The democratization of cancer care

A rise of almost 50 percent until the year 2040, this is what the American Cancer Society expects for the global cancer burden. One of the reasons for this is the fact, that only selected patients receive best-in-class cancer care in many societies – because it is time-consuming and cost-intensive. Tobias Gass, Tomasz Morgas and Christopher Boylan from Varian, a Siemens Healthineers company, have contributed to a solution that democratizes cancer care. They enable adaptive radiation therapy within the standard time slot of care, and they are awarded as Siemens “Inventors of the Year 2021” in the category “Outstanding Invention”. 

“Clinicians have for a long time wanted the ability to efficiently adapt radiotherapy treatments to daily changes in patient anatomy,” explains Tomasz Morgas, product manager at SHS Clinical Solutions. “An adaptive treatment plan that takes into account the daily changes and adjusts the dose distribution of radiation therapy enables the reduction of treatment toxicity and better tumor control.” The technology that enables such adaptive treatment plans is called ETHOS Therapy.

“ETHOS therapy democratizes advanced cancer care through efficient workflows that are enabled and supported by automation”, says Tobias Gass, Manager Treatment Session Adaptation at SHS Adaptive Solutions. Tobias and Tomasz are both based in Baden, Switzerland. The team they work with is based in five different countries and consists of more than 130 people. 

For the latest improvement of the ETHOS workflow, Tobias and Tomasz closely collaborated with Christopher Boylan, based in Finland. While the colleagues in Baden took care of the patient modeling workflow, Christopher and his team in Helsinki worked on the treatment plan adaptation software inside ETHOS.

“The workflow that we built together with the ETHOS team from Baden is guiding the user from an initial prescription,” Christopher explains. During initial planning, ETHOS therapy quickly produces several customized plans, showing the possible radiation dose distributions and how those meet the clinical treatment goals. Then, each day, the clinician selects the plan—original or adapted—that meets their intent.

The game-changing improvements that make ETHOS suitable for standard care are its accuracy, speed, and intuitiveness. “ETHOS therapy asks the user simple questions,” Christopher says, “and always only one question at a time. For example: Is the acquired image acceptable? Is the patient model created correctly? And then, the final question is being asked: Do you prefer to continue as planned or adapt?” Through such questions, the user is safely guided by the technology.

“Through collaboration with clinicians, researchers and business leaders we were able to understand their needs, and establish clear goals”, Tobias says. “Together with Tomasz and Chris and their teams we discussed how technology could help to fulfill those needs. We defined the clear goal that adaptive radiation therapy should be possible in a standard treatment time slot.”

“We see first adoptions in community centers where adaptive radiation therapy was previously completely unavailable,” Tomasz says. So far, the feedback they get is that in more than 80% percent of the cases, the user opts for the adaptive plan. He adds: “We see this as a proof that the concept works. And we also see the type of delegation of authority that we wanted to make possible: from doctors to technicians. It saves the doctors time for tasks that need their expertise.”