Introduction: Finalizing the treatment plan to utilize on a cancer patient continues to be a collaborative process between the patient and clinician, often with input from the patient’s family. By referencing the tumor size and location from radiology reports and biomarkers from pathology reports, a patient is verbally educated on their disease and prognosis. Referencing common clinical studies and the corresponding results, the clinician provides several recommendations for treatments to the patient. A collaborative decision is made, and therapy follows. With the inability to visualize their tumor and lacking individualized treatment predictions (including associated statistics for likely success or failure), a patient is unable to fully comprehend their disease. Focused on empowering the patient, we developed clinical reports that consolidate key results from the diagnosis process, and provide visualization of a patient’s tumor prior to treatment, the predicted tumor burden post-neoadjuvant chemotherapy (NACT) and predicted growth of the tumor in absence of therapy.
Method: We performed an analysis of all key discrete elements referenced in oncologist notes during patient visits. In doing so, we found that the size of the tumor is referenced, but that a visual representation of the tumor from the various imaging modalities (e.g., MRI, ultrasound, mammogram) was not reviewed with the patient during the treatment planning process. We designed a report that combines key data elements such the ER/PR/HER2 status, stage, grade and genetic markers with patient-friendly descriptions of their significance. Additionally, via proprietary image segmentation methods, an initial 2D map of the patient’s tumor and diseased lymph nodes (with corresponding location/dimensions within the tumor) are composited on maximal intensity projections of the patient’s breast. Finally, using in silico simulations, a prediction of the most probable tumor response to recommended therapies (and without) are presented along with expected tumor dimensions and morphology, in a comparative side-by-side view.
Results: During interviews and system overviews performed with 10 medical oncologist and surgeons representing both Academic and Community Cancer Centers, 9 out of 10 oncologists agreed they did not have the appropriate tools to educate their patients and highlight the key characteristics of their disease. After review of the SimBioSys TumorScope Report, all 10 oncologists agreed to the potential enhancement of the patient – doctor collaboration and experience. Surgeons specifically highlighted the utility of the report in surgery planning.
Conclusion: Cancer diagnosis and treatment is the work of a diverse team representing multiple specialties consisting of Radiologists, Oncologists, Pathologists and Surgeons. While their collective presence in every patient meeting is unfeasible, the data collected by these groups can consolidated and presented to reflect their combined perspective. A report that is accessible to both the patient and doctor can help to “level the playing field” and provide clarity for the patient during the most critical time in their lives. While work needs to be done with patients and patient advocacy groups to determine the appropriate methods to convey both visual and textual information to the patient via clinical reports, it is clear that visualization of tumor and the predicted response can improve the patient – physician collaboration and experience.
