Dr. H. Jack West, medical oncologist and Founder/CEO of Global Resource for Advancing Cancer Education (GRACE, www.CancerGRACE.org), spoke to WA state Attorney General's office about the changing landscape of cancer care and how the internet and specifically online patient communities and education will become disruptive in changing the patient/physician dynamic.
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Dr. Jack West Oncology 2.0, to WA AG's Office
1. Oncology 2.0:
Integrating Cancer Patients and
Caregivers to Improve Cancer Care
Howard (Jack) West, MD
Swedish Cancer Institute
Seattle, WA
Founder & CEO
GRACE
October 14, 2011
8. EML4-ALK Translocations in NSCLC
Soda et al., Nature 448: 561-566, 2007
EML4-ALK frequency:
~4% (64/1709)
Primarily adenoCa, minimial
or no smoking history
Bang, ASCO 2010
#2 (Plenary)
9. 48 yo Female Never Smoker with Stage IV NSCLC
Positive for EML4-ALK Target
Pre-Treatment After 2 cycles PF-02341066
11. Lung Cancer Mutation Consortium:
Incidence of Single Driver Mutations
At least 1 mutation was found in 54% (280/516)
of tumors completely tested (CI 50%–59%)
CI = confidence interval.
Kris et al, 2011.
12.
13. Misalignment of Goals
Oncologists are not always incentivized
to give what is best for patients
• Time to learn best Rx
• Time, effort to give best Rx
• Financial rewards greater
for alternative Rx
14. BOTTOM LINE(S)
1) We could do much better vs.
cancer today if people received the
best treatments available now.
2) Nobody is better incentivized to
learn best treatment than the patient.
21. The Internet Makes it Easy to
Propogate Poor Quality Information
• Case studies of unusually good or bad outcomes
• Fears about clinical research
• Conspiracy theories about cure for cancer
“Don’t let your doctor tell you NO”
25. Leveraging the Internet to
Convey High Quality Information
• Not time-limited • Not limited by geography
• 25-30K visits/mo
• 15-20K absolute
unique visitors/mo
31. Dr. George Demetri, Medical Director of Center
for Sarcoma & Bone Oncology, DFCI
The new research model pioneered by the Life Raft Group is making it
possible for patients and family members to contribute to clinical
research for their diseases in unprecedented ways.
- Dr. George Demetri, DFCI
32. Patients Can Aggregate to Reveal
Unknown/Underappreciated Adverse Effects
• Tips for managing EGFR inhibitor toxicities
• Runny nose with erlotinib
• Muscle aches with bevacizumab
• Swelling/irritation around eyes with pemetrexed
• ?Serious but rare adverse effects
33.
34. Final Thoughts
• Medicine, especially cancer, is becoming more
complex, requiring more expertise
• The genie isn’t going back into the bottle
• Integration of patients/caregivers into their care
will be disruptive, potentially good or bad,
depending on quality of information available
• Telemedicine is likely to fill this space as a
means of providing specialized care across a
broader geography
35. www.CancerGRACE.org
west@CancerGRACE.org
a 501(c)3 nonprofit
Twitter: @JackWestMD