Innovation in medicine is constantly changing. The pace of new investments, scientific developments and novel discoveries has rapidly increased and has substantially transformed patient outcomes over the course of the last century. From a macroscopic perspective, medicine has made immense progress in just a few short decades, with significant increases in average life spans and quality of life for many patients.
However, progress does not come easy, and often faces significant challenges in advancement.
For example, chimeric antigen receptor (CAR) T-cell therapy has dominated recent news cycles as a potentially cutting-edge treatment modality for cancer. The American Cancer Society explains the nuances of this treatment. At a very high level, the process entails transforming T cells (a type of cell that belongs to the immune system) to find and destroy specific types of cancer cells. This is done by harvesting T cells from the patient’s blood, and then modifying them in a lab setting by adding a gene for a receptor (i.e., the chimeric antigen receptor) that will recognize and attach to a specific cancer cell. Once the T cell attaches to that cancer cell, it can then activate its native processes to destroy it. However, the entire process is incredibly challenging to execute— from harvesting the cells from the patient’s blood and altering their genome, to growing and multiplying them, and eventually then infusing them back into the patient—by no means is this a straightforward process.
The scientific community has also expressed concern about potential side effects from the treatment, such as the formation of secondary primary malignancies (SPM). A Nature study published earlier this month found that “At a median follow-up of 10.3 months, 16 patients (3.6%) had SPM,” and “one case of TCL was observed, suggesting a low risk of TCL post-CART.”
Overall, this example illustrates a common conundrum with catastrophic disease states and their respective treatments: the consistent need to balance risk vs. benefits by healthcare professionals and patients. For this reason, the practice of medicine is often debated as somewhat of an art, rather than purely a science. While the study of medicine and treatment of disease is largely based on empirical and evidence based foundations, the actual practice is based largely on judgement. Especially when it comes to more complicated fields such as oncology and rare malignancies, many of the therapeutic models often depend on a risk vs. benefit analysis, and an understanding that for prolonged life expectancy or a better quality of life, there may be some risks associated with the treatment. Patients often also carry this decision burden, and have to undertake a very similar process of weighing the risks vs. benefits and understanding their own diagnosis and prognosis; only with a comprehensive review of the data and guidance from a trained professional can patients make a reasonable decision for their own treatment.
Indeed, these perspectives are what make the practice of medicine so challenging and somewhat of an art. While scientific discoveries are necessary and paramount to progress, ultimately, the execution, delivery and tactical aspects of patient care entail a very human approach, requiring a tailored and thoughtful touch. Nevertheless, though the work is just getting started, the progress that has been made in medicine in such a short time provides hope for the decades to come.
The content of this article is not implied to be and should not be relied on or substituted for professional medical advice, diagnosis or treatment by any means, and is not written or intended as such. This content is for information purposes only. Consult with a trained medical professional for medical advice.
