What is Precision Medicine?

What is interventional radiology?

Precision medicine is an advanced form of medical treatment that uses a person’s lifestyle factors and genetic information in order to prevent, diagnose, or treat a particular type of disease. When used in cancer care, this medicinal approach focuses on the information stored within a patient’s tumor to help determine a treatment plan, find out if it’s working well, and even establish a prognosis.

Sometimes referred to as personalized medicine, precision medicine is often recommended for patients who are genetically predisposed to developing certain types of cancers. However, it can also be used for any cancer patient to determine if their tumor has a biomarker that can be evaluated, regardless of personal or family medical history. In doing so, the doctor and their medical team can identify whether a patient is at a higher risk for cancer or determine if the type of cancer will be affected by certain cancer treatments altogether.

What Are Cancer Biomarkers?

In past years, all patients with a particular form of cancer were administered the same treatment, regardless of their background, family history, or the type of tumor they were dealing with. However, with advanced technologies and breakthrough research, we now know that all tumors have unique qualities, even if they share the same cancer type. In fact, the location of the tumor matters less than its molecular profile.

Now, through the use of patient biomarkers, cancer specialists are able to characterize differences or mutations in a specific type of tumor. With this added level of detail, a patient’s cancer team is better equipped to create a more comprehensive cancer treatment plan – one that is built to suit the exact needs and genomic profile of the patient in front of them.

The biomarkers used to indicate a tumor’s abnormality include DNA, RNA, protein profiles, and metabolomic profiles. Each of these biomarkers can be used to help with the following:

  • Evaluating if a patient has a low/high risk of developing certain cancers
  • Discovering if a patient has a high probability of recurring cancer diagnoses
  • Determining whether a specific cancer therapy is working or will work for a patient
How Are Cancer Biomarkers Used To Guide Treatment?

After a biomarker is indicated in a patient’s tumor or genomic sequencing, their cancer team will establish if any available treatment drugs are designed to target that abnormality. If so, the patient will often be administered that drug at the start of treatment, or in conjunction with other forms of medication, surgery, or oncology.

Because of this approach, precision medicine ends up leading to a more fruitful care program and better patient outcome by providing several benefits to their treatment plan, including:

  • Improved Diagnosis: Precision medicine enables healthcare providers to diagnose conditions more accurately and earlier in the disease process, which can improve outcomes and reduce the need for invasive or costly treatments.
  • Reduced Side Effects: By using treatments that are specifically targeted to an individual patient’s unique genetic makeup, precision medicine has the potential to reduce the number and severity of side effects associated with treatment.
  • Improved Survival Rates: Precision medicine has the potential to improve survival rates for patients with cancer and other complex diseases by identifying the most effective treatment options for each individual patient.
  • Increased Understanding of Disease: By analyzing large amounts of data from patients, precision medicine can increase our understanding of diseases and their underlying causes. This can lead to the development of new and improved treatments.

This is a very promising field in cancer research, and one that shows the ability to extend patient lives. However, while we continue to learn about the common differentiations of biomarkers and how they affect cancer treatment, it’s important to note that this is a growing field, and there are still several treatment options in the early stages of research. At the time of this writing, not all tumor abnormalities are actionable.

Capital Health’s Precision Oncology Program

The Capital Health Precision Oncology Program is distinctively designed to meet an individual patient’s needs in real time. Leveraging our accreditation as the only cancer center in the region with NCORP/NCI access to the National Clinical Trials Network (NCTN), we are able to incorporate cutting-edge bioinformatics, deep learning, and other advanced tools to help our patients spend more time with their physicians. This personalized approach allows us to create a better, more thoughtful treatment journey, offering patients all the best that Capital Health has to offer:

  • Advanced Technology: Incorporating advanced technologies, such as next-generation sequencing and liquid biopsy, we offer patients the most advanced and accurate testing available.
  • Rapid Turnaround Time: Streamlining our process for collecting, analyzing, and using patient data, we allow patients to start their personalized treatment plan as soon as possible.
  • Collaborative Team Approach: Bringing together a team of experts from various disciplines, including medical oncologists, genetic counselors, and pathologists, we offer a unique, collaborative approach to precision medicine, ensuring that each patient receives the best possible care.
  • Clinical Trials: Offering patients access to cutting-edge clinical trials, we give them ability to try new treatments that may not be available at other hospitals in the region.

Patient Education and Support: Provoding educational resources and support services, such as genetic counseling and patient advocacy programs, we do everything we can to support patients throughout their journey and empower them to make informed decisions about their care.

Our Approach to Precision Medicine

The Capital Health Cancer Center takes a unique approach to precision medicine, which is incorporated throughout the patient’s cancer journey. From diagnosis, to decision making, to therapy, our team works hand-in-hand with the our cancer lab to create a seamless experience for the patient. It typically works as follows:

  • Tumor Cell Collection: After a patient has undergone surgical removal of their tumor, a sample of the tumor cells is collected and sent to a laboratory for analysis.
  • Laboratory Analysis: The laboratory analyzes the collected tumor cells to identify any genetic mutations or changes that are driving the growth of the cancer.
  • Incorporation of Liquid Biopsies: A type of diagnostic test, liquid biopsying involves analyzing a patient’s blood or other bodily fluids for cancer cells or genetic mutations associated with cancer. It is becoming an increasingly important tool in cancer care for recurrence of disease detection, monitoring the presence of minimal residual disease, and guiding therapeutic decisions.
  • Multidisciplinary Discussion and Treatment Plan Development: Once the laboratory results are available, the medical oncology team uses the information to determine the best course of treatment for the patient. This may involve selecting a targeted therapy drug or combination of drugs that target the specific genetic mutations found in the patient’s tumor cells.
  • Patient Discussion: At the first appointment with the medical oncology team, the patient discusses the results of the laboratory analysis with their physician. The physician explains the treatment plan, the potential benefits and risks, and answers any questions the patient may have, including clinical trials available.

In summary, our Cancer Center’s approach to precision medicine fits into the patient care plan by using the results of a laboratory analysis to determine the best course of treatment for each individual patient. This personalized approach has the potential to improve patient outcomes and reduce side effects associated with treatment.

Understanding Cancer Biomarkers: More Information

The concept of a cancer biomarker can sometimes be difficult for a patient to understand, especially one who has recently been diagnosed with cancer. The has a detailed, reader-friendly explanation of what biomarkers are, what their role is in making treatment decisions, and how biomarker testing is conducted, which patients can find using the link at the bottom of the page.

The, which calls itself the largest professionally led nonprofit network of cancer support worldwide, is dedicated to “ensuring that all people impacted by cancer are empowered by knowledge, strengthened by action, and sustained by community.”

Takes an X-ray of the arteries or veins by inserting a catheter into a blood vessel and injecting it with X-ray dye—called contrast agent—to see what’s happening inside your blood vessels. Doctors use the images angiography produces to check for blockages and other blood vessel problems.

Combines several techniques (like angiography, balloon angioplasty, tenting, and thrombolysis) to improve blood flow through a fistula or graft—a necessary process for the patient to get hemodialysis.  Hemodialysis—also known as dialysis for short—is a procedure that takes on the role of the kidneys by removing toxins from the blood when the kidneys can’t.

Opens blocked or narrowed blood vessels by inserting and inflating a very small balloon.

Uses a stent (which is a small mesh tube) to open up blocked biliary ducts to allow bile to drain from the liver.

Is a procedure that collects a small sample of tissue for pathologic evaluation. Doctors often order biopsies when an initial test suggests an area of tissue in the body is abnormal.

As with standard biopsies, your doctor will remove a small piece of tissue from your tumor to see if it is cancerous. Breast biopsies sometimes use specialized equipment.

Involves the insertion of a catheter into a vein so that patients can receive medication or nutrients directly into the blood stream. This procedure also allows for easy blood draws.

Involves blocking the blood supply to a tumor after anti-cancer drugs are applied. Sometimes the drugs themselves are attached to small beads that block the blood flow as they release the drug. Blocking the blood flow helps to starves the tumor of nutrients while it is receiving the drug, which may kill more cancer cells. It is most commonly used to treat cancers of the endocrine system and liver and often causes fewer side effects than other treatments.

Allows a doctor to place a small, hollow, flexible tube in your chest to act as a drain. It is usually used to drain blood, fluid or air from the area around your lungs, heart or esophagus.

Destroys diseased tissue by essentially “freezing” it with extremely cold gas.  It is often less invasive than surgery and patients can go usually home the same day.

Opens up blocked or narrowed blood vessels by inserting and inflating a very small balloon that contains an extremely cold substance that freezes the surrounding tissue. The freezing lowers the chance of the blockage happening again.

Inserts a drainage tube into an area where a lot of fluid has built up or where pus has collected. A collection of pus is called an abscess and is a sign of infection.

Reinforces a weak area in the aorta (called an aneurysm). A specialized stent made from fabric and wire mesh is inserted into the aorta to prevent further damage or rupture.

Delivers clotting agents (coils, gel foam, plastic particles, etc.) directly to an area that is bleeding. In addition, these agents can be used to block blood flow to problem areas, such as an aneurysm or uterine fibroids.

Involves injecting steroid medication into a specific location in the spine to provide relief of pain.

Inserts a thin feeding tube into the stomach to provide food and fluids to those patients who are having trouble eating or swallowing.

Is a procedure that takes on the kidneys’ role of filtering out toxins from the blood when they either are unable to do so or can’t do the job completely.

To diagnose or rule out certain conditions, your doctor might need a sample of your cerebral spinal fluid. To get this sample, your doctor will insert a needle into your lower back to draw out fluid from the hollow space that surrounds your spinal cord.

Allows the doctor to see the spinal cord and other structures more clearly than with standard X-rays. A contrast dye is injected into the spinal column before the procedure and appears on the X-ray screen to illuminate potential problems.

Uses high-frequency sound waves, or ultrasound, to drain excess fluid from your belly either to diagnose a condition or to relieve symptoms.

Is a procedure that causes the layers of tissue on top of your lung to form a scar and heal together, preventing more fluid from collecting on top of your lung. It involves injecting a medicine or chemical into your chest through a tube.

Drains excess fluid from your lungs or in your belly by inserting a tube into the area where fluid has collected – either on top of your lungs or in your belly. This permits you or your doctor to drain the fluid repeatedly and frequently.

Is a minimally invasive technique that uses a slender probe to create energy and heat that kills cancer cells. This technique is also used to stop a nerve from sending pain signals to provide relief to people in chronic pain.

Is a treatment where doctors inject SIR-Spheres® microspheres, which are small beads that contain radiation or high energy, directly into the tumor to destroy cancer cells. One of the good things about SIRT is that it targets only the tumor without affecting the surrounding healthy tissue in the process.

Inserts a small flexible tube made of plastic or wire mesh into the body to treat a variety of medical conditions. For example, doctors may insert stents in blood vessels or other areas that have been blocked or narrowed by tumors or other obstructions. Some stents, called drug-eluting stents, contain medication.

Uses ultrasound, or high-frequency sound, to drain excess fluid from the space around your lung to help diagnose a disease and/or relieve symptoms.

Describes the act of using medicine to break up a blood clot. You may be most familiar with its use to bust up clots in veins and arteries, but it’s also used in many other situations, like dialysis catheters and dialysis fistulas or grafts.

Removes a blood clot from a blood vessel—and often treats blood clots that form in the feet and legs (called “deep vein thrombosis”). Thrombectomy can also be used to treat blood clots that form in arteries that block blood flow to tissue.

Is a procedure used to treat high blood pressure in the veins that carry blood from the intestines to the liver. A stent is placed into a liver vein to form a channel (or shunt) that bypasses the liver and reduces pressure in the portal vein, thus lowering the risk of ruptures and bleeding in enlarged veins.

Describes the act of blocking off a blood vessel with small particles—like beads or sponges. Doctors perform this procedure on uterine arteries to stop life-threatening bleeding after a woman gives birth, which could prevent hysterectomy. This procedure can also be used to treat uterine fibroids by blocking blood flow to the fibroids.

Is a minimally invasive procedure that uses laser energy to seal a vein shut. It is not particularly painful and is commonly used to treat varicose veins.

Is a tiny cage-like device that your doctor inserts into a vein to trap blood clots to keep them from traveling to the heart and lungs.

Are fancy terms for a procedure that repairs a broken or cracked area in the thickest area of your vertebrae, called a vertebral body. To stabilize the vertebral body and relieve pain, doctors will inject bone cement (polymethyl methacrylate or “PMMA”) into the broken area.