Yeah. It then gets even more complex when a cancer spreads as another secondary cancer to a different part of the body. You suddenly get the specialists scratching their heads about who guides the treatment.
I knew someone a while ago (who recovered) who had a secondary brain tumor. His doctors basically admitted -- they had no idea what effect the cocktail of drugs he was taking would do. The drugs were complex in themselves, let alone in (probably unique) combination.
I think one very accessible innovation in medicine is genetics and drugs. Even just (relatively) simple genetic-drug effect matching could yield some big improvements.
This is already beginning to happen- melanoma patients are screened for V600E mutations to determine if they can receive new treatments, as with breast cancer and tamoxifen or her petit although this happens with immunohistoxhemistry rather than sequencing.
The V600E mutation also appears in some other cancers (bowel, from memory) so occasionally used there too
The BRAF V600E gene mutation occurs in about 55% of melanomas. The fact that there are targeted therapies to address that mutation is hopeful. Unfortunately, the first generation BRAF-inhibitors showed quick and early promise (shrinking many patients' tumors tremendously), these effects only last 12 to 18 months (at most), as new melanoma cells develop in the body resistant to the BRAF-inhibitation. So, now trials are combining BRAF-inhibitors with MEK-inhibitors to attack the path that melanoma cells often take to circumvent the BRAF-inhibitation. This approach is showing further progress.
It's a bit like whack-a-mole. Unfortunately, it takes time and money to find the best treatment paths.
Fortunately, more progress has made in the fight against melanoma in the last five years than the previous twenty. As a 2.5 year melanoma survivor (Stage IV in Summer 2012), I'm appreciative of this fact each and every day.
I knew someone a while ago (who recovered) who had a secondary brain tumor. His doctors basically admitted -- they had no idea what effect the cocktail of drugs he was taking would do. The drugs were complex in themselves, let alone in (probably unique) combination.
I think one very accessible innovation in medicine is genetics and drugs. Even just (relatively) simple genetic-drug effect matching could yield some big improvements.