Treatment for cancer is as diverse as cancer itself. Depending on the type of illness, its stage, and numerous patient factors, treatment may include radiation, oral medications, chemotherapy, or surgery. The course of treatment is often referred to as “Standard of Care.” The National Cancer Institute defines the standard of care as “treatment that is accepted by medical experts as a proper treatment for a certain type of disease and that is widely used by healthcare professionals. Also called best practice, standard medical care, and standard therapy.” These are the guidelines for treating the vast majority of cancer types affecting patients in the US, approved by the FDA.

These practices are written by the National Comprehensive Cancer Network (NCCN), a non- profit alliance of US-based cancer centers designated by the National Cancer Institute (NCI) to produce guidelines on cancer treatment options and management. The people and the research that produce these guidelines are world class and highly applicable. However, as far too many people have experienced, cancer is a moving target and updating comprehensive guidelines by committee is a methodical process.

In addition to the NCCN guidelines, cancer and research centers are constantly producing and updating new information. For example, MD Anderson (repeatedly rated the top cancer center in the country) publishes 7-10 cancer research papers per day, and that’s just one institution! We need to move away from the idea that physicians can both consume all available research on cancer treatment and treat patients all day.

Upon hearing Robert’s story after his death, a world renowned oncologist and clinical investigator told me that “medical schools train doctors to administer the right treatment, but not how to unwind the wrong treatment.” The latter could save lives. In order to make a course correction, you must recognize you’re on the wrong course. Then, when patients do receive an inaccurate or incomplete diagnosis or a treatment that isn’t right for them, there needs to be a more comprehensive assessment of alternatives.

1104Health and the cheryl app aims to empower patients with better alternatives.