Hagar M. Mohamed, Mahmoud Khalifa, Amina Toumi, Muna Ali
Major engineering advances synthetic biology, precision genome editing, nanotechnology, advanced biomaterials, scalable manufacturing, and artificial intelligence are converging to enable therapeutic paradigms that could shift oncology from long-term disease control toward durable cures. Yet technical breakthroughs alone are insufficient. Realizing care-driven care at scale requires adaptive regulatory frameworks, outcome-linked financing models, federated data governance, manufacturing policy for decentralized production, and equity-centered implementation. This paper synthesizes the engineering frontier, maps translational bottlenecks, and proposes a practical policy-aware translational ecosystem the Cure-Driven Partnership Model (CDPM) to accelerate safe, ethical, and equitable deployment of curative cancer interventions. We conclude with prioritized research objectives, governance recommendations, and an implementation checklist for stakeholders.
Javier David Benítez Fuentes, Rodrigo Lastra del Prado, Miguel Borregon-Rivilla, Alicia de Luna Aguilar · 15 authors
Despite significant advances in oncology, cancer care globally continues to face critical challenges, including stark disparities in access, insufficient preventive focus, fragmented primary health care (PHC) integration, unsustainable financing models, workforce shortages, and inadequate community involvement. This paper revisits the Alma Ata Declaration's principles-health equity, universal access, preventive care, and community participation-as a conceptual framework to address these persistent issues in cancer care. We highlight opportunities to strategically integrate oncology services within strengthened PHC systems, balancing centralized specialist resources with decentralized community-based care. Evidence from diverse settings illustrates how reinforcing PHC infrastructures enhances preventive measures, early detection, and survivorship care, thus mitigating geographic and socioeconomic disparities. Sustainable financing mechanisms and targeted workforce strategies, including task-shifting and multidisciplinary training, are proposed as essential components. Effective community engagement models demonstrate improved care relevance, acceptance, and outcomes. Additionally, we emphasize the critical role of health policy alignment with universal health coverage objectives, robust pharmacoeconomic evaluations, and evidence-based national cancer control plans. Integrating Alma Ata's principles into contemporary oncology provides a viable, scalable model to advance equitable, accessible, and sustainable cancer care globally, laying the theoretical groundwork for future research initiatives and informed policy development.
Open access
Economic and Financial Impacts of Cancer
Health Systems, Economic Evaluations, Quality of Life
The non-fungible tokens (NFTs) mark an evolution in ownership of healthcare data. This chapter provides an overview of healthcare data ownership and its significance in the process of merging NFTs with the healthcare system. NFTs are digital assets built on top of a blockchain with a unique identification number and metadata that cannot be copied, making them arguably very well suited to revolutionising the generation, sharing, and control of healthcare data. The versatility of their application is highlighted by reviewing several patient records, medical images, and research data. The chapter further delves into contemporary issues regarding healthcare data ownership. NFTs can improve data provenance and security, introduce smart contracts allowing for controlled access, and enable health data to be monetised so that patients are active stakeholders in their healthcare journey. The chapter discussed the several advantages provided by NFTs and challenges such as the adoption of technical tools, legal and ethical issues, data security risks, and regulatory compliance, which must be overcome when using NFTs in healthcare. The chapter concluded with a focus on the future prospects of NFTs in healthcare to develop a system that maintains new ideas while protecting the patients.
Gareth Baxendale FBCS CITP, Head of Technology at the NIHR Clinical Research Network, asks whether bitcoin’s blockchain technology can revolutionise electronic patient records (EPRs).
Many cancer centers reach out to their elected officials by meeting with them on Capitol Hill and inviting them to tour their institutions. But few go as far as the Ohio State University Comprehensive Cancer Center (OSUCCC). At this National Cancer Institute-designated center based in Columbus, Ohio, elected officials and their staffs take on the roles of patients, researchers, or healthcare providers to gain a more personalized understanding of the importance of translational research and its impact on patient care. “At the end of their visit, we have roundtable discussions, and the feedback is always, ‘we never knew how complex cancer care and research is’,” says Jennifer Carlson, director of government relations for OSUCCC. As further proof of the program's success, legislators discussing cancer-related legislation at government hearings have referred to their participation in Project Cancer Education and the knowledge they gained from it, Carlson notes. “This hands-on program literally takes policymakers from the bench to the bedside and helps them understand some of the challenges we face,” she says, adding that it also helps illustrate some of the lost opportunities that can occur with lack of government investment or support of medical research and care. Because Project Cancer Education has been so successful in Ohio, OSUCCC Director Michael Caligiuri, MD, who was recently elected president of the Association of American Cancer Institutes (AACI), proposed making it available to member centers across the country. The program is “the cornerstone of our advocacy efforts this year,” he notes. “We have had amazing success in seeing important anticancer legislation move forward in Ohio because of the impact Project Cancer Education has had on our elected officials,” Dr. Caligiuri says. “We are asking the community of American cancer centers through the AACI to implement this best practice at their centers because it will help to justify the greater investment in cancer research and make our elected officials and staff aware of why our cause is such an urgent one.” Participants in Project Cancer Education learn about the challenges of cancer care through role-playing scenarios. Carlson is chairing the committee within the AACI that is developing a toolkit based on her center's existing collateral materials for all member centers to refine and adopt to fit their specific needs. They plan to have the materials available this spring. Additionally, they are working with the National Cancer Institute to roll out a similar program for congressional committee staffers who are based in Washington, DC. The toolkits will include different “tracks,” such as a patient scenario or a researcher scenario. The program can range from 2 hours, geared mainly toward the elected officials, to a half-day or full day, which is designed for their staff members. Participants also receive graduation certificates and pose for a photograph, which is later E-mailed to them to reinforce the program's messages. The program that supported your research has been eliminated because of federal budget cuts. Your second- and third-year budgets have been zeroed out. The institutional review board determined that you did not plan to have enough research nurses for your proposed phase 1 study. Wait 6 months and try again. Due to cuts in federal funding line for your grant, your budget has been reduced by 30% for the next 3 years. Visits to cancer care and research facilities allow participants to see the intricacies of discovery and treatment firsthand. Participants encounter positive results too, such as, “The drug you developed is ready to come to market and is expected to bring in large profits to the university during its patent lifetime. The new science building on campus will be named in your honor.” In the patient scenario, some of the challenges participants learn about are lack of insurance coverage for clinical-trial patient-care costs, the importance of proper insurance authorization for specific treatments, and the intensive recovery that occurs with an allogeneic marrow transplant for acute myeloid leukemia. In some cases, policymakers get a chance to talk with patients participating in clinical trials who are living proof of research's value, Carlson notes. She is confident that cancer centers across the country will find the program beneficial. “By partnering with our elected officials, we can take cancer care to the next level,” she says. The Ohio legislative cancer education program, Project Cancer Education, is set to roll out nationwide. The program gives elected officials a chance to walk in the shoes of researchers and patients. Legislators and their staffs experience firsthand the challenges faced by cancer centers. Cancer centers will receive toolkits from AACI to help tailor their own programs.
BACKGROUND: Changing patterns of patient referral, decreasing payments for service provision, confusing network participation and reimbursement, as well as challenges to autonomous clinical decision-making jeopardize the traditional role of the oncologist in delivering cancer care. The cancer patient also may be at risk with unproven cancer delivery systems that displace the oncologist as decision-maker and care provider. The authors have constructed a model that preserves the oncologist's clinical and financial autonomy while meeting marketplace demands for improved access, decreasing costs and preserved quality of care. METHODS: During a 4-year period, a group of private practice medical oncologists initiated a formal business plan to evaluate marketplace needs, then designed and implemented a novel cancer care delivery model. The model required reconfiguring the practice into an integrated Joint Commission on Accreditation of Healthcare Organizations-certified cancer service corporation, providing medical, radiation, and gynecologic oncology. Palliative care, pain management, psychologic, and nutritional services were instituted as well as the vertical integration of home health and hospice care. Clinical pathways and treatment protocols were designed to enhance patient care and facilitate cost-of-care projections in designated populations using a cancer incidence forecasting model. Outcomes analysis are performed as part of ongoing continuous quality improvement, which continues to change this health care delivery system. RESULTS: In the 3 years since implementation of the model, the practice has increased from 16 to 24 physicians, and the number of offices has increased from 12 to 17. Patient encounters, both new and established, have doubled. Cost of services, specifically hospitalization, have been reduced by 50%. Clinical research referrals have increased 300%. Physician compensation has improved >20%. CONCLUSIONS: The model created a low cost, high value provider not burdened by allocated overhead. Decentralized care enhanced community access, which improved patient compliance, enhanced patient satisfaction, decreased hospitalization, and thereby decreased cost. The horizontal structure permited the flexibility for varied purchaser products and politically sensitive physician and hospital provider panels. Consensus-based protocol and pathway determination achieved maximum physician participation, which preserved clinical and financial autonomy, decreased variance, and facilitated clinical research.