I had the opportunity to talk today at the Best of ASCO, Miami meeting about the changing dynamics as we move into a new era of increasing complexity with molecular oncology and how that coincides with also a time of social media and sharing of so much information online. How is that changing the dynamic between physicians and patients? What I really wanted to focus on was this idea that the field of oncology has become incredibly more complex over the last five, ten, fifteen years as we’ve gone from just seeing a monolithic diagnosis of something like non-small cell lung cancer give way to much smaller sub-groups of patients with EGFR mutations and ALK and even smaller groups like ROS1 and MET mutations that are 1-2% of the population. That has led to better treatments for patients but it has also led to a much greater complexity that makes it all but impossible for the individual oncologist to keep up with, especially if they see ten or fifteen different kinds of cancer every day and might have just one patient with an ALK rearrangement or ROS1 every year or two. How can you keep that information?
The idea that I wanted to convey is that we’ve moved away from a time when you can possibly hope to keep all that information in your head and instead it’s all now available largely online on demand if you go search for it. But at the same time we need to avail ourselves of the best way to do that. That includes trying to keep as timely as possible by following social media, seeing things that are shared by our colleagues, ideally even contributing content to that discussion. But also recognising that patients have increasing access to that too and that isn’t necessarily a bad thing as long as the information that is made available to them is very high quality, credible content. We accept that the patient is a partner in their care and not just a passive agent but that they can sometimes spend a lot of time looking up everything that they can possibly know about their rare mutation and the treatments for it. Even if they come in with more information than we might have available based on our knowledge it doesn’t make us a bad doctor, it just makes you a partner in sharing the best information and figuring out a best plan together. The key is just ensuring that people have online the best information available and recognising that if we have something that we might be able to contribute, ideally to produce content or at least direct patients to some of the best sources so that they can help themselves and it doesn’t just rely on one person knowing everything there is to know about cancer because that’s just not a tenable model anymore.