According to the World Health Organization (WHO), by 2030 the number of new cancer cases will reach 21.6 million per year – a 53 percent increase from 2012. Cancer is a chronic condition, which requires long-term commitment by both patients and healthcare professionals. For affected individuals, the potential benefits of digital health in terms of enhanced self-management and convenience are substantial.
A study in BMC Cancer found that technology can be used to deliver cancer follow-up at home, safely and effectively. Other research suggests that, by facilitating the early detection and management of symptoms and patient deterioration, digital health technologies may play an important role in creating more efficient and sustainable healthcare systems. Unsurprisingly, global sales of wearable self-monitoring health products are skyrocketing. According to a report from BCC Research, they will reach $18.8 billion by 2019. Yet, Philips’ 2016 Future Health Index research recently revealed that 40 per cent of cancer survivors don’t own or use connected health devices, which suggests that many may be missing out on the benefits offered by technology.
Here are some innovative ways in which digital health solutions can help improve cancer management.
Wearable health technology
Fitness bands and similar devices are currently in the spotlight for their potential to encourage healthy behaviours that may reduce the risk of cancer. But they are also emerging as key players in the management of the disease. They contain sensors that enable people living with cancer to measure their heart rate, blood pressure and body temperature, and also to track sleep patterns and activity levels.
More sophisticated versions allow the oncology team to analyse this information in real time, and advise or intervene, as needed. University of California researchers demonstrated the technology at a White House event, in October last year. They said that the collected data could “lead to better treatment decisions, better survival rates, and better understanding between physician and patient.”
Smart piezoelectric necklaces
Pioneering research is being conducted also on non-invasive ways to monitor patient adherence to treatment, which is crucial to successful outcomes. Among the many novel technologies in the pipeline is a smart necklace that a study in Artificial Intelligence in Medicine has shown can accurately detect the swallowing of medications. The device uses a piezoelectric sensor, which converts the movements that occur in the neck during swallowing into electrical signals. These are transmitted to a smart phone app whose algorithms can recognise swallowing due to medications, vitamins, saliva, drinking or speaking.
Implantable and ingestible sensors
Not all sensors have to be wearable, though. Thanks to advances in microelectronics, data processing and wireless communication, some can be implanted under the skin or ingested, allowing for the continuous and unobtrusive monitoring of key vital signs, like heart rate, or medication adherence for example.
These sensors can also alert patients and caregivers if a problem is detected, increasing the likelihood of health problems being addressed, before they become so serious that medical treatment is required.
Home blood tests
The Christie NHS Foundation Trust, an international leader in cancer research and treatment, will soon pilot a remote monitoring device that allows cancer patients to test their blood at home. The device can measure the levels of white cells and haemoglobin (a protein in red blood cells that carries oxygen around the body) from a drop of blood obtained with a finger-prick kit. Using 3G technology, the results are then transmitted to the hospital, for the oncology team to assess.
The technology can be of particular benefit to patients receiving chemotherapy. These need a laboratory blood test before each treatment cycle. And if their white blood cell levels are too low, the chemotherapy is cancelled. By enabling patients to test their blood at home, the new device can reduce the number of trips to the hospital, saving time and resources. It can also measure body temperature and assess symptoms, enabling prompt intervention by the oncology team if the patient’s health deteriorates.
Wearable therapeutic devices
Technology is opening up exciting new possibilities also in cancer treatment. Take, for example, the Optune system for patients with glioblastoma, a type of brain cancer. It is worn on the head and has four thin adhesive patches that deliver low-intensity electric fields to the brain that aim to stop cancer cells from dividing and growing. Patients can wear the device, as they go about their daily routine, while treatment is delivered in a non-invasive way for up to 18 hours a day.
Scientists at the Scripps Translational Science Institute in San Diego, California, are conducting a clinical trial of patients with metastatic cancer of the breast, intestine or prostate using cutting-edge pain-relief technology. This consists of a lightweight band that wraps around the upper calf. Called Quell, the device uses electricity to stimulate the nerves that carry neural pulses to the brain, and induce the latter to block pain signals around the body. The technology includes a smart phone app that allows patients to track sleep, physical activity and other health indicators.
Automated home-based monitoring
Cancer-related pain can also be addressed through interventions that combine remote monitoring with telecare management. This was demonstrated, for instance, in an American study published in JAMDA by researchers from the Regenstrief Institute, Indianapolis.
The study involved patients with different types of cancer – including that of the lungs, breast and stomach – who had pain, depression or both. They used an automated home-based symptom monitoring system consisting of a web-based application or interactive voice-recorded phone calls. Additionally, they received scheduled telephone calls by a nurse. By the end of the study, which lasted 12 months, the patients had significant less pain and depression.
Embracing the digital health age
With digital technology beginning to offer improved and less invasive cancer management strategies, it is hoped that more individuals and healthcare providers will embrace the digital age. Digital technology has the potential to create innovative models of healthcare delivery that empower people living with cancer.