Patients must use internet to find better treatments, and they do. Eminent oncologist explains. Expert medical second opinion initiated by patients is very important. Dr. Anton Titov, MD. Patients become more proactive. They seek information about the disease that they have. Yes, yes. Hopefully patients can find the correct information on internet. Yes, patients are coming to us now. That's interesting. They've researched their disease. They have looked it on the internet. Patients found alternatives to the standard therapy. They come to us and say. Dr. Anton Titov, MD. "What do you think of this therapy? Do you think we should try this treatment rather than going through the usual therapy?" Dr. Bruce Chabner, MD. Sometimes their ideas are actually quite interesting. I remember this story. Maybe 45 years ago I was seeing a patient with cancer. I can't remember what kind of cancer. I think it was a uterine cancer. It was at Yale New Haven hospital in Connecticut. It was an Italian family. This patient brought to me a research medical article. It was in Italian. "I've got a new cancer medication that was being tested in Italy for cancer." Patient said "Doctor, what do you think of this new cancer treatment?" I said to the patient. "I've never heard of it before!" It turned out to be Doxorubicin. We then began testing this new cancer medication. Dr. Bruce Chabner, MD. A year or two later it turns out to be a very important cancer medication. I think that was a lesson for me. I don't know everything. I don't know all new cancer treatments. There is research going on in the rest of the world. It could be very helpful for treatment of patients. Dr. Anton Titov, MD. I think that the history of medicine speaks about that again and again. I've spoken to several colorectal surgeons. Surgeons mentioned that Professor Bill Heald. He developed the TME, the total mesorectal excision. It was an important cancer surgery method. He first developed it in the beginning of 1980s. But it had not spread around the world until almost 15 to 20 years later. TME method allowed for significantly better survival of colon cancer patients. It's just one example. Dr. Anton Titov, MD. Of course, Helicobacter Pylori story is another example. Well, there are many new treatment stories from around the world. I think that's why we have international meetings. It's important for patients to be able to travel across borders to hear what's going on. In two days I'm going to Japan again to a conference. It has been very informative for me. Dr. Bruce Chabner, MD. Because there's a lot of good medical research going on all over the world. It's not simply in the United States, absolutely. Seeking medical expert opinion is important. patients have to be proactive. Patients have to sometimes push against the physicians with authority. The sad part of it is that most patients don't have the resources to do this. So you have to depend on your doctor to be informed. You can't go off to the United States if you're living in Poland or Russia. You cannot see an expert over here. And it may not be helpful. But in certain cancer cases it probably would be. But most patients can't afford that. So those are valid barriers, those are challenges. Well an internet could help to find the best cancer therapy. Internet may help, absolutely, correct! Dr. Anton Titov, MD. There are so many objective diagnostic tests available. The doctors can review the situation remotely. Experts can review pathology tumor slides. Radiology experts can review CT and MRI scans. They can review laboratory data. Dr. Bruce Chabner, MD. Actually, we do that. Each month we have a teleconference. There is a video conversation with our colleagues in Botswana. They present cases and we go over the diagnosis and the treatment. Our pathologists read the slides. We look at the X-rays. It is possible to remotely do a lot of this. You're correct! I'm doing a fair amount of this with patients from China now. It's a particularly active interaction with China. Many patients are coming over here. Dr. Anton Titov, MD. Diseases have no bothers. Physicians should also not be constrained by borders. Dr. Bruce Chabner, MD. Correct!