{
  "version": "https://jsonfeed.org/version/1.1",
  "title": "Radical Health Blog",
  "description": "Notes from the Radical Health team on oncology AI, clinical evidence, and patient experience.",
  "home_page_url": "https://radicalhealth.ai/blog/",
  "feed_url": "https://radicalhealth.ai/feed.json",
  "language": "en-US",
  "icon": "https://radicalhealth.ai/og/logo-512.png",
  "authors": [
    {
      "name": "Radical Health",
      "url": "https://radicalhealth.ai"
    }
  ],
  "items": [
    {
      "id": "https://radicalhealth.ai/blog/aesclea-our-oncology-foundation-model/",
      "url": "https://radicalhealth.ai/blog/aesclea-our-oncology-foundation-model/",
      "title": "Aesclea: Our Oncology Foundation Model",
      "summary": "Long-range temporal predictive modelling for oncology: building a unified transformer over 11M patients to forecast outcomes across a patient's lifespan.",
      "content_html": "<p>import Dateline from '../../components/blog/Dateline.astro';</p>\n<p>San Francisco, California It's no secret that ML and AI is going to transform healthcare, but building the models to do so is incredibly difficult. Unlike other \"easier\" domains, such as self driving cars or coding, where there are clear constraints on the action space and the input signal is (almost) fully observable, the medical domain is unbounded and only partially observed. Here, the signal about a patient is severely undersampled in the sense that we only extract certain observations about what is actually happening internally to them, such as blood tests, vitals, etc., but ignore a whole host of information, such as genomics, detailed logs of the patient history (did they live with asbestos in 1967?) etc. An analogy to the \"easier\" domains would be like training a self driving car that can only take an image of a constrained view, or drive without knowing the speed or direction it's going for most of the time; or training a coding agent without looking at full code files. Which, as you can probably understand, would be incredibly difficult.</p>\n<p>So if this is so hard, why even bother? Because we believe that this is where the value of AI really lies, and not in replacing low skilled workers, which is what is typically happening. Medical predictions is a much harder problem, because as innovators it requires us to reimagine what is physically possible without using the guiding light of what humans can already do to show us the way; and secondly for the reason mentioned above, there often simply isn't the data in a format that is amenable to modelling right now, but we're getting there, and there are now methods to extract data that we can use to great effect.</p>\n<p>Something that has enabled a step change towards this is the advent of LLMs, which now enables the large scale feature extraction of key events and values in a patient's clinical notes. Is this perfect? No, as information is not always in the notes, and we need to know a priori what data to use. But it enables us to now leverage predictive features that up to this point were not available at this scale. A typical outcome from a patient event extraction would look something like the data below, and can be extracted for less than $0.01.</p>\n<pre><code>EVENT_DATE,EVENT_TOKEN\n1972-07-03 00:00:00,DEMO_SEX_MALE\n2018-03-12 09:00:00,ADM_Outpatient\n2018-03-12 00:00:00,DIAG_I10\n2019-11-01 00:00:00,DIAG_R91\n2019-11-01 00:00:00,LAB_PDL1_POSITIVE_60PCT\n2019-11-01 00:00:00,LAB_EGFR_L858R\n2023-01-15 08:00:00,PROC_BRONCHOSCOPY\n2023-01-15 00:00:00,PATHOLOGY_NSCLC_ADENOCARCINOMA\n2023-01-15 14:23:00,ADM_Routine/Elective\n2023-02-10 00:00:00,MED_TYROSINE_KINASE_INHIBITOR\n2023-02-10 07:10:00,ADM_Start_Treatment\n2023-06-05 00:00:00,DIAG_R63\n2023-06-05 00:00:00,MED_ANTIEMETIC\n2023-06-05 10:44:00,ADM_Followup\n2024-03-22 00:00:00,PROC_LOBECTOMY_RIGHT\n2024-03-22 06:50:00,ADM_Surgery\n2024-09-14 00:00:00,LAB_TMB_HIGH\n2024-09-14 00:00:00,MED_IMMUNOTHERAPY\n2024-09-14 09:00:00,ADM_Infusion_Center\n2024-09-18 09:00:00,CENSORED\n</code></pre>\n<p><em>This is simulated data, not PHI.</em></p>\n<p>So how do we model this? Sequence modelling problems have been worked on for a very long time (with moderate effect) until a very popular method called the transformer emerged in 2018. The transformer is nearly 8 years old now, but despite this, its impact in healthcare is only just starting to be felt. At its heart, it's a fantastic architecture for modelling autoregressive sequences (of which language is particularly well suited), but perhaps what is of greater impact is modelling the sequences of key medical events that occur over a patient's lifespan.</p>\n<p>It's the combination of large scale data extraction, coupled with the computational power of these models, that enables a new era of predictive modelling in patient outcomes. Why is the transformer such a powerful model? Because it is excellent at dynamically modelling pairwise events and then systematically composing them to create complex interdependence between several events. We're starting to see models such as Delphi-2m and SleepFM show impressive performance at predicting outcomes such as mortality or disease incidence. What is more powerful though, is these models' natural ability to predict a range of potential outcomes and not just single events such as mortality.</p>\n<p>This is a big swing we're taking at Radical, where we're building a single unified model that models the entire history of oncology patients by encapsulating the relationships between key events during a patient's lifespan, and then simulating what outcomes for the patient look like. Doing so is incredibly valuable, as it allows patients to make more informed decisions about their care, provides alerts for when patients should seek extra testing, and any other medical outcomes that are being directly modelled in the data. This is an inflection point for what's becoming possible: the architectures are now becoming powerful enough to model these long range dependencies and compose them into robust predictions, and most essentially hospitals are opening up their data silos to enable these predictions to happen. At Radical we're partnering with top US centres to provide the data of 11m patients and billions of temporal events to power our unified Aesclea model.</p>\n<p>The model is still cooking, and we'll provide some results very soon, so watch this space. If you're interested in <a href=\"https://radicalhealth.ai/how-it-works/\">what we're building</a>, want to brainstorm or simply have a chat, please <a href=\"mailto:contact@radicalhealth.ai\">reach out</a>, we'd be really keen to talk to you.</p>\n",
      "date_published": "2026-01-03T00:00:00.000Z",
      "image": "https://radicalhealth.ai/og/blog-aesclea-our-oncology-foundation-model.png",
      "tags": [
        "research"
      ]
    },
    {
      "id": "https://radicalhealth.ai/blog/radical-health-perfect-100-on-medical-licensing-exam/",
      "url": "https://radicalhealth.ai/blog/radical-health-perfect-100-on-medical-licensing-exam/",
      "title": "Radical Health's AI Achieves 100% on the US Medical Licensing Exam",
      "summary": "Radical Health's AI scored a perfect 100% on the USMLE, validation of the knowledge engine powering personalized cancer reports for patients and doctors.",
      "content_html": "<p>import Dateline from '../../components/blog/Dateline.astro';</p>\n<p>We're validating a new standard of medical knowledge to ensure no cancer patient has to wonder, \"Is there a better option I don't know about?\"</p>\n<p>San Francisco, California Today, we are thrilled to announce a landmark achievement: Radical Health's AI has earned a perfect 100% score on the United States Medical Licensing Examination (USMLE), a comprehensive exam required for all physicians to practice medicine in the US.</p>\n<p>Our AI recently demonstrated mastery of medical knowledge, far exceeding the 60% score physicians typically need to pass the rigorous exam (access the full report <a href=\"https://radicalhealth.ai\">here</a>). This achievement isn't about replacing the crucial role of your oncologist; it's about augmenting their expertise. We see this as a pivotal step toward a future where every patient, in partnership with their doctor, can benefit from the full scope of medical knowledge when making life's most important decisions.</p>\n<h2>The overwhelming uncertainty of a cancer diagnosis</h2>\n<p>If you or a loved one has been diagnosed with cancer, you know the feeling of uncertainty that follows. The late-night research, the complex medical terms, and the nagging fear that you might be missing a critical piece of the puzzle. Knowing <a href=\"https://radicalhealth.ai/blog/5-questions/\">the right questions to ask your oncologist</a> helps; having a system that has memorized every answer to those questions, and the latest research behind them, helps more.</p>\n<p>That fear is not unfounded. A landmark study from the Mayo Clinic revealed that up to 88% of patients who sought a second opinion with them received a new or refined diagnosis changing their care plan or lives.</p>\n<p>Expertise matters profoundly. Yet, access to these leading centers can take months and cost tens of thousands of dollars, leaving the vast majority of patients to navigate their journey without this crucial perspective.</p>\n<h2>Bridging the gap: your expert cancer researcher</h2>\n<p>Even the best doctors, however brilliant, cannot be expected to have instantaneous recall of the latest research, every new clinical trial, rare drug interaction, and genomic markers and their relevance to your personal medical case. Human physicians provide something irreplaceable: wisdom, empathy, and clinical judgment. Our goal is to arm them, and you, with a tool that masters the other half of the equation: comprehensive, up-to-the-minute data placed in your context.</p>\n<p>Our 100% score on the USMLE is more than a statistic. It is validation, proving the rock-solid foundation of part of the knowledge engine that powers our platform.</p>\n<p>Built in collaboration with experts from world-leading institutions like UCSF and the Mayo Clinic, the Radical Healthcare platform acts as your personal cancer specialist AI, in your corner, available 24/7.</p>\n<p>Here's how it empowers you and your care team:</p>\n<ul>\n<li><strong>Securely connect</strong>: Aggregate your complete medical records from over 50,000 healthcare providers in the US.</li>\n<li><strong>Comprehensive analysis</strong>: Our AI analyzes your unique medical history, pathology reports, genetic data, and imaging against millions of data points, including the latest clinical trials and research.</li>\n<li><strong>Actionable clarity</strong>: Within an hour, you receive a clear, personalized report. This report doesn't dictate treatment. It identifies the most effective, evidence-based options, raises questions for your oncologist to consider, and surfaces potential clinical trials, giving you the confidence to have a more informed conversation with your doctor about your care.</li>\n</ul>\n<p>Think of it as having a dedicated team of researchers working 24/7 on your specific case, delivering a concise briefing to you and your doctor before your next appointment.</p>\n<h2>Methodology</h2>\n<p>Our AI's 100% score on the USMLE is testament to its robust knowledge engine. The specific model that achieved this result is our knowledge recall module, forming part of our larger architecture. We achieved this performance largely through a novel medical-focused multi-agent architecture with tuned real-time prioritized search and grounding.</p>\n<p>The model was evaluated on an official sample USMLE exam totaling 325 questions prepared by Kung et al., 2023 and publicly available at <a href=\"https://www.usmle.org\">usmle.org</a>. We made two specific edits to the data used for evaluation: we identify and correct an erroneously recorded answer for Question #78 from the Step 3 examination. Similarly, Question #125 from the Step 3 exam has an incorrect answer, which we correct.</p>\n<h2>A new standard of hope</h2>\n<p>We envision a future where every cancer patient, regardless of their location or background, has access to world-class oncological expertise.</p>\n<p>The 100% USMLE score is an early milestone, not the destination. It is the validation of our commitment to building a trusted, reliable, and accessible source of medical knowledge. The real goal is to ensure that every patient can confidently say, \"I know all my options. This one is the best.\"</p>\n<p>If you or a loved one is facing a cancer diagnosis, you deserve to know all your options. Because when it comes to cancer, you shouldn't have to settle for uncertainty. Get your AI-powered personalized cancer report in hours at <a href=\"https://platform.radicalhealth.ai\">platform.radicalhealth.ai</a>.</p>\n<p>For healthcare providers, researchers, or investors interested in partnering with us, contact us at <a href=\"mailto:contact@radicalhealth.ai\">contact@radicalhealth.ai</a>.</p>\n<hr />\n<p><em>Footnote: We recognize that benchmarks like the USMLE, while important, don't fully capture what cancer patients actually need: comprehensive treatment evaluation, personalized therapy selection, and synthesis of cutting-edge research into actionable guidance. Our platform is powered by a system of AI agents that do much more than answer questions, and we're working to soon publish new benchmarks that better reflect real-world oncology care.</em></p>\n",
      "date_published": "2025-09-20T00:00:00.000Z",
      "image": "https://radicalhealth.ai/og/blog-radical-health-perfect-100-on-medical-licensing-exam.png",
      "tags": [
        "company"
      ]
    },
    {
      "id": "https://radicalhealth.ai/blog/cancer-clinical-trials-explained-part-2/",
      "url": "https://radicalhealth.ai/blog/cancer-clinical-trials-explained-part-2/",
      "title": "Cancer Clinical Trials Explained: Should You Participate? (Part 2)",
      "summary": "Cancer clinical trials, the decision: eligibility, consent, what to ask, and what to do if you don't qualify for any trial.",
      "content_html": "<p>This is Part 2 of our clinical trials guide. If you haven't read it yet, <a href=\"https://radicalhealth.ai/blog/cancer-clinical-trials-explained-part-1/\">Part 1</a> covers what trials are, the common myths, the four phases, and the trade-offs. This part focuses on the decision: eligibility, the questions to ask, and what to do if you don't qualify.</p>\n<h2>Understanding trial eligibility criteria</h2>\n<p>Every trial has strict <strong>inclusion criteria</strong> (what you must have) and <strong>exclusion criteria</strong> (what disqualifies you).</p>\n<h3>Common inclusion criteria</h3>\n<ul>\n<li>Specific cancer type and subtype</li>\n<li>Specific stage (metastatic, early-stage, etc.)</li>\n<li>Specific biomarkers (EGFR mutation, PD-L1 expression, etc.)</li>\n<li>Age range</li>\n<li>Performance status (ECOG 0 to 1, meaning able to perform daily activities)</li>\n<li>Adequate organ function (liver, kidney, bone marrow)</li>\n<li>Previous treatment history (sometimes need specific prior treatments, sometimes can't have had any)</li>\n</ul>\n<h3>Common exclusion criteria</h3>\n<ul>\n<li>Other active cancers</li>\n<li>Brain metastases (though some trials now include these)</li>\n<li>Poor organ function</li>\n<li>Autoimmune diseases (for immunotherapy trials)</li>\n<li>Recent heart attack or serious heart disease</li>\n<li>Pregnant or breastfeeding</li>\n<li>HIV, hepatitis (though changing for some trials)</li>\n<li>Recent surgery (within certain timeframe)</li>\n</ul>\n<p><strong>Frustration alert:</strong> You might match 90% of criteria but be excluded for one factor.</p>\n<p>Why so strict?</p>\n<ul>\n<li><strong>Safety</strong>: Protect participants from treatments that might harm them</li>\n<li><strong>Scientific rigor</strong>: Reduce variables to better understand the treatment</li>\n<li><strong>Regulatory requirements</strong>: FDA requires specific trial designs</li>\n</ul>\n<p><strong>Important:</strong> Criteria sometimes relax as trials progress and more safety data is available.</p>\n<h2>Questions to ask before enrolling in a trial</h2>\n<h3>About the trial design</h3>\n<ul>\n<li>\"What phase is this trial, and what is its primary goal?\"</li>\n<li>\"Is this trial randomized? If so, what are the different arms?\" (Make sure you'd be comfortable receiving ANY arm of the study.)</li>\n<li>\"Will I know which treatment I'm receiving?\" (Some trials are blinded, some are open-label.)</li>\n<li>\"How many patients will be enrolled in this trial?\" (Larger trials are generally more definitive.)</li>\n<li>\"What is the rationale for this treatment? What earlier results suggest it might work?\" (Look for Phase 2 data if it's a Phase 3 trial. Ask about response rates in earlier phases.)</li>\n</ul>\n<h3>About the treatment</h3>\n<ul>\n<li>\"What does the treatment involve?\" (How is it given? Oral pill, IV infusion, etc. How often? For how long? Where? At home, in clinic, hospital?)</li>\n<li>\"What are the known and potential side effects?\" (Common side effects, serious side effects, unknown risks especially in Phase 1 to 2.)</li>\n<li>\"How does this compare to the standard treatment I would otherwise receive?\"</li>\n<li>\"What happens if I have severe side effects? Can the dose be adjusted?\"</li>\n<li>\"What other medications or treatments can't I take while on this trial?\" (Some trials prohibit certain supplements, other medications.)</li>\n</ul>\n<h3>About logistics</h3>\n<ul>\n<li>\"How often will I need to come for appointments?\" (Weekly? Monthly? More frequent than standard care?)</li>\n<li>\"Where do I need to go for treatment and follow-up?\" (Can any visits be at my local oncologist? What must be at the trial site?)</li>\n<li>\"How long is the trial expected to last?\" (Treatment period and follow-up period.)</li>\n<li>\"What costs will I be responsible for?\" (Trial covers experimental drug, but what about other costs? Will insurance cover routine care costs? Are there programs to help with travel/lodging?)</li>\n</ul>\n<h3>About outcomes and next steps</h3>\n<ul>\n<li>\"What happens when the trial ends?\" (Can I continue receiving the treatment if it's helping? What are the next treatment options?)</li>\n<li>\"What if the treatment doesn't work? Can I leave the trial and pursue other treatments?\" (You can ALWAYS leave a trial. But good to understand the process.)</li>\n<li>\"Will I find out the results of the trial?\" (Some trials share results with participants. Timeline: trials can take years to complete and publish.)</li>\n<li>\"Can I continue seeing my regular oncologist?\" (Most trials encourage coordination with your regular team.)</li>\n</ul>\n<h3>About safety and oversight</h3>\n<ul>\n<li>\"Who is sponsoring this trial, and who is overseeing safety?\" (Pharmaceutical company, NCI, academic institution? IRB approval? Data Safety Monitoring Board?)</li>\n<li>\"What happens if I'm harmed by the trial treatment?\" (What care is provided? Is there compensation?)</li>\n</ul>\n<h2>The informed consent process</h2>\n<p>Before enrolling, you'll go through informed consent.</p>\n<h3>What it includes</h3>\n<p>Written consent form (often 20 to 30 pages) explaining:</p>\n<ul>\n<li>Purpose of the trial</li>\n<li>What you'll be asked to do</li>\n<li>Treatments you might receive</li>\n<li>Known risks and benefits</li>\n<li>Alternative treatments</li>\n<li>Your rights</li>\n<li>Privacy protections</li>\n<li>Costs</li>\n</ul>\n<p>Verbal explanation from:</p>\n<ul>\n<li>Principal investigator (lead doctor)</li>\n<li>Research nurse</li>\n<li>Clinical trial coordinator</li>\n</ul>\n<p>Time to consider (never rush):</p>\n<ul>\n<li>Take the consent form home</li>\n<li>Review with family</li>\n<li>Discuss with your regular oncologist</li>\n<li>Ask questions</li>\n<li>No pressure to decide immediately</li>\n</ul>\n<h3>Your rights</h3>\n<ul>\n<li>Right to ask questions (any and all questions)</li>\n<li>Right to take time to decide</li>\n<li>Right to discuss with others (family, your oncologist, second opinion)</li>\n<li>Right to refuse without affecting your standard care</li>\n<li>Right to leave the trial at any time, for any reason, without penalty</li>\n<li>Right to receive all information about risks and benefits</li>\n</ul>\n<p><strong>Important:</strong> Signing consent is NOT a final commitment. You can withdraw at any time.</p>\n<h2>Making your decision: should you join this trial?</h2>\n<p>Consider \"Yes\" if:</p>\n<ul>\n<li>You meet all eligibility criteria</li>\n<li>You'd be comfortable with ANY arm of a randomized trial</li>\n<li>The trial offers a treatment potentially better than standard care</li>\n<li>The logistics are manageable (location, time commitment)</li>\n<li>You understand and accept the risks</li>\n<li>Your regular oncologist supports the decision</li>\n<li>The trial aligns with your goals and values</li>\n</ul>\n<p>Consider \"No\" or \"Not yet\" if:</p>\n<ul>\n<li>You're not comfortable with the randomization or trial design</li>\n<li>The logistics are prohibitive (distance, time away from work/family)</li>\n<li>You have concerns about risks that haven't been adequately addressed</li>\n<li>Standard treatment is highly effective for your cancer</li>\n<li>You haven't fully explored standard options</li>\n<li>Your intuition says it's not right</li>\n</ul>\n<h3>Consider getting a second opinion about the trial</h3>\n<p>Many patients benefit from discussing the trial with:</p>\n<ul>\n<li>Their regular oncologist (if the trial is elsewhere)</li>\n<li>Another oncologist at a different institution</li>\n<li>A patient advocate familiar with trials</li>\n<li>AI-powered tools that can summarize how the trial compares to standard options</li>\n</ul>\n<p><strong>Remember:</strong> This is YOUR decision. No one should pressure you either way.</p>\n<h2>What happens if you join a trial</h2>\n<h3>Enrollment process</h3>\n<ol>\n<li><strong>Screening</strong>: Additional tests to confirm eligibility (blood work, scans, biopsies, other testing per protocol)</li>\n<li><strong>Baseline assessment</strong>: Establish your starting point (detailed medical history, physical exam, quality of life questionnaires, tumor measurements)</li>\n<li><strong>Randomization</strong> (if applicable): Assignment to treatment arm</li>\n<li><strong>Treatment begins</strong>: Following strict protocol schedule</li>\n</ol>\n<h3>During the trial</h3>\n<p>Regular monitoring:</p>\n<ul>\n<li>More frequent appointments than standard care typically</li>\n<li>Blood tests, scans, physical exams per protocol schedule</li>\n<li>Side effect assessment and management</li>\n<li>Quality of life questionnaires</li>\n<li>Diaries or logs (some trials)</li>\n</ul>\n<p>Strict adherence required:</p>\n<ul>\n<li>Taking medication exactly as prescribed</li>\n<li>Attending all appointments</li>\n<li>Reporting all side effects</li>\n<li>Not taking prohibited medications</li>\n</ul>\n<p>Communication:</p>\n<ul>\n<li>Regular contact with trial team</li>\n<li>24/7 emergency contact for serious issues</li>\n<li>Coordination with your regular oncologist</li>\n</ul>\n<h3>Your ongoing rights</h3>\n<ul>\n<li>Continue asking questions</li>\n<li>Report any side effects or concerns</li>\n<li>Request to speak with the principal investigator</li>\n<li>Leave the trial if you choose</li>\n<li>Access your medical records</li>\n</ul>\n<h2>What if you don't qualify for any trials?</h2>\n<p>Many patients are disappointed to find they don't meet eligibility criteria. Options:</p>\n<h3>Expand your search</h3>\n<ul>\n<li>Look at trials at multiple institutions</li>\n<li>Consider trials for related cancers</li>\n<li>Check for \"basket trials\" (target specific mutations regardless of cancer type)</li>\n<li>Look at prevention or supportive care trials</li>\n</ul>\n<h3>Ask about compassionate use</h3>\n<ul>\n<li>Expanded access programs may provide experimental drugs outside trials</li>\n<li>For patients with serious conditions who've exhausted other options</li>\n<li>Contact drug manufacturers</li>\n<li>Your oncologist can apply on your behalf</li>\n</ul>\n<h3>Focus on optimizing standard care</h3>\n<ul>\n<li>Not being in a trial doesn't mean inferior care</li>\n<li>Standard treatments are proven effective</li>\n<li>Consider comprehensive genomic testing to personalize standard approaches</li>\n<li>Optimize supportive care</li>\n</ul>\n<h3>Keep checking</h3>\n<ul>\n<li>New trials open regularly</li>\n<li>Your eligibility may change as your treatment evolves</li>\n<li>Set up alerts on ClinicalTrials.gov for your cancer type</li>\n</ul>\n<h2>Special types of trials to know about</h2>\n<h3>Basket trials</h3>\n<p>What they are: Trials that accept multiple cancer types sharing a specific genetic mutation.</p>\n<p>Example:</p>\n<ul>\n<li>Trial for any cancer with NTRK fusion</li>\n<li>Trial for any tumor with high microsatellite instability</li>\n</ul>\n<p><strong>Advantage:</strong> Expands options for rare mutations regardless of cancer type.</p>\n<h3>Umbrella trials</h3>\n<p>What they are: Multiple sub-studies under one master protocol.</p>\n<p>How it works:</p>\n<ul>\n<li>All participants undergo genomic testing</li>\n<li>Assigned to sub-study based on their mutations</li>\n<li>Receive matched targeted therapy</li>\n</ul>\n<p>Examples: NCI-MATCH, Lung-MAP.</p>\n<p><strong>Advantage:</strong> Personalized matching to treatment based on your tumor's specific characteristics.</p>\n<h3>Window of opportunity trials</h3>\n<p>What they are: Brief treatment before planned surgery.</p>\n<p>Purpose:</p>\n<ul>\n<li>See if treatment shrinks tumor</li>\n<li>Study how treatment affects tumor biology</li>\n<li>Doesn't delay your surgery</li>\n</ul>\n<p><strong>Advantage:</strong> Contribute to research without changing your standard treatment plan.</p>\n<h3>Neoadjuvant trials</h3>\n<p>What they are: Treatment BEFORE surgery (instead of or in addition to standard neoadjuvant therapy).</p>\n<p>Purpose:</p>\n<ul>\n<li>Shrink tumor to make surgery easier</li>\n<li>Treat microscopic disease early</li>\n<li>Test treatment response</li>\n</ul>\n<p>Example: Immunotherapy before surgery for certain cancers.</p>\n<h2>The bottom line: clinical trials and you</h2>\n<p>Clinical trials are how cancer care advances. Every effective treatment available today started in a clinical trial.</p>\n<p>Should you participate? Consider it if:</p>\n<ul>\n<li>You want access to cutting-edge treatments</li>\n<li>You're comfortable with the trial design and logistics</li>\n<li>You understand and accept the risks</li>\n<li>You want to contribute to advancing cancer care</li>\n</ul>\n<p>It's also perfectly okay to choose standard treatment if:</p>\n<ul>\n<li>Standard treatment is highly effective for your cancer</li>\n<li>Trial logistics are prohibitive</li>\n<li>You're not comfortable with uncertainties</li>\n<li>Your personal situation makes trial participation difficult</li>\n</ul>\n<h3>Key points to remember</h3>\n<ul>\n<li>Trials are NOT just for desperate situations; many are for newly diagnosed patients</li>\n<li>You rarely receive a placebo in cancer trials; usually comparing active treatments</li>\n<li>You can leave at any time; enrollment is not a permanent commitment</li>\n<li>Trials offer intensive monitoring; often more careful follow-up than standard care</li>\n<li>Ask questions, lots of them, before making any decision</li>\n<li>Get a second opinion about whether a trial is right for you</li>\n<li>Your regular oncologist should support you whether you choose trial or standard care</li>\n</ul>\n<h3>Finding the right trial</h3>\n<ul>\n<li>Start with your oncologist</li>\n<li>Search <a href=\"https://clinicaltrials.gov\">ClinicalTrials.gov</a></li>\n<li>Contact disease-specific organizations</li>\n<li>Use trial matching services</li>\n<li>Consider AI-powered matching for comprehensive search (we wrote about <a href=\"https://radicalhealth.ai/blog/aesclea-our-oncology-foundation-model/\">the foundation model we're building over 11M patient journeys</a> that powers this kind of search)</li>\n</ul>\n<h3>Making your decision</h3>\n<ul>\n<li>Take your time (when medically safe to do so)</li>\n<li>Read the full consent form</li>\n<li>Discuss with family and your care team</li>\n<li>Trust your instincts</li>\n<li>Make sure it aligns with your goals and values</li>\n</ul>\n<p>Cancer treatment is increasingly personalized. Clinical trials are one way to access the most personalized, cutting-edge approaches, but they're not the only path to excellent care.</p>\n<p>import Disclaimer from '../../components/blog/Disclaimer.astro';</p>\n<hr />\n",
      "date_published": "2025-04-15T00:00:00.000Z",
      "image": "https://radicalhealth.ai/og/blog-cancer-clinical-trials-explained-part-2.png",
      "tags": [
        "patient-education"
      ]
    },
    {
      "id": "https://radicalhealth.ai/blog/training-a-model-that-understands-your-notes-7x-better-than-openai/",
      "url": "https://radicalhealth.ai/blog/training-a-model-that-understands-your-notes-7x-better-than-openai/",
      "title": "A medical embedding model that beats OpenAI 7x on note recall",
      "summary": "How we fine-tuned EmbeddingGemma-300m on MIMIC-III clinical notes to predict disease at AUROC 0.934, outperforming OpenAI embeddings 7x on next-note recall.",
      "content_html": "<p>import Dateline from '../../components/blog/Dateline.astro';</p>\n<p>San Francisco, California Our new medical EmbeddingGemma-300m fine-tuned on medical data can predict diseases from patient notes with an AUROC of 0.934 and provide increased survival analysis.</p>\n<h2>The problem with embedding models</h2>\n<p>The current problem with embedding models is that they are trained to match text content, but text covers a whole range of information, from language to style, to semantics, to the underlying information or instructions. When it comes to needing embeddings which contain the specific information and are agnostic to stylistic information, off-the-shelf embeddings typically fail.</p>\n<p>For the medical context this is critical, as we need to be able to faithfully extract the correct clinical information and prioritise this over other stylistic information.</p>\n<h2>Fine-tuning our own embedding model for clinical utility</h2>\n<p>We built the first generation of an internal embedding model by fine-tuning the EmbeddingGemma-300m using the MIMIC-III dataset, which is a large, freely available critical care database containing de-identified health records from over 40,000 ICU patients between 2001 and 2012. Using the contrastive loss, we fine-tune the embedding model by setting the anchor to be a patient note at time <em>t</em> and the positive to be a patient note at <em>t + 1</em>. This forces the model to match notes based on the medical context and not to rely on the style of writing, which is typically consistent between notes.</p>\n<p><img src=\"./training-a-model-that-understands-your-notes-7x-better-than-openai/_assets/finetuning-architecture.avif\" alt=\"Contrastive fine-tuning architecture: patient notes at index n and n+1 each pass through a Text Encoder to produce query and key vectors, which are matched in an N x N similarity matrix.\" /></p>\n<p>Fine-tuning a model this way yields surprisingly powerful results. Given a recall task of recalling the next patient note, our model is able to achieve a top-5 accuracy of 65%, far surpassing the accuracy of the base model and OpenAI embeddings, which achieve 6% and 9% respectively.</p>\n<p>This isn't surprising as we're optimising for this in the loss, but where this gets exciting is that these representations make for much better medical performance on downstream tasks. Our model beats the base model and OpenAI when trying to predict diagnosis (ours: 0.934, OpenAI: 0.809, base: 0.674 AUROC), and when performing survival analysis (ours: 0.70, OpenAI: 0.67, base: 0.59 C-Index).</p>\n<p>We can clearly see why the model is so powerful at producing these results when we create UMAP plots and color code by common disease type. Compared against the off-the-shelf base model and OpenAI embeddings, our trained model produces visibly tighter clusters per diagnosis:</p>\n<p><img src=\"./training-a-model-that-understands-your-notes-7x-better-than-openai/_assets/umap-base-model.avif\" alt=\"UMAP projection of clinical note embeddings from the BASE EmbeddingGemma-300m model. Points are colored by the top 10 primary diagnoses (malignant neoplasms of various lung regions, septicemia, etc.); clusters are diffuse and overlap heavily.\" /></p>\n<p><img src=\"./training-a-model-that-understands-your-notes-7x-better-than-openai/_assets/umap-openai-model.avif\" alt=\"UMAP projection of clinical note embeddings from the OpenAI text-embedding model on the same diagnoses. Clusters are tighter than the base model but still substantially overlapping.\" /></p>\n<p><img src=\"./training-a-model-that-understands-your-notes-7x-better-than-openai/_assets/umap-trained-model.avif\" alt=\"UMAP projection of clinical note embeddings from our trained EmbeddingGemma-300m model on the same diagnoses. Clusters are clearly separated, with each primary diagnosis occupying a distinct region of the embedding space.\" /></p>\n<p>The contrast tells the story: the same clinical notes, the same diagnoses, but a clinically meaningful geometry emerges only after fine-tuning. This is the foundation we're building toward <a href=\"https://radicalhealth.ai/blog/aesclea-our-oncology-foundation-model/\">Aesclea</a>, our long-range temporal model of oncology patients, and the same medical-knowledge stack that lets <a href=\"https://radicalhealth.ai/blog/radical-health-perfect-100-on-medical-licensing-exam/\">our patient-report platform score 100% on the US Medical Licensing Exam</a>. See <a href=\"https://radicalhealth.ai/how-it-works/\">how it works end-to-end</a> for the patient-facing product.</p>\n<p>If you're working on medical AI and want to compare notes (or use these representations on a real downstream task), <a href=\"mailto:contact@radicalhealth.ai\">reach out</a>.</p>\n",
      "date_published": "2025-04-13T00:00:00.000Z",
      "image": "https://radicalhealth.ai/og/blog-training-a-model-that-understands-your-notes-7x-better-than-openai.png",
      "tags": [
        "research"
      ]
    },
    {
      "id": "https://radicalhealth.ai/blog/cancer-clinical-trials-explained-part-1/",
      "url": "https://radicalhealth.ai/blog/cancer-clinical-trials-explained-part-1/",
      "title": "Cancer Clinical Trials Explained: Should You Participate? (Part 1)",
      "summary": "Cancer clinical trials, the basics: phases, common myths, types of trials, and how participation fits into modern cancer care.",
      "content_html": "<p>When you hear \"clinical trial,\" you might think it's a last resort for patients who've run out of options. This is one of the biggest misconceptions in cancer care.</p>\n<p>The reality: clinical trials are often where the best, most cutting-edge treatments are available, sometimes years before they become standard care. Many trials are specifically for newly diagnosed patients, and participation in clinical trials is associated with better outcomes.</p>\n<p>This comprehensive guide explains everything you need to know about cancer clinical trials to make an informed decision. It comes in two parts; you're reading Part 1, which covers the basics. <a href=\"https://radicalhealth.ai/blog/cancer-clinical-trials-explained-part-2/\">Part 2</a> covers eligibility, the questions to ask, and the consent process. For a broader checklist of what to bring up at your next oncology appointment, see <a href=\"https://radicalhealth.ai/blog/5-questions/\">the five questions every cancer patient should ask their oncologist</a>.</p>\n<h2>What is a cancer clinical trial?</h2>\n<p>A clinical trial is a carefully controlled research study that tests:</p>\n<ul>\n<li>New treatments (drugs, devices, procedures)</li>\n<li>New combinations of existing treatments</li>\n<li>New ways to use existing treatments</li>\n<li>Prevention strategies</li>\n<li>Screening methods</li>\n<li>Quality of life interventions</li>\n</ul>\n<p>The goal: determine if new approaches are:</p>\n<ul>\n<li><strong>Safe</strong> (do they cause acceptable side effects?)</li>\n<li><strong>Effective</strong> (do they work better than current standards?)</li>\n<li><strong>Better than existing treatments</strong> (improved survival, fewer side effects, better quality of life)</li>\n</ul>\n<h2>Why clinical trials matter: yesterday's trials are today's standard care</h2>\n<p>Every cancer treatment you have access to today was once in a clinical trial:</p>\n<ul>\n<li><strong>Immunotherapy</strong> (pembrolizumab, nivolumab): Clinical trials 2010s, standard care now</li>\n<li><strong>Targeted therapies</strong> (imatinib for CML, trastuzumab for breast cancer): Trials 1990s to 2000s</li>\n<li><strong>FOLFIRINOX for pancreatic cancer</strong>: Trial 2010, now a standard option</li>\n<li><strong>Checkpoint inhibitors for melanoma</strong>: Trials 2011 to 2014, revolutionized treatment</li>\n</ul>\n<p>Patients who participated in these trials often had better outcomes than those receiving standard care at the time.</p>\n<h2>Common myths about clinical trials (debunked)</h2>\n<h3>Myth #1: \"Clinical trials are only for people who've run out of options\"</h3>\n<p><strong>Reality:</strong> Many trials are ONLY for newly diagnosed or early-stage patients.</p>\n<p>Examples:</p>\n<ul>\n<li>Adjuvant trials (treatment after surgery to prevent recurrence)</li>\n<li>First-line treatment trials for metastatic disease</li>\n<li>Prevention trials for high-risk individuals</li>\n<li>Early detection trials</li>\n</ul>\n<p><strong>Fact:</strong> Some of the most promising trials specifically exclude patients who've had previous treatment.</p>\n<h3>Myth #2: \"I might get a placebo and receive no treatment\"</h3>\n<p><strong>Reality:</strong> In cancer trials, you rarely receive a placebo alone.</p>\n<p>How it actually works:</p>\n<ul>\n<li>Most cancer trials: New treatment vs. current standard treatment</li>\n<li>Some trials: Standard treatment alone vs. standard treatment + new drug</li>\n<li>Very rare: Placebo alone (only when no effective treatment exists)</li>\n</ul>\n<p><strong>Important:</strong> If you're in a trial comparing Treatment A vs. Treatment B, you'll receive one of them, both are real treatments.</p>\n<h3>Myth #3: \"Clinical trials are dangerous experiments\"</h3>\n<p><strong>Reality:</strong> Clinical trials have extensive safety oversight.</p>\n<p>Safety measures include:</p>\n<ul>\n<li>Ethics review by Institutional Review Board (IRB)</li>\n<li>FDA oversight and approval</li>\n<li>Data Safety Monitoring Boards that can stop trials if safety concerns arise</li>\n<li>Informed consent process explaining all risks</li>\n<li>Strict eligibility criteria to protect patient safety</li>\n<li>Close monitoring (often more frequent than standard care)</li>\n</ul>\n<p><strong>Fact:</strong> Clinical trial participants often receive MORE careful monitoring than patients receiving standard care.</p>\n<h3>Myth #4: \"I'll be a guinea pig\"</h3>\n<p><strong>Reality:</strong> By the time a treatment reaches human trials, it has undergone extensive laboratory and animal testing.</p>\n<p>The development process:</p>\n<ol>\n<li>Laboratory research (2 to 5 years)</li>\n<li>Animal studies (1 to 3 years)</li>\n<li>Phase 1 human trials (safety testing)</li>\n<li>Phase 2 trials (does it work?)</li>\n<li>Phase 3 trials (is it better than current standard?)</li>\n</ol>\n<p>You participate in Phase 1, 2, or 3, after years of preliminary research.</p>\n<h3>Myth #5: \"Clinical trials are free treatment\"</h3>\n<p><strong>Reality:</strong> It's complicated.</p>\n<p>What's typically covered by the trial:</p>\n<ul>\n<li>The experimental drug/treatment</li>\n<li>Extra tests required by the trial protocol</li>\n<li>Additional doctor visits required by the study</li>\n</ul>\n<p>What you/insurance typically pay:</p>\n<ul>\n<li>Standard cancer care costs (would pay these anyway)</li>\n<li>Routine tests and scans</li>\n<li>Treatment of side effects</li>\n<li>Hospital stays</li>\n</ul>\n<p><strong>Important:</strong> The Affordable Care Act requires most insurance to cover routine costs of clinical trial participation.</p>\n<h2>The phases of clinical trials explained</h2>\n<p>Understanding trial phases helps you assess potential benefits and risks.</p>\n<h3>Phase 1 trials: Is it safe?</h3>\n<p><strong>Purpose:</strong> Determine safe dosage and identify side effects</p>\n<p><strong>Participants:</strong> 20 to 80 people, usually with advanced cancer</p>\n<p>What happens:</p>\n<ul>\n<li>Start with very low dose</li>\n<li>Gradually increase dose in different patient groups</li>\n<li>Carefully monitor for side effects</li>\n<li>Determine \"maximum tolerated dose\"</li>\n</ul>\n<p><strong>Success rate:</strong> ~5% of participants have tumor shrinkage (not the goal; safety is the goal)</p>\n<p>Consider Phase 1 if:</p>\n<ul>\n<li>You have advanced cancer</li>\n<li>Standard treatments have stopped working</li>\n<li>You have a cancer type with no effective treatments</li>\n<li>The drug targets a mutation your tumor has</li>\n</ul>\n<p><strong>Risks:</strong> Unknown side effects, may not help your cancer</p>\n<p><strong>Benefits:</strong></p>\n<ul>\n<li>First access to potentially breakthrough treatments</li>\n<li>Intensive monitoring and care</li>\n<li>Some patients do respond even in Phase 1</li>\n</ul>\n<h3>Phase 2 trials: Does it work?</h3>\n<p><strong>Purpose:</strong> Determine if the treatment works against specific cancers</p>\n<p><strong>Participants:</strong> 100 to 300 people with specific cancer types</p>\n<p>What happens:</p>\n<ul>\n<li>Given the dose determined safe in Phase 1</li>\n<li>Researchers measure tumor response (shrinkage)</li>\n<li>Continue monitoring side effects</li>\n<li>Determine which cancer types respond best</li>\n</ul>\n<p><strong>Success rate:</strong> ~30% of Phase 2 trials show enough promise to move to Phase 3</p>\n<p><strong>Response rates:</strong> Vary widely (10 to 70% of participants might have tumor response)</p>\n<p>Consider Phase 2 if:</p>\n<ul>\n<li>The treatment targets your specific cancer type</li>\n<li>Early results are promising</li>\n<li>Standard options are limited</li>\n<li>You want access to newer approaches</li>\n</ul>\n<p><strong>Risks:</strong> Treatment may not work, side effects still being characterized</p>\n<p><strong>Benefits:</strong></p>\n<ul>\n<li>Treatment specifically for your cancer type</li>\n<li>If it works, access years before FDA approval</li>\n<li>Contribute to knowledge about the treatment</li>\n</ul>\n<h3>Phase 3 trials: Is it better than standard treatment?</h3>\n<p><strong>Purpose:</strong> Compare new treatment to current standard of care</p>\n<p><strong>Participants:</strong> 300 to 3,000 people (large trials)</p>\n<p>What happens:</p>\n<ul>\n<li>Randomization: Assigned to either new treatment or standard treatment</li>\n<li>Neither you nor your doctor choose which arm</li>\n<li>Often \"blinded\" (you don't know which you're getting)</li>\n<li>Followed for months or years</li>\n<li>Researchers compare survival, response rates, side effects</li>\n</ul>\n<p><strong>Success rate:</strong> ~33% of Phase 3 trials show new treatment is better</p>\n<p>Consider Phase 3 if:</p>\n<ul>\n<li>You're comfortable with randomization</li>\n<li>Both arms of the trial are acceptable to you</li>\n<li>The new treatment has shown promise in Phase 2</li>\n<li>You want to contribute to advancing cancer care</li>\n</ul>\n<p><strong>Risks:</strong></p>\n<ul>\n<li>Might receive standard treatment (but that's what you'd get anyway)</li>\n<li>New treatment might not be better</li>\n<li>New treatment might have more side effects</li>\n</ul>\n<p><strong>Benefits:</strong></p>\n<ul>\n<li>50% chance of receiving potentially better treatment</li>\n<li>Even if in standard arm, receive excellent care with close monitoring</li>\n<li>If new treatment is better, entire study population may be offered it</li>\n</ul>\n<p><strong>Important:</strong> Many Phase 3 trials allow \"crossover\", so if you're in the standard arm and the trial shows the new treatment is better, you can switch to it.</p>\n<h3>Phase 4 trials: Post-approval studies</h3>\n<p><strong>Purpose:</strong> Continue studying a treatment after FDA approval</p>\n<p><strong>Participants:</strong> Thousands</p>\n<p>What happens:</p>\n<ul>\n<li>Treatment is already approved and available</li>\n<li>Study long-term effects, optimal use, other cancer types</li>\n</ul>\n<p>Consider Phase 4 if:</p>\n<ul>\n<li>You're receiving the treatment anyway</li>\n<li>You want to contribute to knowledge</li>\n<li>Trials sometimes cover drug costs</li>\n</ul>\n<h2>Types of cancer clinical trials</h2>\n<h3>Treatment trials</h3>\n<p>Test new:</p>\n<ul>\n<li>Chemotherapy drugs</li>\n<li>Targeted therapies</li>\n<li>Immunotherapies</li>\n<li>Combinations of treatments</li>\n<li>Surgery techniques</li>\n<li>Radiation approaches</li>\n</ul>\n<p>Most common type of cancer trial.</p>\n<h3>Prevention trials</h3>\n<p>Test interventions to prevent cancer in:</p>\n<ul>\n<li>High-risk individuals (genetic mutations, family history)</li>\n<li>Cancer survivors (prevent second cancers or recurrence)</li>\n<li>General population</li>\n</ul>\n<p>Examples:</p>\n<ul>\n<li>Vaccines (HPV vaccine to prevent cervical cancer)</li>\n<li>Medications (tamoxifen to prevent breast cancer in high-risk women)</li>\n<li>Lifestyle interventions</li>\n</ul>\n<h3>Screening / early detection trials</h3>\n<p>Test new ways to detect cancer earlier:</p>\n<ul>\n<li>Blood tests for cancer markers</li>\n<li>Imaging techniques</li>\n<li>Genetic screening approaches</li>\n</ul>\n<p>Example: Liquid biopsy trials to detect cancer from blood samples.</p>\n<h3>Quality of life / supportive care trials</h3>\n<p>Test interventions to:</p>\n<ul>\n<li>Manage side effects</li>\n<li>Reduce pain</li>\n<li>Improve nutrition</li>\n<li>Address psychological needs</li>\n<li>Enhance survivorship</li>\n</ul>\n<p>Examples:</p>\n<ul>\n<li>Exercise programs during chemotherapy</li>\n<li>Medications for neuropathy</li>\n<li>Integrative therapies (acupuncture, meditation)</li>\n</ul>\n<h2>Benefits of participating in clinical trials</h2>\n<p><strong>Potential medical benefits:</strong></p>\n<ul>\n<li>Access to cutting-edge treatments before they're widely available</li>\n<li>More intensive monitoring and medical attention</li>\n<li>Multidisciplinary care from specialist teams</li>\n<li>Additional testing and scans (catching problems earlier)</li>\n<li>Possibly better outcomes (many trials test treatments that may be superior)</li>\n</ul>\n<p><strong>Data supports this:</strong> Studies show clinical trial participants often have better outcomes than similar patients receiving standard care, even those in the \"standard treatment\" arm, likely due to more careful protocol adherence and monitoring.</p>\n<p><strong>Personal benefits:</strong></p>\n<ul>\n<li>Active participation in your care</li>\n<li>Sense of purpose and hope</li>\n<li>Contributing to science that may help others</li>\n<li>Access to expert teams at leading cancer centers</li>\n<li>Empowerment through knowledge and engagement</li>\n</ul>\n<p><strong>Financial considerations:</strong></p>\n<ul>\n<li>Trial sponsor covers experimental treatment costs</li>\n<li>Some trials cover travel, lodging, or other expenses</li>\n<li>May reduce out-of-pocket costs for some treatments</li>\n</ul>\n<p>However: you typically still pay for standard care costs.</p>\n<h2>Risks and downsides of clinical trials</h2>\n<p><strong>Medical risks:</strong></p>\n<ul>\n<li>Unknown side effects (especially Phase 1 to 2)</li>\n<li>Treatment may not work for you</li>\n<li>More frequent visits and testing (time burden)</li>\n<li>Strict protocols (less flexibility in treatment adjustments)</li>\n<li>Possibility of receiving standard treatment in randomized trials</li>\n</ul>\n<p><strong>Practical downsides:</strong></p>\n<ul>\n<li><strong>Time commitment</strong>: More appointments, often at specific research centers</li>\n<li><strong>Travel</strong>: May need to go to distant cancer center</li>\n<li><strong>Paperwork</strong>: Extensive consent forms, questionnaires</li>\n<li><strong>Restrictions</strong>: Strict eligibility criteria, can't take certain other medications</li>\n<li><strong>Uncertainty</strong>: Don't know if you're in experimental or standard arm (in randomized trials)</li>\n</ul>\n<p><strong>Important considerations:</strong></p>\n<ul>\n<li>May delay standard treatment while screening for trial eligibility</li>\n<li>Might not qualify after going through screening process</li>\n<li>Could be randomized out of experimental treatment arm</li>\n</ul>\n<p>Continue to <a href=\"https://radicalhealth.ai/blog/cancer-clinical-trials-explained-part-2/\">Part 2</a> for eligibility criteria, the questions to ask before enrolling, the informed consent process, and how to decide.</p>\n<p>import BlogFAQ from '../../components/blog/BlogFAQ.astro';\nimport Disclaimer from '../../components/blog/Disclaimer.astro';</p>\n<p>&lt;BlogFAQ\n  heading=\"Common myths about clinical trials, debunked\"\n  items={[\n    {\n      question: \"Are clinical trials only for people who've run out of options?\",\n      answer: \"No. Many trials specifically target newly diagnosed patients or those receiving first-line treatment. Trials exist at every stage of the cancer journey, from prevention through advanced disease. Asking about trials early can open access to next-generation treatments that aren't yet standard of care.\",\n    },\n    {\n      question: \"Will I get a placebo and receive no treatment?\",\n      answer: \"Placebo-only arms are rare in cancer trials. In most trials, the control arm receives the current standard of care, and the experimental arm receives the standard of care plus the new treatment. Truly inactive placebos are typically only used in supportive-care or prevention trials where no proven standard exists.\",\n    },\n    {\n      question: \"Are clinical trials dangerous experiments?\",\n      answer: \"Modern trials go through years of preclinical safety testing and ascending-dose Phase 1 studies before any patient receives the full dose. Trials are continuously monitored by data safety monitoring boards that can stop the trial if harm appears. They are typically safer than off-protocol experimental use because the protections are formalized.\",\n    },\n    {\n      question: \"Will I be treated like a guinea pig?\",\n      answer: \"No. Patients in trials often receive more frequent monitoring, more specialist time, and tighter care coordination than patients receiving standard treatment. The informed consent process is extensive, you can withdraw at any time, and your care team's primary obligation remains your individual well-being.\",\n    },\n    {\n      question: \"Are clinical trials free treatment?\",\n      answer: \"Partially. The trial sponsor typically covers the experimental drug and trial-specific tests. Standard-of-care costs (routine labs, imaging, hospitalization for unrelated issues) are usually billed to insurance as they would be off-trial. Some trials cover travel and lodging; ask the coordinator for a full cost breakdown before enrolling.\",\n    },\n  ]}\n/&gt;</p>\n<hr />\n",
      "date_published": "2025-03-15T00:00:00.000Z",
      "image": "https://radicalhealth.ai/og/blog-cancer-clinical-trials-explained-part-1.png",
      "tags": [
        "patient-education"
      ]
    },
    {
      "id": "https://radicalhealth.ai/blog/5-questions/",
      "url": "https://radicalhealth.ai/blog/5-questions/",
      "title": "5 Questions Every Cancer Patient Should Ask Their Oncologist",
      "summary": "Essential questions to ask your oncologist about diagnosis, treatment options, side effects, and prognosis. Get the information you need to make decisions.",
      "content_html": "<p>When you're diagnosed with cancer, you'll face more medical decisions in a few weeks than most people make in a lifetime. The difference between good and excellent cancer care often comes down to one thing: asking the right questions.</p>\n<p>This guide provides the essential questions every cancer patient should ask, and explains why each answer matters for your care.</p>\n<h2>Before we start: how to have effective conversations with your oncologist</h2>\n<p><strong>Preparation tips:</strong></p>\n<ul>\n<li>Write questions down before your appointment</li>\n<li>Bring someone with you to take notes (two sets of ears are better than one)</li>\n<li>Record the conversation (with permission, most doctors are fine with this)</li>\n<li>Request copies of all test results and reports</li>\n<li>Don't apologize for asking questions, it's your life</li>\n</ul>\n<h2>Question 1: \"What is my exact diagnosis, including the type, stage, and grade of cancer?\"</h2>\n<h3>Why this matters</h3>\n<p>Your treatment plan depends entirely on your specific cancer characteristics. \"Breast cancer\" isn't enough, you need details:</p>\n<p><strong>Cancer type examples:</strong></p>\n<ul>\n<li><strong>Breast cancer</strong>: Invasive ductal carcinoma vs. invasive lobular carcinoma vs. inflammatory breast cancer</li>\n<li><strong>Lung cancer</strong>: Adenocarcinoma vs. squamous cell vs. small cell</li>\n<li><strong>Lymphoma</strong>: Hodgkin vs. non-Hodgkin, and dozens of subtypes</li>\n</ul>\n<p><strong>Stage (0 to IV):</strong></p>\n<ul>\n<li>Tells you how far cancer has spread</li>\n<li>Drives treatment decisions</li>\n<li>Stage 3 colon cancer and stage 4 colon cancer have very different treatments</li>\n</ul>\n<p><strong>Grade (1 to 3 or 4):</strong></p>\n<ul>\n<li>How abnormal the cancer cells look under the microscope</li>\n<li>Higher grade usually means more aggressive growth</li>\n<li>Affects prognosis and treatment intensity</li>\n</ul>\n<h3>What to ask for</h3>\n<ul>\n<li>\"Can you write down the complete pathology diagnosis?\"</li>\n<li>\"What does this stage mean in practical terms?\"</li>\n<li>\"Is there any uncertainty in the diagnosis that requires additional testing?\"</li>\n</ul>\n<h3>Red flag</h3>\n<p>If your doctor seems vague about your exact diagnosis or stage, this is a sign you may need a second opinion or additional testing.</p>\n<h2>Question 2: \"What are ALL my treatment options, including the option of doing nothing?\"</h2>\n<h3>Why this matters</h3>\n<p>Oncologists sometimes present one recommended treatment without discussing alternatives. You deserve to know:</p>\n<ul>\n<li>Standard treatments (chemotherapy, surgery, radiation)</li>\n<li>Targeted therapies (if your cancer has specific markers)</li>\n<li>Immunotherapy (if your cancer type responds)</li>\n<li><a href=\"https://radicalhealth.ai/blog/cancer-clinical-trials-explained-part-1/\">Clinical trials</a> (experimental treatments)</li>\n<li>Active surveillance (watching and waiting)</li>\n<li>No treatment (if treatment risks outweigh benefits)</li>\n</ul>\n<p><strong>Important:</strong> For many cancers, there are multiple equally effective options. Your oncologist's recommendation may be based on their specialty or institutional preference, not necessarily what's uniquely best for you.</p>\n<h2>Question 3: \"What genetic testing or biomarker testing should be done on my tumor?\"</h2>\n<h3>Why this matters</h3>\n<p>Modern cancer treatment is increasingly personalized based on your tumor's genetic profile. Testing should happen BEFORE starting treatment when possible.</p>\n<h3>Critical tests by cancer type</h3>\n<p><strong>Breast cancer:</strong></p>\n<ul>\n<li>ER/PR/HER2 status (determines hormone therapy and targeted therapy)</li>\n<li>Oncotype DX or similar (helps decide if chemotherapy is needed)</li>\n<li>BRCA1/2 testing (patient and tumor)</li>\n</ul>\n<p><strong>Lung cancer:</strong></p>\n<ul>\n<li>EGFR mutations</li>\n<li>ALK rearrangements</li>\n<li>ROS1 rearrangements</li>\n<li>PD-L1 expression</li>\n<li>Comprehensive genomic profiling</li>\n</ul>\n<p><strong>Colon cancer:</strong></p>\n<ul>\n<li>MSI/MMR status (determines immunotherapy eligibility)</li>\n<li>RAS mutations (determines biologic therapy options)</li>\n<li>BRAF mutations</li>\n<li>HER2 amplification</li>\n</ul>\n<p><strong>All advanced cancers:</strong></p>\n<ul>\n<li>Consider comprehensive genomic profiling (tests hundreds of genes at once)</li>\n<li>Platforms: Foundation Medicine, Guardant360, Tempus, Caris</li>\n</ul>\n<h3>What to ask</h3>\n<ul>\n<li>\"Has my tumor been tested for all relevant biomarkers?\"</li>\n<li>\"Should we do comprehensive genomic profiling?\"</li>\n<li>\"Will these test results change my treatment options?\"</li>\n<li>\"How long will testing take, and can I start treatment while waiting?\"</li>\n</ul>\n<h3>Warning</h3>\n<p>Starting treatment before complete testing is sometimes necessary (fast-growing cancers), but often patients begin chemotherapy before knowing they might benefit from targeted therapy or immunotherapy with fewer side effects. The breadth of relevant biomarkers, and the speed at which the list grows, is part of why we built <a href=\"https://radicalhealth.ai/blog/radical-health-perfect-100-on-medical-licensing-exam/\">an AI knowledge engine that scored 100% on the US Medical Licensing Exam</a> before we let it touch a patient's records.</p>\n<h2>Question 4: \"What does success look like, and how will we measure it?\"</h2>\n<h3>Why this matters</h3>\n<p>Different treatments have different goals:</p>\n<p><strong>Curative intent:</strong></p>\n<ul>\n<li>Goal: Eliminate all cancer</li>\n<li>Measurement: No evidence of disease (NED) on scans, normal tumor markers</li>\n<li>Example: Surgery for early-stage colon cancer</li>\n</ul>\n<p><strong>Life extension:</strong></p>\n<ul>\n<li>Goal: Shrink or control cancer, extend survival</li>\n<li>Measurement: Progression-free survival, overall survival</li>\n<li>Example: Chemotherapy for metastatic cancer</li>\n</ul>\n<p><strong>Palliative / symptom control:</strong></p>\n<ul>\n<li>Goal: Improve quality of life, manage symptoms</li>\n<li>Measurement: Pain levels, functional status, symptom burden</li>\n<li>Example: Radiation for bone metastases causing pain</li>\n</ul>\n<p><strong>Active surveillance:</strong></p>\n<ul>\n<li>Goal: Avoid treatment side effects unless cancer progresses</li>\n<li>Measurement: Stable disease on monitoring</li>\n<li>Example: Watching small kidney tumors</li>\n</ul>\n<h3>What to ask</h3>\n<ul>\n<li>\"Is this treatment intended to cure my cancer or control it?\"</li>\n<li>\"What are the success rates for patients like me?\"</li>\n<li>\"How will we know if treatment is working?\"</li>\n<li>\"When will we do scans or other tests to check progress?\"</li>\n<li>\"What happens if this treatment doesn't work?\"</li>\n</ul>\n<h2>Question 5: \"What are the side effects, and how will they impact my daily life?\"</h2>\n<h3>Why this matters</h3>\n<p>Treatment side effects can range from minor inconveniences to life-altering complications. You need realistic expectations:</p>\n<h3>Questions to ask about side effects</h3>\n<ul>\n<li>\"What side effects do most patients experience?\"</li>\n<li>\"What are the rare but serious side effects I should watch for?\"</li>\n<li>\"Will this treatment affect my ability to work?\"</li>\n<li>\"What about sexual function, fertility, and intimacy?\"</li>\n<li>\"Are the side effects temporary or permanent?\"</li>\n<li>\"How will we manage side effects if they occur?\"</li>\n<li>\"What should I do if I experience [specific side effect] at 2am on a weekend?\"</li>\n</ul>\n<h3>Side effects often not discussed (but should be)</h3>\n<p><strong>Cognitive effects (\"chemo brain\"):</strong></p>\n<ul>\n<li>Memory problems</li>\n<li>Difficulty concentrating</li>\n<li>Can last months to years</li>\n</ul>\n<p><strong>Sexual and fertility effects:</strong></p>\n<ul>\n<li>Erectile dysfunction</li>\n<li>Vaginal dryness or pain</li>\n<li>Infertility (discuss egg/sperm banking BEFORE treatment)</li>\n<li>Loss of libido</li>\n</ul>\n<p><strong>Appearance changes:</strong></p>\n<ul>\n<li>Hair loss (head, eyebrows, eyelashes, body hair)</li>\n<li>Weight gain or loss</li>\n<li>Skin changes</li>\n<li>Scarring from surgery</li>\n</ul>\n<p><strong>Financial toxicity:</strong></p>\n<ul>\n<li>Out-of-pocket costs</li>\n<li>Inability to work</li>\n<li>Travel costs for treatment</li>\n</ul>\n<p><strong>Emotional impact:</strong></p>\n<ul>\n<li>Anxiety and depression (very common)</li>\n<li>PTSD symptoms</li>\n<li>Relationship strain</li>\n</ul>\n<p><strong>Important:</strong> Ask for written information about side effects. You won't remember everything discussed in the appointment.</p>\n<p>import BlogFAQ from '../../components/blog/BlogFAQ.astro';\nimport Disclaimer from '../../components/blog/Disclaimer.astro';</p>\n<p>&lt;BlogFAQ\n  heading=\"Quick reference: the five questions\"\n  items={[\n    {\n      question: \"What is my exact diagnosis, including the type, stage, and grade of cancer?\",\n      answer: \"Ask for the specific cancer type and subtype (not just 'breast cancer' but the histology), the TNM stage, the tumor grade, and the result of any molecular or genetic markers. These details drive every downstream treatment decision and let you research evidence-based options that apply to your case.\",\n    },\n    {\n      question: \"What are ALL my treatment options, including the option of doing nothing?\",\n      answer: \"Ask the oncologist to list every reasonable option, including standard care, clinical trials, and watchful waiting. For each, ask about goals (cure vs. control), evidence quality, expected response rate, side effects, and the trade-offs. Request the option to do nothing or wait so you understand the natural history of your disease.\",\n    },\n    {\n      question: \"What genetic testing or biomarker testing should be done on my tumor?\",\n      answer: \"Many cancers have actionable biomarkers (EGFR, ALK, BRCA, PD-L1, microsatellite instability, tumor mutational burden, and more) that change which treatments are most likely to work. Ask which tests are recommended for your cancer type and whether results would change the treatment plan or open up clinical-trial options.\",\n    },\n    {\n      question: \"What does success look like, and how will we measure it?\",\n      answer: \"Ask about realistic outcomes: cure, remission, stable disease, or symptom control. Ask which imaging or lab values will track progress, how often they'll be repeated, and what would prompt a treatment change. Aligning on the definition of success up front prevents misaligned expectations later.\",\n    },\n    {\n      question: \"What are the side effects, and how will they impact my daily life?\",\n      answer: \"Ask for the most common side effects of each treatment, the serious-but-rare ones, how long they typically last, what can be done to manage them, and how they will affect your ability to work, drive, eat, sleep, and care for family. Request written side-effect information you can review at home.\",\n    },\n  ]}\n/&gt;</p>\n<hr />\n",
      "date_published": "2025-02-15T00:00:00.000Z",
      "image": "https://radicalhealth.ai/og/blog-5-questions.png",
      "tags": [
        "patient-education"
      ]
    }
  ]
}