The world of cancer is a dark place with complex, ever increasing data. Cognitive computing is poised to be the shining becon of hope which would light up an oncologists’ path to treatment. By M Neelam Kachhap
Fear of unknown has always limited the outcome of cancer. ‘Right here right now’ answers are hard to come by while a patient’s condition detoriates. Even with the new age detection tools, all cancers are not diagnosed in its early stage and all that the patient is worried about is how much time do they have left. Advance cognitive computing has emerged as a ray of hope in the fight against cancer. “Oncologists depend on a vast amount of complex, ever-changing information to find suitable care for their patients,” says Rob Merkel, Vice President, Oncology and Genomics, IBM Watson Health. “It is very difficult for a person to keep abreast and analyse this vast amount of literature and this is where cognitive computing plays a role,” he added.
Watson for Oncology is the first commercially available cognitive computing capability that analyses high volume of data, understands complex questions posed in natural language and proposes evidence-based answers. “The introduction of Watson for Oncology will be a game changer for cancer patients across the country,” says Dr Ajay Bakshi, MD and CEO, Manipal Hospitals which was the first hospital to deploy Watson for Oncology in India. The cognitive computing platform is now in use by oncologists at six locations in the Manipal Hospitals’ network to provide information and insights to physicians to help them identify personalised, evidence-based cancer care options across India.
“Cancer is a family of thousands of various complex cancer groups with varied treatment protocol with millions of evidence and medical literature. In oncology this is an era of organ preservation protocol with a thrust on minimum effective treatment and not maximum tolerable treatment with multi-disciplinary MDT team approach for optimal results for cancer patients. Watson Oncology is creating a new partnership between people and computers that enhances scales and accelerates human expertise,” says Prof Dr Somashekhar SP, Chairman and HOD Surgical Oncology Robotic Surgeon, Manipal Hospital.
But how does Watson for Oncology work? Watson for Oncology is a knowledgeable colleague to the oncologist. It is trained by Memorial Sloan Kettering clinicians to interpret cancer patients’ clinical information and identify individualised, evidence-based treatment options. The corpus of Watson is fed with numerous clinical papers, textbooks and medical journals which can remember and it can be fed with patient data. At the click of a button, the super-computer analyses all this information and provides treatment options.
“As a doctor in oncology, it is very important to keep ourselves updated with the medical information that is coming every day. However, it is equally difficult to keep pace with that barrage of knowledge due to time constraints. Technology of IBM Watson, I think, would not only help me in selecting the best treatment option for my patient, but the additional information that it gives regarding outcome data, references, side effects of drugs used. It would also be informative to the patient,” says Dr Poonam Patil, Consultant & HOD Oncologist, Manipal Hospital.
From a clinician stand point, Watson would help in personalised decision making for each individual cancer patients. “We would be able to get the ‘best standard of care’ treatment option within minutes. This would not only improve quality of patient care, but also improve our efficiency in the clinic,” says Dr Amit Rauthan, Consultant Oncologist, Manipal Hospital.
But what if the super-computer does not have Indian study to fall back on? “Watson corpus is fed with publications that are relevant. If it is appropriate peer reviewed literature, it is part of Watson,” assures Merkel. At present, the super-comp suggests chemotherapy but soon will also be able to suggest surgery. “The overall care plan shows everything today and then the detailed therapy options shows chemotherapy,” explains Merkel. “Cervical cancer is the first disease that we would show radiation and surgical intervention for. It would be a multi-disciplinary approach with all three integrated treatment solutions,” he adds.
Clearly Watson for Oncology is on the right path. In time to come rare cancers, new chemical entities and immunotherapies would also be ingested into the system. “There is an entire strategy on how we are going to integrate these things over time. We are looking at it very broadly,” shares Merkel. “What if it is a rare disease or new drug that has suddenly become available. If there is a clinical trial and peer reviewed literature we could ingest that in. But sometimes, you get into a situation where you have very rare circumstances for an individual. We are working on how we are going to address that issue in long term. There may not be a perfect paper for that patient but we have a whole range of capabilities on how to analyse patients, how to determine cohorts, how to render thoughts on how you may approach a patient like this,” says Merkel.
Recently, Manipal Hospitals announced the introduction of an expert second opinion cancer care consulting service for patients as well as oncologists. “Second opinion and multiple opinions in oncology field is a norm and with IBM’s Watson Oncology, it is not the era of second opinion, but will be the final and last opinion ever required. Beyond this, no more evidence based opinions would be required,” opines Dr Somashekhar.
“I have no doubt that this option is going to scale to many organisations quickly,” says Merkel. “Manipal is first and that is a testament to their innovative nature. But it is not going to be exclusive to Manipal it is going to transform rapidly,” he adds.
“Around the world, Watson for Oncology is deployed at 18 academic medical institutions with engagements in Europe and South Asia. It is scaling very quickly,” Merkel concludes.