys’ lead in-development products, harnessing spatial biophysics with AI and data science to help surgeons and patients decide which type of surgery would be most appropriate by showing a visual 3D image of their own breast cancer and its surrounding tissue.
“When I see a patient, I take into consideration the footprint of their cancer relative to their breast size and shape to make a recommendation. Part of the challenge for both of us is that it’s hard to visualize their results. Many think that it’s vain to worry about how they look,” said Dr. Rosen. “As an oncoplastic surgeon, I try to tell them that that’s not the case and that caring about your appearance afterwards is not vanity, but recovery. In fact, in certain cases, women may actually look better after surgery than they did before. Many of my patients come to embrace this ‘silver lining’ as a bright spot in an otherwise difficult life experience.”
He added, “While patients have different views on what they prefer, there is one universal truth – every patient wants back the life they had before they felt that lump or had an abnormal mammogram. You’re going to get that life back much faster if there’s not a daily reminder of your disease. I think that TumorSight Plan will empower patients. When they’re able to see what they could look like, they’re much more likely to feel confident in their decision, no matter what it might be. And doctors are, as a result, able to provide care that is truly patient-centric.”
Dr. Rosen compares TumorSight Plan’s approach to doing a home remodeling project. “Instead of immediately starting the remodel, the best contractors with the right tools can give you a 3D model of your current home and walk you through the best option for the remodel and explain why certain things are possible or not. These tools not only help contractors determine what is possible and optimal, but they serve as an important educational tool that helps homeowners understand more clearly, make a more informed decision, and feel much more confident in that decision. That’s what we’re striving for with breast cancer surgery – we have that level of technology already for home projects, but we don’t have it yet for this field.”
In addition to TumorSight Plan, SymBioSys is developing other tools in the TumorSight platform to help oncologists of all specialties. “Another thing that made me interested in SymBioSys’ approach was their TumorSight IQ platform, which is designed to help radiologists predict responses to chemotherapy. We’ve developed AI technologies that can detect cancer on a mammogram or MRI, but being able to predict how tumors will respond to different therapies would be a quantum leap. We’re able to do this somewhat with genetic profiling, but it’s expensive and can take time, versus here you could theoretically upload an image to the TumorSight platform and get results back quicker and at a lower cost.”
“While there’s still work to be done, I think the future looks very bright.”
DISCLAIMER: Dr. Barry Rosen is an advisor for SimBioSys. This article is meant to be solely informative and is not meant to convey medical advice. TumorSight Plan and TumorSight IQ are currently in development and are not yet FDA approved.
About SimBioSys:
SimBioSys is a TechBio company deploying a combination of artificial intelligence, data science, and spatial biophysics to redefine precision medicine, transform patient care, and defeat cancer. By seeing cancer more completely, SimBioSys aims to empower clinicians, patients, and researchers with a more informed understanding of a patient’s tumor to optimally assess all available options and deliver on the promise of truly individualized patient care. To learn more, visit us at https://www.simbiosys.com/
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