Gabriel Miller; Richard Schilsky, MD


June 25, 2014

At the American Society of Clinical Oncology (ASCO) 2014 annual meeting, Richard L. Schilsky, MD, chaired an education session, "50 Years of Precision Medicine: Advances in the Field and Prospective and Innovative Randomized Clinical Trials." During the session, Dr. Schilsky, who currently serves as ASCO's first Chief Medical Officer, predicted that patient engagement would be one of 4 advances revolutionizing cancer care in the 21st century.

In an interview with Medscape, Dr. Schilsky discussed how patients' involvement in their own care will affect the field of oncology, as well as medicine at large, as technology creates opportunities for greater transparency between physicians and their patients.

Medscape: At ASCO, you suggested that patient engagement -- alongside big data, payment reform, and cancer panomics -- would be the "fourth revolution" affecting how cancer is treated in this century. How do you define patient engagement?

Richard Schilsky, MD

Dr. Schilsky: To me, what that really means is that today's patients are generally much better informed than patients in the past. They have access to much more information about their own personal medical condition as well as about medicine in general.

That is enabling them to be more actively involved in managing their own care and to take more responsibility for achieving the best outcomes of their care. Patients are becoming more of a partner with their healthcare team to achieve the optimal outcomes than has been the case in the past. Now, patient engagement, to some extent, is always going to be dependent upon the personality and the characteristic of each person. It's going to be dependent upon the context of the clinical situation and so on, but I think at the end of the day, what we are really talking about is a circumstance where patients are feeling much more empowered, much bolder, and much better equipped to really participate in making key decisions that affect their health and their healthcare than ever before.

Medscape: Big data, payment reform, and cancer panomics are often cited as revolutionary forces affecting patient care. Patient engagement is not, relatively speaking. How will patient engagement have as significant an effect as these other widely recognized forces?

Dr. Schilsky: I think this is going to have a significant impact on both the way we do research and the way that we practice medicine in many ways. One thing, of course, that's become very important in the cancer domain is that you have patients who are interested in treatment outcomes that are not always the outcomes that are assessed in clinical trials. In clinical trials, we're typically measuring overall survival, progression-free survival, or response rate -- things of that sort. What we hear from patients all the time is, "I want to know how this treatment is going to make me feel, how it's going to enable me to function. Is it going to relieve my symptoms?" What the patient is really telling us is that they want us as physicians and investigators to consider their own patient-reported outcomes -- the new buzz word -- in both the assessment of treatment and in the prescription of treatments to them. That's one way that patient engagement is going to be increasingly important: the increasing capture of patient-reported outcomes, both in the research context and in the course of routine clinical care.


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