Precision Oncology: Shaping a New Diagnostic and Treatment Frontier

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Stas Louca, MD at architecture practice H+A, on how the latest in medical technology and research provides a new way of treating cancer.

An event to celebrate Movember, the month that highlights the importance of men's health, was held in Abu Dhabi on 21st November. Movember is the global movement of growing moustaches in November to raise awareness of men's health issues like prostate cancer and testicular cancer.

In light of Movember as well as the issues faced by cancer patients, caused by the globe’s focus on COVID-19, Stas Louca, Managing Director at Healthcare and Hospitality architecture practice, H+A brings to light how the latest in medical technology and research is able to provide a new way of approaching and treating cancer.

Precision oncology is a specific way healthcare providers can offer and plan cancer related care based on a person's genetics. This form of preventative healthcare looks at how a specific gene might affect a person's risk of developing cancer or, if they already have it, how certain treatments might be affected by their genes.

It also looks at a person’s likelihood of developing certain types of cancers. Precision oncology is set up to help make a more accurate diagnosis and improve treatment. It can also help people make decisions about healthy habits, earlier screening tests and other steps towards prevention if they are at risk for a particular cancer.

In recent years, precision medicine has transformed oncology diagnostics and treatment. Technological advances for characterizing patients’ genomic profiles, combined with the development of digital means of allowing patients to access their medical records and easily share them, along with the tools to analyze them, have allowed clinicians to tailor treatments to prevent the onset of potential illnesses.

This will be especially useful for the prevention of cancer as today, one in three people are affected by it. This may also prevent or delay the need to use treatments with less favorable side effects that are also potentially more costly.

Latest medical advancements

Advances in genomic medicine are revolutionizing our understanding of and treatments for cancer. Molecular-guided therapy in oncology represents a proactive approach to treatment and has the potential to reduce the time and financial expenditures of ineffective treatments, thus increasing the patient’s duration and quality of life.

Both breast cancer and melanoma have well-validated molecular targets that are actionable with FDA-approved therapies. These advances are also changing the diagnostic and treatment platforms of other forms of cancer.

In addition to genomic data, other forms of precision data are on the horizon, including transcriptomics, epigenomics, proteomics, metabolomics and digital pathology from the tumor, surrounding tissues, circulating blood, and other body fluids.

Technological evolution allows treatment across multiple cancer types. The recent technology introduction of Pencil Beam Scanning (PBS) allows for higher beam accuracy, expanding the range of cancer sites potentially treated by Proton Beam Therapy (PBT).

In the UK roughly 9,000 patients per annum are treated with PBT with around 200 of these patients sent overseas by the National Health Service at an average treatment cost of £114,000 according to the Office of National Statistics UK, this marks a huge opportunity for the Middle East to become an oncology treatment destination.

Cancer in the Middle East

Breast cancer is the most common form of cancer across the Middle East and globally. According to the World Health Organisation (WHO) in 2018, the UAE had 4,707 new cancer cases and 2,079 deaths. Saudi Arabia had 24,485 new cases and 10,518 deaths. It is estimated that by 2040 there will be 29.5m cases globally.

The increases in the incidence of different types of cancer in Saudi Arabia in the past decade could be due to the revolutionary change in socioeconomic status and it has been rewarding to see a national plan established for cancer prevention, screening and therapy. In its efforts to align with 2030 Vision and satisfying the related strategic objective of National Transformation Program (NTP) 2020 “Promoting Public Health and Prevention”, the Saudi government has taken a national healthcare decision as well as support policy makers to develop evidence informed health policies.

The healthcare sector in the United Arab Emirates has witnessed huge developments that have made it possible for the UAE health system to compete with the top international health systems and gained a prominent presence amongst leading specialist healthcare provision destinations, globally, according to the cancer incidence in United Arab Emirates annual report of the UAE - national cancer registry – 2014.

While cancer is the third leading cause of death in the UAE behind cardiovascular disease and accidents, approximately 4,500 new cases are reported each year and the UAE government has vowed to lower the number of fatalities from cancer by 2021 with programs encouraging regular screenings and the building of more modern facilities like the GICC.  

What’s next?

Across the Middle East we already have all the key ingredients to become a frontrunner in precision oncology. There is buy in from governments to address the growing concern over local speciality treatments as well as a commitment to becoming Promoting Public Health and Prevention, specialist hospitals and wellness centers.

Anfas Medical Care Health Group’s (AMCHG) Wellness Village project in Jeddah, Saudi Arabia was in fact designed to create the first of its kind, world class, preventative healthcare and wellness campus. The Wellness Village incorporates a long-term care centre, women and children’s facilities, wellness clinics, a boutique wellness hotel and spa, sports fitness facilities, health-related F&B and retail outlets.

The site provides a holistic end-to-end approach to healthcare with a focus on preventative care for the local population as well as visitors, from birth to retirement age. This type of centre can be modified to cater specifically to precision oncology and should be attached to specialist centres like the Abu Dhabi Proton Centre (ADPC), part of the existing Gulf International Cancer Centre (GICC) in Abu Dhabi.

This type of set up will create a destination for oncology prevention and treatment. Using the latest medical advancements will enable clinicians to reduce mortality rates and even prevent cancer onsets.

Hospitals are expensive to run and the current general hospital model is coming under pressure to change. Technological advances will impact the design of all future healthcare facilities and as an outcome, hospitals will be smaller and more efficient, especially around the outpatient setting.

While specialty centres will continue to be a necessity, wellness centres are an evolution of the outpatient clinic and should be affiliated with speciality centres for an end-to-end solution. 

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