There is a slow and steady march toward treating each individual—each unique patient—as an n of 1.
Novel assays and targeted therapies are being developed to one day address each person’s distinct medical needs. Nowhere is this inexorable progress more evident than in cancer care.
But what happens when a new targeted therapy is tested on a small group of cancer patients—say 50—and 49 go on to die, while one individual experiences a complete and durable remission?
Routinely, that drug is considered a failure and further investigation is stopped in its tracks. Should this be the case?
What about that single individual who experienced a remarkable response; what was it about this person that was so different from all others in the study group?
What about patients that incorporate integrative medicine and core lifestyle approaches into their conventional oncology care? And those that refuse conventional care altogether, and go on to achieve remarkable clinical outcomes using alternative medicine?
What is it about their biology, genetics, mindset, relationships or overall method of care that was so effective? Should these outlier cases be chalked up as simply ‘the lucky ones’—anecdotal cases not worthy of closer inspection?
Should integrative oncology approaches be viewed under the same lens as precision medicine?
Delivered comprehensively, integrative oncology is truly personalized care focused on the host—the patient herself. At varying degrees it can not only mitigate conventional treatment side effects, but can also impact underlying malignancy.
I am advising Harvard Medical School’s Department of Biomedical Informatics on their NEER (Network of Enigmatic Exceptional Responders) study. NEER is doing a big data exploration into the phenomena of what makes an exceptional responder so exceptional.
I am also personally registered as a participant in this retrospective study and have agreed to submit all clinical notes, tissue samples and slides, and pathological reports covering my 27 year case. My DNA will undergo whole genome sequencing. My microbiome will be assessed. I will wear a Fitbit to measure my level of physical activity, calories burned and sleep patterns.
I share my thoughts on exceptional responders and the NEER study in a new commentary in the Journal of Alternative and Complementary Medicine’s Special Focus on Integrative Oncology.
The publisher has agreed to make the article open-access (free) until October 24, 2018. I encourage you to read it.