By - Dr. Raj Nagarkar, MD & Chief of Surgical Oncology & Robotic Services, HCG Manavata Cancer Centre, Nashik.
About a decade back, Artificial Intelligence (AI) seemed like a script of the Sci-fi movie but today in 2023, AI has become a reality and a catalyst for transformation of the world into a new digital era. Today we all are governed or guided by AI in some or the other way, be it Facebook or other social-media handle feeds, or even if we are searching online for directions or a good restaurant, a movie, most of our search engines are guided or forced upon us by AI. Does it mean that AI is bad? Not really. Science takes time to mature and we are in that era where AI has started taking baby steps and it will definitely help us in the long run, across various aspects of our life.
So as a cancer surgeon how do I feel or where all in today’s scenario does AI play a role in diagnosis treatment, or research as far as cancer is concerned. If we try to divide AI in cancer it will be in four different categories – AI in cancer research, means facilitating early diagnosis or drug discoveries
AI in Screening or early diagnosis - this early diagnosis needs to be accurate diagnosis because if it is not accurate it will be a waste. In a country like India – breast cancer and cervical cancer is the most common type of cancer ailing the women population whereas oral cavity cancer is most common in men. How can AI impact early diagnosis or screening of these modalities? For example – breast cancer mammography which is a very good tool, however there is a scarcity of trained radiologists to report the reading of mammography so AI can have pre-determined various models or various algorithms wherein if a mammogram is done and fed to the computer based on the algorithms set up the mammogram is read and can detect if this is a cancerous case or not. Also, if required it can flag an additional clinic consultation if needed.
Similarly, when it comes to cervical cancer – Paps smear or other related tests can be done in a fraction of a second by AI guided microscopic reporting. Similarly, as oral cavities is concerned very happy to share that HCG Manavata is now part of a global study where we are trying to identify pre-cancerous and cancerous legion of the oral cavity with help of a simple photograph which can be taken by your own mobile phone like a selfie of your oral cavity. All of us are so tuned to take selfies either with pouts or without – now take a selfie of your oral cavity with your mouth open at certain angles and positions so we are looking to develop close to 3 Mn algorithms wherein one you take a photograph of the oral cavity if there is pre cancer legion your app in the phone will detect it and raise a red flag and will tell you what care needs to be done and what are nextsteps in clinical consultation. Also, will tell you the nearest specialist you can visit.
When it comes to treatment for cancer obviously the major role already being played by AI is in robotic surgery. AI guided robotics surgery has helped improve the precision for the surgery and reduce the possible risks of complications at the same time AI enabled models help in the training part when the surgical is going through the training for robotic surgery program. It is well known that, better to sweat in peace rather than bleed in war – so most of us before really starting our surgical program on the patients we go through AI enabled virtual training and after that we go into cadaver models or animal model before we are ready to embark on surgical proceedings on humans.
In Medical oncology or chemotherapy – precision medicine that is laboratory to bedside, most of the chemotherapeutic drugs are now tested in the lab in such a way that are actually being tested on patients. So one can pre-empt which drug is likely to stir a positive response from the patient and thus reducing the chances of side effects and benefits is enhanced immensely
In pathology various AI enabled advanced tests are there to improve not only diagnosis but also decision making. Self-programming something we have not heard of is, now being brought into clinical practice RT cell therapy / immunotherapy is now the realty which has come, and this is possible only due to AI.
With the tremendous advancement of technology, we can leverage marvels like AI to build better medical facilities and procedures which will not only enhance the present-day healthcare eco-system but also help develop future drugs and procedures to combat the terminal illness and thus help create a heathier and safer future.