What once seemed impossible in cancer research is now a reality thanks to a number of technological innovations that have led to breakthroughs in the ways we find, visualize, understand, and treat cancer. A golden era of cancer research, which encompasses the discovery and development of technologies that have permitted advancement, dawned with the signing of the National Cancer Act of 1971. Technologies and innovations like Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR), artificial intelligence, telehealth, fluid biopsy and robotic surgery are helping accelerate progress against cancer.
In this quick conversation with The Indian Practitioner, Dr. Sachin Marda, Senior Consultant Oncologist & Robotic Surgeon (Cancer Specialist), elaborates on the technological and technical advancements that have resulted in improvements in the ways cancer is detected and treated.
The Indian Practitioner (TIP): As we know, Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) forms the base for genome editing technology. In what all ways does CRISPR help beyond genome editing?
Dr. Marda (Dr. M): The brand-new cancer treatment and gene-editing device fixes DNA like a pair of scissors and glue. Cuts in the DNA can turn off particular genes, get rid of cancer-causing mutations, or solve a production issue. Drug-resistance genes can be removed by scientists from tumour DNA. As a result, chemotherapy would be more effective and could prevent mutations from turning into malignancies that are aggressive, improving the quality of life for cancer patients.
TIP: Fluid biopsies could be a possible game changer in cancer care given that it’s a non-invasive alternative to surgical biopsies. Could you give us a few insights on the working of a liquid biopsy?
Dr. M: It involves the examination of tumors utilizing biomarkers found in blood and other bodily fluids. Re-biopsies are required during cancer therapies to modify the regimen. To determine the next stage of the therapy, it entails collecting a fresh sample from the dynamic tumor. This presents both patients and medical personnel with a significant difficulty given the existing invasive biopsy techniques. However, a fluid biopsy gets cancer cells from a straightforward blood sample.
TIP: New biomarkers and methods for classification of cancer subtypes, diagnosis, prognosis and prediction of response to therapy have been emerging. Can you elaborate on real-time cancer diagnostics in its roles in causes, treatments & managements?
Dr. M: There are many innovative tools available for tumour diagnostics during surgery. Over 20% of breast cancer patients, according to a large-scale study published in 2019, required a second surgery since the disease’s malignant cells were missed during the initial procedure. For instance, the imaging tool from OncoRes Medical gives surgeons access to crucial intraoperative data during a lumpectomy. The handheld device employs artificial intelligence to help distinguish between tumour and healthy tissue, significantly increasing the results of breast-conserving surgery and lowering the number of follow-up procedures for breast cancer patients. Although not yet available in India, the future is unquestionably bright.
TIP: Next-generation targeted medicines are altering the way that cancer is treated. How does targeted therapy work?
Dr. M: By interfering with particular molecules involved in the initiation, progression, and dissemination of cancer, certain medications can prevent the growth or spread of the disease. These specifically targeted medicines use knowledge of a person’s genes and proteins to stop just malignant cells. Such targeted medications can help with illness prevention, diagnosis, and therapy, providing limitless patient benefits. As technology advances, we are now aiming for and working toward greater accessibility and affordability.
TIP: What are molecular cancer diagnostics?
Dr. M: It is a promising and alluring precision oncology strategy involving matching the appropriate targeted therapy to the appropriate patient based on the unique molecular genetic mutations found in each cancer patient’s tumour.
TIP: What are the key patient benefits linked with precision robotic surgery?
Dr. M: Using surgical robots, surgeons may conduct procedures with a level of accuracy never before possible. The possibility of operating on early-stage tumours or tumours adjacent to delicate organs may increase more than ever if the robot is made to function as an extension of the surgeon’s intellect and abilities. Modern surgical robots contain 3D cameras that can simultaneously stream and record operations. The extra benefit of the robot is that it helps the surgeon do suturing, tissue dissection and tissue retractions with more accuracy.
TIP: Immunotherapy is one of the most happening areas of research. What is your opinion on the immunotherapy approach?
Dr. M: We are getting closer to a time when cancer is a treatable illness thanks to new methods to control the immune system. The ability to cure cancer with personalized vaccinations, cell therapy, gene editing, and microbiome treatments are four such technologies.
TIP: What other developments can help Telehealth & Digital Health Records?
Dr. M: Virtual tumour boards and expert consultations to enhance clinical care. In order to provide a continuity of care, the patient journey is being mapped utilising cellphones and cloud-based data capturing.