The Cancer Treatment Revolution Is Here. The Problem? We’re Not Ready for It.

The issue is not solving science, nor technology. The issue is changing the people and their bloody attitudes.

When I was a strategy consultant, envisioning the future was never the hard part. Dealing with idiots was.

Envisioning the future, based on existing components. That was the easy part. I could build roadmaps, models, and blue-sky scenarios that dazzled. I could show clients where the world was heading; what was possible, probable, and profitable.

But here’s what always killed the momentum: people didn’t want to change. Not really.

They’d nod along in workshops, fill sticky notes with bold ideas, and commission PowerPoint decks packed with ambition. But when it came time to challenge entrenched habits, rewire incentives, or dismantle outdated structures? Suddenly, everything got “complicated.” And now, in healthcare, especially in cancer care, we’re facing the same damn problem on a much larger scale.

We’re not held back by imagination. We’re held back by inertia. We already have the tools to fundamentally reshape cancer care. We have genomics. We have real-time data. We have AI. We have scenario tools. We have game modeling tools. We have the computing power to individualize treatment like never before, moving from generic protocols to strategic, adaptive care plans tailored to each patient’s biology, life, and preferences.

So why hasn’t this happened? Because the biggest obstacle is no longer technological. It’s human.

The Bottleneck Is Change

Healthcare is notoriously conservative. And for good reasons: lives are at stake, and anything new must prove itself rigorously. But this caution has morphed into inertia. Innovation in oncology too often gets confined to new drugs, while systemic transformation, how we orchestrate care, gets ignored or actively resisted.

Clinicians are buried under administrative burden. Hospitals cling to legacy systems.
Medical culture rewards protocol-followers, not system-challengers. And every stakeholder, from payers to providers to regulators, has their own incentive to not upset the status quo.

It’s not that people don’t care. It’s that no one owns the system. And no one wants to be the first to leap into a new paradigm without a guaranteed soft landing.

The Technology Is Ready. The People Are Not.

You can already build a platform that:

• Ingests a patient's genomics, imaging, history, and real-world biomarkers

• Cross-references this with global databases of similar cases

• Projects future tumor behavior using adaptive models

• Tailors therapy based on both risk and the patient’s values

But implementing this would require upending workflows, retraining clinicians, rewriting billing models, and letting go of rigid treatment algorithms forged in the pre-data era. It means trusting a system that learns. A system that changes course midstream. A system that thinks. That’s deeply uncomfortable to institutions built on standardization, control, and fear of litigation.

If the Hypothesis Is True, Then What?

If the problem is cultural, political, and structural, not technological, then that’s where the change must begin.

1. Start with Incentives
   We need reimbursement models that reward personalization and outcomes, not procedures and protocol adherence. Payers must help make this shift profitable.

2. Design for the Clinician
   Any AI-driven system must reduce cognitive load, not add to it. Make the interface invisible. Give clinicians time back, not another dashboard.

3. Tell Better Stories
   Progress stalls when the vision feels abstract. Show what personalized cancer care looks like in the life of a real patient. Tell stories that stick, stories that make doing nothing feel unethical.

4. Build Coalitions, Not Just Startups
   This shift requires alliances between hospitals, tech developers, regulators, and patients, and in those enlightened countries where healthcare won’t bankrupt you, governments. No single player can flip the switch.

5. Let Patients Pull
   Patients already expect personalized everything. The more they demand intelligent, adaptive care and move their loyalty and data to the institutions that offer it, the faster laggards will lose relevance.

The Brutal Truth

If you’re in healthcare leadership and you're not actively building or implementing this kind of system, you're part of the delay.

If you're a policymaker still rewarding volume over value, you're funding stagnation.

If you're a clinician clinging to checklists instead of pushing for intelligent systems, you're complicit in mediocrity.

And if you're a health tech founder focused on building yet another scheduling app, what the hell are you doing?

Patients don’t have time for your politics, your turf wars, or your “pilot program” excuses. This isn’t a moonshot anymore. It’s overdue.

Get in, build it, or get out of the way.