DEVELOPMENT AND INNOVATION IN CANCER MEDICINE - Innovation in the Biopharmaceutical Industry - page 60

treatment options. Patients and health professionals will trust in computer-aided
decision making because of the evidence they will have that the programmes work.
The way the service will be designed around patients' needs and expectations
will be determined by the available improved treatments and their individualisation.
In early stages of the disease, care will be available close to where patients live.
Even the most sophisticated diagnostic machinery and robotic surgeons will be
mobile, so that intervention can be carried out by technicians and nurses, while
the highly trained professionals at a distant base are in audio-visual contact. When
cancer centres first developed in the mid-20th century, the diseases they treated
were relatively rare, and survival was low. Although these centres concentrated
expertise, being referred to one of them was distressing for some patients. Cancer
will become a commonly accepted chronic condition. Even when inpatient care is
required, patients will be able to choose from many “cancer hotels” around the world
where they may receive care. But that option will not even be necessary for many
patients. Patients may be treated in their own communities because most new drugs
will be administered orally (West, 2003). However, this approach to cancer and
other concomitant chronic conditions will place a huge burden on social services
and families. Systems will be put in place to manage these diseases and conditions,
psychologically as well as physically. Pain relief and control of other symptoms
associated with cancer treatment will be much improved.
Seventy per cent of today's cancer budget is being spent on care in the last six
months of patients' lives. Although many recognise that such treatment has more to
do with managing fear than with managing cancer, medical professionals have rel-
atively few treatment options available, and there is limited awareness as to which
patients would benefit. There is also an industry-wide reluctance to do anything that
would destroy a patient's hopes. This reluctance leads to confusion about the limits of
conventional medicines and anxiety about facing the inevitable on the part of patients
as well as their families and doctors. There is a widespread perception that patients
who continue being offered anti-cancer treatment might have their health restored.
As better treatments emerge, consumers of services will be able to focus more on
quality of life. Much of the fear that is now associated with cancer, will be mitigated.
Demand will be high for treatments with fewer side effects or lower toxicity, even if
these have only modest survival gains. The transition between active and palliative
care is often sudden, but in future the change will be less apparent, because patients
will have greater control over their own situation (Table 8).
Professional Reconfiguration
In the future, one of the greatest challenges to providing the best cancer care will
be putting the right people into the right jobs. It will be essential to stop training