Transforming cancer care by 2040: Glossary

Terms And Definitions

Adaptive and assistive technologies: Devices that mitigate cognitive and physical side-effects and impairments, such as ergonomic tools, that help people living with cancers as well as survivors improve their performance at work and at home.¹

Digital Radiology: Digital radiology uses imaging techniques like X-rays to create detailed pictures of the inside of the body, which can be displayed on a computer.² This can be aided by artificial intelligence (AI) which is increasingly being integrated into digital radiology workflows to help doctors analyze these images more quickly  and accurately, increasing the volume of medical images that can be analyzed by one person.³

AI-driven predictive analytics: AI and machine learning use data and algorithms to make predictions and has the potential to integrate diverse datasets to predict cancer risk.⁴

Antibody-drug conjugates (ADCs): These treatments combine a protein called an antibody with a cancer-fighting drug. The antibody is designed to find and attach to cancer cells by recognizing specific markers on their surface. Once the antibody connects to the cancer cell, it delivers the drug directly inside, where it can effectively kill the cancer without harming cells nearby.⁵

Biomarker: A biomarker is a biological molecule found in blood, bodily fluids and tissues, that is a sign of a normal or abnormal process, or of a condition or disease. A biomarker can be used to see how well the body responds to a treatment for a disease or condition.⁶

Biomarker testing: This can be conducted using tissue or blood samples, immunohistochemistry or genetic sequencing, and is often used during diagnosis to inform treatment selection.⁷

Bispecific antibodies: These treatments target two different protein markers at the same time helping the immune system recognize and attack cancer cells more effectively.⁸

Blockchain-based healthcare wallets: A health data wallet is a secure digital repository for all health-related information in one place.⁹ This can be integrated with blockchain technology, an advanced databased mechanism that allows transparent information sharing within a business network.¹⁰ This technology has the potential to empower patients, ensure interoperability, transparency and security in transactions.⁹

Cancer vaccines: These are designed to help the body’s immune system recognize and attack cancer cells. Unlike other types of vaccines that help prevent illnesses, cancer vaccines can either help prevent certain cancers from developing by targeting viral infections that increase the risk of cancer development (such as Hepatitis B or Human Papillomavirus) or treat cancers that are already present by stimulating the immune system to attack the cancer cells.¹¹

CAR-T cell therapies: This technology uses a patient’s immune cells, called T-cells, and modifies them to make them better at finding and destroying cancer cells. These therapies can offer a targeted way to treat cancer.¹²

Cholangiocarcinoma: Cholangiocarcinoma is bile duct cancer; a rare condition where cancer cells form in the bile ducts, which are a network of tubes that connect the liver, gallbladder and small intestine, and collect bile.¹³

DALY: The DALY (disability-adjusted life year) is a metric used to quantify the overall burden of disease on individuals in different populations. It is calculated by combining years of life lost due to premature mortality and years of life lost due to time lived in states of less than full health, or years of healthy life lost due to disability. One DALY represents one lost year of healthy life, emphasizing the overall health gap caused by disease or injury.¹⁴

Digital and computational pathology: This technology combines digital pathology, where a sample is first digitized, with AI and machine learning, to analyze images consistently and in a level of detail not visible to the human eye, helping to generate more precise diagnoses.¹⁵ This technology could help to overcome barriers to diagnosis like location and shortages of equipment and specialists.¹⁶

Digital twins: In healthcare, a digital twin is a virtual substitute of a human body that allows scientists to examine possible outcomes of various treatments. In the future, a cancer patient’s digital twin could be used for research and clinical trials aimed at developing personalized medicines, for simulating treatment outcomes and side effects and for supporting clinicians in their care decisions.¹⁷

DNA damage response targeted therapies: The biological mechanisms that repair DNA play a key role in driving cancers, which often have deficient DNA repair capabilities.¹⁸ By developing treatments that inhibit the DNA repair pathways of cells, it is possible to stop cancer cells from repairing their DNA, thereby killing them. However, to implement this, biomarkers must be identified in patients with underlying changes in DNA repair pathways, to enable them to be targeted with these therapies.¹⁹

Electronic pathway solutions: These solutions often involve creating a tool to guide healthcare professionals through each step of the diagnostic process, from initial patient evaluation to final diagnosis and treatment of a suspected cancer.²⁰ This helps doctors to offer guideline-concordant care, reduce delays and uncertainty for patients, and improve communication between different members of a patient’s multidisciplinary team.²¹

Epigenome: The epigenome consists of chemical compounds that modify or mark the genome in a way that tells it what to do, where to do it and when to do it. Different cells have different epigenetic marks, which are not part of the DNA itself, but can be passed on as cells divide, from one generation to the next.²²

Epigenetic therapies: These therapies target the epigenome, or the heritable modifications to the way in which the DNA code is expressed. In cancerous cells, genetic and epigenetic changes work together to maintain cancer progression.²³ As epigenetic changes to cell expression are reversible, therapies are in development which aim to reprogram cancer cells into a non-cancerous state.²⁴

Fiscal space: The capacity of a government to allocate resources for a desired purpose without jeopardizing its long-term fiscal sustainability.²⁵

Genome: The genome is the entire set of DNA instructions found in a cell. In humans, the genome consists of 23 pairs of chromosomes located in the cell’s nucleus as well as a small chromosome in the cell’s mitochondria. A genome contains all the information needed for an individual to develop and function.²⁶ Studying the genome may help researchers understand how different types of cancer form and respond to treatment, which can help find new ways to diagnose, treat and prevent cancer.²⁷

Healthcare funding: Healthcare funding refers to the sources of financial resources allocated to health systems, which mainly include taxation, private health insurance, and social health insurance.²⁸

Healthcare financing: Healthcare financing is a core function of health systems that enables progress towards universal health coverage by improving effective service coverage and financial protection. The World Health Organization’s (WHO) recommendations on health financing include contracting and payment arrangements that can incentivize care coordination and improve quality of care, and sufficient and timely disbursement of funds to providers to help to ensure adequate staffing and medicines to treat patients. The WHO’s approach to health financing focuses on the following core functions: revenue raising, pooling of funds and purchasing of services.²⁹

Liquid biopsies: Non-invasive tests on bodily fluids including blood and saliva that can identify oncogenes and/or cancer cells that have been shed from tumors and are freely floating in a person’s body.³⁰

Multi-cancer early detection (MCED) tests: A type of liquid biopsy test, that is currently under development, that has the potential to detect many kinds of early-stage cancer cells in a single blood sample.³¹ This can lead to a decrease in costs and increase in effectiveness of early identification, if proven effective.³² This technology can also be used to detect minimal residual disease (or MRD), where cancer cells remaining after treatment can’t be detected by traditional scans or tests.^33,34 These cells have the potential to come back and cause relapse in our patients.

MR-Linacs: Magnetic Resonance Linear Accelerator (MR Linac) combines two technologies – an MRI scanner and linear accelerator, to precisely locate tumors, tailor the shape of X-ray beams in real time and accurately deliver doses of radiation to moving tumors. The technology can significantly reduce treatment times, side effects and inconvenience for patients.³⁵

Online support services: These services – which include emotional support, financial aid, education, and rehabilitation – are evolving with the integration of digital platforms that enhance their accessibility and efficiency.³⁶ For instance, virtual support groups,³⁷ AI-powered counselling apps, chatbots,³⁸ and online financial navigation are helping patients overcome barriers in their patient journey.³⁹

Point-of-care (POC) diagnostic devices: POC diagnostic devices conduct clinical, laboratory tests close to the site of patient care or where treatment is provided. POC diagnostics tend to provide rapid test results with the potential to improve clinical and economic outcomes compared to traditional laboratory testing.⁴⁰ Examples of commercially available POC diagnostics include PSA test for prostate cancer, fecal occult blood for colorectal cancer and nuclear matrix protein for bladder cancer.⁴¹

Primary cancer prevention: Primary care prevention measures include interventions that block the initiation of cancer by altering exposure to risk factors such as tobacco smoke, alcohol, occupational carcinogens, radiation, overweight and obesity, and other factors that are modifiable by changes in behavior or policy.⁴²

Proteomics: Proteomics is the study of the structure and function of proteins, including the way they work and interact with each other inside cells.⁴³

QALY: Quality-adjusted life year is a measure of the state of health of a person or group, in which the benefits (in terms of length of life) are adjusted to reflect the quality of life. One quality-adjusted life year (QALY) is equal to 1 year of life in perfect health. QALYs are calculated by estimating the years of life remaining for a patient following a particular treatment or intervention and weighing each year with a quality-of-life score (on a 0 to 1 scale). It is often measured in terms of the person’s ability to carry out activities of daily life, freedom from pain and mental disturbance.⁴⁴

Quantum technologies: Quantum technology in healthcare, specifically oncology care, is an emerging field that has multiple potential applications in precision diagnosis, including the analysis of genomic and omics data to reveal trends in cancer types.^45,46 Quantum technology can enhance medical imaging and provide increased accuracy compared to current methods. Researchers have used a quantum framework to analyze mammograms and automate the segmentation of images to identify abnormalities.⁴⁷ By minimizing the need for annotated datasets (used by existing techniques), this method is time saving and could accelerate time to diagnosis.

Radioconjugates: These therapies use a combination of radioactive materials and special targeting molecules to attack cancer cells.⁴⁸ The radioactive part releases radiation that can kill cancer cells, while the targeting molecules help guide the treatment directly to the tumor, sparing nearby healthy tissue.⁴⁹

Radioimmunotherapies: Radioimmunotherapy is a type of radiation therapy in which a radioactive substance is linked to a monoclonal antibody and injected into the body. The monoclonal antibody can bind to substances in the body, including cancer cells. The radioactive substance gives off radiation which may help kill cancer cells. It is being used to treat certain types of cancer such as lymphoma.⁵⁰

Secondary cancer prevention: Secondary cancer prevention measures aim to detect cancer early and stop it from getting worse. It includes screening tests to identify and treat cancer early in its development. Primary and secondary prevention strategies together can reduce the cancer burden by one third to a half and are therefore cost effective and core components of a national cancer strategy.⁴²

Social return on investment (SROI): SROI is an expanded form of cost benefit analysis that seeks to capture the social, economic and environmental impacts of interventions, as well as acknowledge the potential negative effects of services. SROI provides a robust framework to conduct a forecast evaluation to determine the value and return on investment, and to inform evidence-based policy and investment strategies.⁵¹

Targeted therapy: Today’s targeted therapies work by interfering with specific proteins that help tumors grow and spread throughout the body. Because a cancer cell mutates further as it tries to adapt and survive a treatment, ongoing innovation is needed in targeted therapy to address the most common “resistance mutations” for today’s targeted therapies.⁵²

Telemedicine platforms: Telemedicine can enhance access by reducing barriers such as travel distance or scheduling conflicts for specialist care, especially for rural or underserved populations. Through video consultations, survivors can regularly connect with therapists, counsellors, or support groups from their homes, ensuring continuity of care without the need to travel.^53,54

Tertiary cancer prevention: This aims to reduce morbidity and disability in cancer patients, as well as preventing secondary cancers and long-term complications.⁵⁵ It may include regular screening and monitoring, rehabilitation programs, psychological support, nutritional counselling, and support in managing side effects of treatment.⁵⁶

Total-body Positron Emission Tomography (PET) scans: This technology provides 40-fold greater sensitivity than traditional PET scans, conferring greater ability to determine whether cancers have spread.⁵⁷

Volatile organic compounds (VOCs): VOCs are chemicals that can easily evaporate into the air, including through a person’s breath or other bodily fluids.⁵⁸ Researchers are exploring how the identification of these compounds in a sample given by a patient can serve as biomarkers to identify cancer earlier and non-invasively.⁵⁹

Wearables: Wearable devices, worn on the bodies of patients, offer opportunities to innovate and improve cancer care delivery from prevention and screening to survivorship. Wearables may be used to support a range of activities including real-time monitoring of patient data such as heart rate, blood pressure or sleep quality, as well as allowing patients to directly report symptoms using the device. This allows for more accurate and ongoing data collection for patients, which can be used to manage and adjust treatment, and to predict the potential of negative outcomes such as hospitalization. Integrating wearables into cancer care holds promise for improving outcomes for patients across the care pathway.⁶⁰

Whole genome sequencing (WGS): This involves sequencing an individual’s entire genome and is the most comprehensive form of genomic testing currently in clinical use. It enables a wide range of variant types in many genes to be tested for simultaneously.⁶¹ When used in cancer patients, WGS can identify why a cancer developed, how the cancer may behave, most effective treatments, any risk of developing other cancers in the future, and implications for family members.⁶²