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Cell signalling and support networks: Mobile phones in cancer and care

by ecancer reporter Will Davies

After my previous article on the history and clinical utility of proton beam therapy, I have had radiation on the brain. This, I’m told, can be cured with a handy holographic sticker, which has the added bonus of realigning my chakras and balancing my M-waves...

Tempting as it is to fall into a goop-hole of mis-steps in science communication, I will try to keep my sources cited and rigour intact. Evidence-based science, and all that.

Mobile phones have made their way into just about everyone’s hands over the last decade, putting the sum of human knowledge and creation just a few swipes away from the worlds fingertips. Unfortunately, as has come up increasingly often in the last few years, you can’t believe everything you read.

Since the public panic of mobile phone use first set in almost ten years back, there has remained a consistent contingent of those warning over unknown long-term effects to the electromagnetic fields of mobile phones. This note has generally been drowned out by the increasing ubiquity, if not requirement, of a personal digital device in the 21st century, but it has remained nonetheless. In some quarters, it has found an audience primed with a distrust of establishment advice and searching for a smaller, simpler answer to their health worries.

So, why not a pocket-sized device that does everyday magic, produced by international organisations who seemingly answer to no-one?

Those who would insulate themselves from the disruptive technology of an LG Cookie were probably as delighted as the rest of the public were shocked in 2011, when IARC announced their classification of electromagnetic fields as a class 2 carcinogen. In the following years, suggestions of links to tumours began to mount.

Many articles stopped short of drawing a definitive line of cause and effect, but more and more have found enough of a link between heavy mobile phone use and brain tumours to not dismiss fears outright. Beyond the brain, fears of radiation damage to testes has only recently been put to bed, and a connection between phone proximity and breast tumours remains inconclusive.

Even out of users hands, there are reported hazards of mobile phone usage across society - their base units are doing… something to the blood of nearby residents. Add to this the determination that man-made electromagnetic fields were having more effect on biological tissues than natural fields, and the picture isn’t looking especially encouraging.

So it’s a good thing none of that seems to have had any real-world effect on cancer rates.

In Australia, brain tumour onset hasn’t increased significantly over the last 30 years, and a similar interrogation of Swedish Cancer registries found that brain cancers were actually being under-reported.

Determining the exact mechanism behind earlier reported links to cell changes is proving hard to nail down too, with no chromosomal damage found in glioblastoma cells, no increase in micronuclei frequency, no solid evidence of DNA damage or abnormal cell behaviour in brain cells, and no impact on DNA integrity at 30 mins intervals of active use (and who talks for half an hour on the phone any more?). In fact, it is only among the heaviest, long term users that any kind of correlation can be drawn for tumourigenesis or reduced birth weights.

Other trials are proving tricky to replicate at all, with ‘methodological shortcomings’ turning up in place of consistent findings. This doesn’t discard the research above, but it does highlight the difference between clinical model and the real world.

That doesn’t sell phone charms, though. Poorly framed statistics, confusing scientific debate for partisanship and being offered the inside track to “what they don’t want you to know” will sell you just about anything, despite green lights from the Health Physics Society and National Institute of Health.

These days, it’s easier to say mobile phones are having a positive impact on cancer care.

So I will.

Mobile phones are changing health care practice, access and engagement around the world for the better.

mHealth, as it can be generally termed, has been implemented across devices and operating systems. So long as there is signal enough for patients to participate. More recent phone models, loaded with biosensors and tracking technology, can feed data to a range of apps to track fitness, heart-rate and other physical wellness measures, while traditional texts and calls close the distance between clinics and patients using less complicated devices.

Text message prompts can be effective nudges for cancer control and disease prevention, changing sun tanning behaviours and screening for breast/cervical cancers. Patients undergoing chemotherapy can even be algorithmically detected for worsening symptoms before scheduled meetings with their physicians, based just on the data gathered through an unmodified smart phone. By integrating questionnaires into daily use of mobile phones, breast cancer patients can comfortably participate in health surveys assessing mental health, and streamline prostate cancer risk quantification for medical professionals.

Even in (what is apparently a field) tele-dentistry, photos from phones improve communication between primary care and oral medicine specialists, facilitating early detection of oral cancers, and mobile microscopes twin easily with phones and tablets for sharing sample images and flow cytometry results.

Tapping in to the latest trend in mobile technology, trials of patients introduced to hospital facilities through virtual reality suites were found to be less anxious about their radiotherapy procedure than others. Similarly, observing and stratifying patients perceptions of medical interventions based on their social media posts can flag most-feared techniques and possibly inform emotional wellbeing assessments.

Bundling multiple functions into a single app with a simplified interface reduces confusion and reduces the need for translation, meaning apps can be introduced to participants the world over. Simplified interactions may improve scheme retention, with functions like journal keeping and symptom reporting ingrained as habits. Once they are, participants may even see their survival prospects improve.

This is the ultimate goal of the iManageCancer project: Improving cancer patient wellbeing, empowerment and survival through mobile phones.

The project is funded by the European Union’s Horizon 2020 research and innovation programme.

iManageCancer apps can connect patients and carers with eachother, support emotional wellbeing of patients and family resilience, and feed into care flows of pain and fatigue. These interactions also carry forward to conversations between patients and healthcare providers, which can be especially tough for patients to navigate in the immediate aftermath of diagnosis.

Among the research outcomes iManagecancer consortium, of which ecancer is a member, is the development of gamified health experiences: ‘Serious’ games for adult patients, and more typical games for younger cancer patients to put molecular actions of therapies in context.

Prof. Dr. Norbert Graf, University of Saarland, described the rationale to ecancer previously: “There is an increasing need for cancer patients and parents of children with cancer to take an active, informed and leading role in their ongoing care to improve their physical, psychological, and social aspects of health thus resulting in a better quality of life.”

"By including psycho-cognitive aspects, a holistic view on patients is guaranteed," he added. "In addition, studying these games will also give us new insights in research."

The project continues to develop, incorporating nutritional and emotional diaries for well-being, treatment guidance for patients and clinicians, drug interactions to avoid, and more features coming soon.

So, all I can ask is that we let history bear out – will fear of a disease that 1 in 3 contract in their lives stop us from using tools already in our hands to improve the lives and livelihood of those already afflicted? Or will we put our trust in the evidence available, work in unity towards a reasonable consensus, and demand intellectual rigor be applied to what might otherwise be inflammatory statements, which will only spread fear and disconnection?

Oh, and wash your hands. Health tip.

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Cancer Intelligence