‘Deep research plus AI key to tackling cancer’

With the profile of cancer changing, patients underestimate the efficiency of radiotherapy due to past accidents and prohibitive cost of setting up centres for cancer therapy, said American radiation oncologist Dr Minesh Mehta, deputy director and chief of radiation oncology, Miami Cancer Institute. India must invest in setting up highcost centres for long-term benefits and better treatment outcomes, said Dr Mehta, in city for an oncology training meet, in an interview to Pushpa Narayan.

› Do you think radiation oncology has got the place it deserves in

cancer treatment

?

›Many cancer patients here don’t have access to medical care. Should India invest in expensive technology such as a proton centre?

›Do you think patients fear radiation often because it gets bad press?

›Do you think oncology will benefit more from AI, ML?

›Radiotherapy now has better research and technological advancements.Yet is cancer getting smarter? How to handle this?Today, lung cancer is one of the largest global problems. In the US, we are seeing a dramatic shift in the incidence of lung cancer with an increase in smoking and pollution levels. We used to treat a lot of patients with squamous cell lung cancer and small cell lung cancer.Now, we see more of adeno-carcinoma. It is no longer a prominent disease among men we see almost equal numbers of men and women. The incidence is also high among less educated segments of the population, where smoking is popular. To beat this, we must educate and increase awareness about the effects of smoking and pollution. To reduce the burden of HPV-associated cervical cancer, India must start mass vaccinations.In the US there is an in-crease in abdominal cancers, particularly among the young. Some cancers are more agressive now. Solutions lie in deep research.Cancer needs multi-modal therapy – surgery, radiation and chemotherapy. Radiation oncology is an underappreciated modality. Most people don’t realise it’s widely used. Estimates in the US say that between 50% to two-thirds of patients with cancer will needradiation therapy .It’s probably the most cost-effective form of taking care of cancer. But in the developing world, the infrastructure costs of starting a radiationtherapy programme are prohibitive. Advanced radiation therapy using proton is an example. India now has just two proton cancer centres, and the cost of treatment is prohibitive. We must find ways to make therapy affordable.Should India go to the south pole of the moon? Should India launch a Mars probe when they have so many people to feed on the street? Yes because the returns are rewarding for the future. If you don’t develop high-tech capabilities in radiotherapy, you will always be at the low end. The long-term cost of investments in such therapies is costeffective. The outcomes and survival rates are superior.Radiation oncology is a technology-oriented modality. All technology is susceptible to faults and if something goes wrong, there is risk and harm to patients. When an aeroplane crashes, an investigation follows. The root cause analysis often leads scientists to prevent similar crashes. It applies to radiation oncology too.The future of what AI can do in radiation oncology is enormous. I think radiation oncology can be the poster child for how AI can change the way medicine is practised. Almost everything we do in our therapy is methodical. We have a process for every step, and that’s where AI and machine learning do very well.