POST January/February 2015

need to cure, he says, while the cancer that
kills needs to be found and treated early.
“Quite honestly, we have a 19th-century
definition of cancer right now, despite all of
these technologies we’ve developed over the
last 150 years. What we really need is a 21stcentury
definition of cancer. A 21st-century
definition is not: ‘This looks like cancer,’ but
‘This is what the genes inside of the cancer
actually intend for this tissue to do.’”
To make it easier to identify cancers, more
data on the behavior and genetics of tumors
must be collected and shared between institutions.
At least one company is looking to offer
that capability. A new health care technology
Chunkit Fung M.D.,
medical oncologist at
Strong Memorial Hospital
larger data observations on patients.
“I don’t want to say that cancer data is
often composed of islands of information
within each oncology practice, but that’s how I
see it,” she says.
“Some of this observational data gets
published within studies and some doesn’t,”
Kenneally says. But many patients don’t have
the luxury of waiting until the patterns are
available to lead to more informed treatment
decisions.”
Today, Kenneally is using what she has
learned as a patient along with her skills in
raising early-stage capital to get more lifescience
and medical startups the necessary
partnerships to benefit patients like her. New
Brawley says.
While some doctors are fearful of litigation
for undertreating patients, others find that
the limitations of screening are too complicated
to explain to patients, he explains. There’s
also a more basic inability to change.
Brawley says: “We’ve seen some panic and
lack of appreciation of science regarding Ebola
and health care workers recently; I see that
regularly in terms of cancer—a lack of appreciation
of scientific fact, a certain amount of
fear, and the end result being some behaviors
that are sometimes very harmful.”
Fung agrees.
“When you change the national guideline,
any policy shift is going to take time, but I
think within the health system, we also have
the responsibility to make sure that we cause
no harm,” Fung says. “I mean, that’s first: We
“And if we think
that overtreating
cancer would cause
a problem in the
patient, we are
actually causing
some harm.”
company called Flatiron Health is building the
first Web-based data platform to provide access
to anonymous patient oncology information
from institutions across the United States.
The company, funded in large part by Google
Ventures, is collecting research, clinical information,
cancer care guidelines and treatment
patterns, among other data, that one day, it
is hoped, will provide clinicians with a better,
more targeted menu of treatment options.
“Flatiron, in my opinion, is going to
revolutionize oncology,” Kenneally says. As a
business executive specializing in funding lifescience
startups, Kenneally is well-positioned
to recognize Flatiron’s potential. She has
introduced the Cleveland Clinic to the Flatiron
idea in order for doctors and patients to make
faster, more informed decisions based on
technology, massive data collection, analysis,
and an updated method of interpreting
screening and testing results are all required,
Kenneally explains, for oncologists to be able
to abandon what often seems like a one-sizefits-all
approach.
But changing the way cancer is considered
is going to take a long time, Brawley says:
“There is a group of people who don’t want it
to happen,” he says. “I see people with DCIS
(a type of breast cancer) who are offended that
a committee might want to decide that they
didn’t have cancer. Then there’s the group who
are so frightened by the word ‘cancer’ that
they feel everything must be done to treat it.
“There has to be a change in our mindset
and in our understanding of cancer, and some
doctors are just as bad as patients on this,”
do no harm. And if we think that overtreating
cancer would cause a problem in the patient,
we are actually causing some harm.”
Kenneally has seen this first hand. She
recently watched a friend suffer, in no small
part, from the same program Kenneally
declined to follow. Her friend, whose cancer
did progress, recently died. Kenneally now
wonders how much the treatment contributed
to her suffering and whether the months by
which the treatment extended her life were
worth the pain.
“A year ago we were walking along the
canal path in Pittsford having ice cream.
(Now) she’s dead. So, you look at that. Now,
her cancer had a faster growth rate, so she
wouldn’t be going down an observational
path, but you know she had her kidney out.
She had a tumor removed, and they gave her
all that caustic treatment, and you know, it
just makes me wonder...”
Issue 9 January / February 2015 | POST 37