Abstract
Cambrosio et al. (2018. “Extending Experimentation: Oncology’s Fading Boundary Between Research and Care.” New Genetics and Society 37 (3): 207–226) argue that “experimental care” in contemporary oncology involves the rapid merging of patient research and care, and invite further study into developments across other health conditions. We present a 2018–2019 study of experimental breast cancer care in an urban clinical setting in the light of two other studies in the same hospital group: in the same cancer service (2013–14) and, prompted by these earlier findings, an interview study in HIV services (2014–15). We found that patients and staff anticipated better outcomes by treating sub-types of breast cancer but they also hoped for a better one-size-fits-all approach, akin to the antiretroviral treatments introduced for HIV and explored in our interview study. We conclude that the promise of targeted treatment for sub-types of disease – variously described as experimental care, personalised, precision, stratified and sub-group medicine – is accompanied by hopes for a single, standard, effective approach.
Highlights
Developments ranging from genomics to data analytics and the involvement of patients and the public suggest a new dawn in biomedical research
We hope to show that research and care build on as they supplant previous platforms for experimental care by looking at two different health conditions We ask in conclusion whether experimental care offers a better future of standardised as well as subgroup treatments
Cambrosio and colleagues associate experimental cancer care with a distributed platform for research participation, which rapidly translates research findings into service protocols, we found that staff and patients recognised the benefits of joining formal research studies to obtain “better” care directly
Summary
Developments ranging from genomics to data analytics and the involvement of patients and the public suggest a new dawn in biomedical research. Evolving platforms promise to deliver successful treatments based on a more precise classification of disease types and perhaps novel aetiologies. Very often, this success is envisaged through a contrast with a previous one-size-fits-all approach that delivered the same treatment to everyone who had the same broad diagnosis. That today’s hopes ignore the diversity of previous and contemporary platforms for research and care These have led to exactly the broad standardised interventions – through vaccination or antiretroviral treatments for HIV for example – that seem outmoded as well as targeted interventions for subgroups. We hope to show that research and care build on as they supplant previous platforms for experimental care by looking at two different health conditions We ask in conclusion whether experimental care offers a better future of standardised as well as subgroup treatments
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