How to Find the Best Cancer Treatment: A Guide to Proactive Patient Advocacy

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• Proactive Patients Use the Internet
• The Doxorubicin Discovery Story
• Global Medical Innovation Examples
• Barriers to Expert Second Opinions
• Remote Consultations and Telemedicine
• The Critical Importance of a Second Opinion
• Conclusion: The Power of Active Advocacy
• Full Transcript

Proactive Patients Use the Internet

Patients are becoming more proactive in their cancer care, using the internet to research their disease and find information on new cancer treatments. Dr. Bruce Chabner, MD, confirms this trend, noting that patients now often arrive at appointments having already investigated alternatives to standard therapy. They actively seek a medical expert second opinion, asking their oncologist to evaluate novel therapies they have discovered online.

The Doxorubicin Discovery Story

A powerful personal anecdote from Dr. Bruce Chabner, MD, illustrates how a patient's initiative can directly influence cancer care. Approximately 45 years ago, a patient with uterine cancer presented him with a research article in Italian about a new cancer medication being tested in Italy. Dr. Chabner had never heard of this treatment, which turned out to be Doxorubicin. This encounter led to testing the medication, which within a year or two became a very important and widely used chemotherapy drug. This experience was a profound lesson for Dr. Chabner that physicians do not know all new cancer treatments and that valuable research occurs globally.

Global Medical Innovation Examples

The history of medicine is filled with examples of important innovations that took time to gain worldwide acceptance. Dr. Anton Titov, MD, and Dr. Bruce Chabner, MD, discuss the development of Total Mesorectal Excision (TME) by Professor Bill Heald in the early 1980s. This surgical technique for rectal cancer significantly improved patient survival, yet it took 15 to 20 years to become a standard procedure around the world. The discovery of Helicobacter pylori's role in ulcers is another prime example of global medical innovation. This is why international medical conferences are so vital, as they facilitate the exchange of groundbreaking research happening everywhere, not just in the United States.

Barriers to Expert Second Opinions

Despite the clear benefits, significant barriers prevent many patients from obtaining an expert medical second opinion. Dr. Bruce Chabner, MD, points out that most patients lack the financial resources to travel internationally for care. For a patient living in Poland or Russia, traveling to see a specialist in the United States is often not feasible. These are valid challenges that can obstruct access to the best possible cancer therapy, making remote solutions increasingly important.

Remote Consultations and Telemedicine

Modern technology offers powerful solutions to overcome geographical barriers through remote consultations and telemedicine. Dr. Bruce Chabner, MD, explains that experts can review pathology slides, CT scans, MRI scans, and laboratory data remotely. He participates in a monthly teleconference with colleagues in Botswana, where they review cases and discuss diagnosis and treatment plans. Dr. Chabner is also actively engaged in remote consultations with patients from China, demonstrating that a vast amount of diagnostic review and expert opinion can be delivered across borders. As Dr. Bruce Chabner, MD, states, "Diseases have no borders. Physicians should also not be constrained by borders."

The Critical Importance of a Second Opinion

Seeking a second opinion is a critical step for any cancer diagnosis. Dr. Anton Titov, MD, and Dr. Bruce Chabner, MD, emphasize that patients must sometimes push against physician authority to advocate for themselves. The internet can be a valuable tool in this process, helping patients identify leading specialists and cutting-edge clinical trials. A second opinion can confirm a diagnosis, provide information on new treatment options, and ultimately lead to a more personalized and effective treatment plan.

Conclusion: The Power of Active Advocacy

The journey of cancer treatment requires active patient advocacy and a collaborative relationship with oncologists. The story of Doxorubicin’s discovery, as shared by Dr. Bruce Chabner, MD, serves as a timeless reminder that medical knowledge is always evolving. Patients who research their condition and seek expert second opinions play a crucial role in their own care and can sometimes contribute to broader medical advances. Utilizing available tools like remote consultations can help bridge the gap for those who cannot travel, ensuring more patients have access to the best cancer therapy available globally.

Full Transcript

Dr. Anton Titov, MD: Patients must use the internet to find better treatments, and they do. Eminent oncologist explains. Expert medical second opinion initiated by patients is very important.

Patients become more proactive. They seek information about the disease that they have. Hopefully, patients can find the correct information on the internet.

Yes, patients are coming to us now. That's interesting. They've researched their disease. They have looked it up on the internet. Patients found alternatives to the standard therapy.

They come to us and say, "What do you think of this therapy? Do you think we should try this treatment rather than going through the usual therapy?"

Dr. Bruce Chabner, MD: Sometimes their ideas are actually quite interesting. I remember this story. Maybe 45 years ago, I was seeing a patient with cancer. I can't remember what kind of cancer. I think it was a uterine cancer.

It was at Yale New Haven Hospital in Connecticut. It was an Italian family. This patient brought to me a research medical article. It was in Italian.

"I've got a new cancer medication that was being tested in Italy for cancer." Patient said, "Doctor, what do you think of this new cancer treatment?" I said to the patient, "I've never heard of it before!"

It turned out to be Doxorubicin. We then began testing this new cancer medication. A year or two later, it turns out to be a very important cancer medication.

I think that was a lesson for me. I don't know everything. I don't know all new cancer treatments. There is research going on in the rest of the world. It could be very helpful for treatment of patients.

Dr. Anton Titov, MD: I think that the history of medicine speaks about that again and again. I've spoken to several colorectal surgeons. Surgeons mentioned that Professor Bill Heald developed the TME, the total mesorectal excision.

It was an important cancer surgery method. He first developed it in the beginning of 1980s. But it had not spread around the world until almost 15 to 20 years later. TME method allowed for significantly better survival of colon cancer patients.

It's just one example. Of course, Helicobacter Pylori story is another example. There are many new treatment stories from around the world.

I think that's why we have international meetings. It's important for patients to be able to travel across borders to hear what's going on. In two days, I'm going to Japan again to a conference. It has been very informative for me.

Dr. Bruce Chabner, MD: Because there's a lot of good medical research going on all over the world. It's not simply in the United States, absolutely.

Seeking medical expert opinion is important. Patients have to be proactive. Patients have to sometimes push against the physicians with authority.

The sad part of it is that most patients don't have the resources to do this. So you have to depend on your doctor to be informed. You can't go off to the United States if you're living in Poland or Russia. You cannot see an expert over here.

And it may not be helpful. But in certain cancer cases, it probably would be. But most patients can't afford that. So those are valid barriers, those are challenges.

Well, the internet could help to find the best cancer therapy. Internet may help, absolutely, correct!

Dr. Anton Titov, MD: There are so many objective diagnostic tests available. The doctors can review the situation remotely. Experts can review pathology tumor slides.

Radiology experts can review CT and MRI scans. They can review laboratory data.

Dr. Bruce Chabner, MD: Actually, we do that. Each month we have a teleconference. There is a video conversation with our colleagues in Botswana.

They present cases and we go over the diagnosis and the treatment. Our pathologists read the slides. We look at the X-rays. It is possible to remotely do a lot of this.

You're correct! I'm doing a fair amount of this with patients from China now. It's a particularly active interaction with China. Many patients are coming over here.

Dr. Anton Titov, MD: Diseases have no borders. Physicians should also not be constrained by borders.

Dr. Bruce Chabner, MD: Correct!