In this monologue Dr. Dino Prato argues that most cancer patients receive generic, population‑based treatment that ignores the unique biology of their tumors and the power of their immune system. He explains that standard‑of‑care is driven by three forces—clinical trial averages, insurance reimbursement, and the technology available at a given hospital—resulting in one‑size‑fits‑all regimens. Prato advocates a precision‑oncology ecosystem that begins with deep multi‑omics profiling (full DNA NGS, RNA transcriptomics, spatial immune biology) to identify thousands of actionable targets. With that data, custom drug design (on‑label, off‑label, repurposed, phytotherapeutics, cellular biologics) and patient‑specific delivery methods (micro‑dosing, image‑guided interventional radiology, adoptive cell therapy) are employed. He stresses that treatment must be immune‑centric, activating natural killer and dendritic cells to turn “cold” tumors “hot” and overcome immune suppressive micro‑environments. Continuous adaptive monitoring—circulating tumor cells, methylation scores, vesicle markers—allows early detection of resistance and rapid therapeutic pivots. Finally, he provides a list of concrete questions patients should ask their oncologists to assess personalization, immune focus, delivery strategy, and real‑time monitoring, urging patients to become informed advocates rather than passive recipients of average care.
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What most cancer patients don't know and how knowledge changes everything. It makes such a difference to know what the right targets are. Access to the best care, not just managing the disease, but going towards remission and long term remission, Mapping out the right targets and most importantly, engaging the immune system. Imagine being rushed into the cancer treatment with only a tiny slice of the full picture and not understanding how it really works until you're deep into care and the plan is preset. The drugs are standard, they're one size fits all. And nobody asks what are your tumors actually need to respond and what are the in depth targets. That's the problem we're going to fix right now. Not settling for outdated generic care and discovering the power of precision targeting. Because your cancer is unique, your life is worth it and your treatment should be too designed for you. You know the Bible says and I love the scripture, my people are destroyed for a lack of knowledge. What they don't know, that's Hosea 4:6 and that couldn't be any truer in today's cancer treatment landscape. In this episode I want to give you some knowledge that most people never hear or at at least don't understand until they're far into therapy. And maybe you might be far into therapy and this knowledge will be helpful for you. I'm Dr. Dino Prado. For the last two decades, my team and I have helped many patients who'd failed the top hospitals in cancer in the United States. Moving away from guesswork, bringing them into precision, mapping out their real care and helping them get the right treatments that they need, the care that is designed for their body, their immune system, their causative agents and helping them to heal. What patients really don't know is access to care doesn't guarantee the best care. So we're always worried in the United States about having the best insurance plan or the best models and you're going to get the same care. All the major hospitals are going to typically use the national Comprehensive Cancer Network guidelines, the standard of care in the U.S. cancer plans usually grow out of three things. Double blind, placebo, clinical trials, the one size fits all that's not you. Those are averages and it's based on population health. The second one is insurance billing. Based on what your insurance covers. That's all you're going to have access to. Quick for fast approvals, easy to code and it's billable. And when you're dealing with the latest technology, it's not usually going to be covered by insurance. Third, hospitals, what is a technology does the hospital near you have. And based on what their revenue models are, their radiation equipment, their surgical suites, the technology they offer, that's what you're going to get. That's how cancer works, unfortunately. So we need to break this. What it's not is built for you. Your unique tumor biology, your immune system, your targets are critical. Clinical trials are valuable, but they serve as an average, not for individuals. Cancer isn't average, it's heterogeneous. It's different in each patient. Different drivers, different immune roadblocks. And here's the proof. Standard of care is built maybe on let's say 24 markers, tumor marker biopsy imaging versus the thousands of markers with proper multiomics testing. That's not just some DNA test, but full DNA ngs, full RNA transcriptomics, full spatial biology with immune profiling, then finding the targets, building the algorithms, custom designing the medications and delivering them to the patients. These are the kinds of things that are so important to patient care. Unless you're working within precision oncology, you're not getting that complete precision ecosystem that's designed on you. The individual. Why the one size fits all model fails the individual. If you only test a few things or even add one genetic test, you're only seeing very few options, which is standard of care that does not work for everybody. Most people get maybe a tiny DNA panel and maybe a couple of RNA signals. That's like reading two pages of a 500 page playbook and calling it a plan. We prefer multi omics, deep mapping that we've custom built. And then when you have all that data, you have to custom build the drugs and the treatments because they're not commercially available. And then you have to take those medicines and deliver them in a detailed manner that's custom to the patient. This is the full ecosystem of precision oncology, multiomics, custom drug design, on label, off label, repurposed drugs, phytotherapeutics, cellular biologics like your natural killer cells, dendritic cells. And this all through immune profiling and targeting. Helps the immune cells get involved, helps the body's ability to turn on and have more options to help patients. Your tumor is not your neighbor's tumor. If you don't map thousands of possible matches and drivers you best targets. And I've seen this over and over again, that could be so helpful for you, the patient. The other part is the treatment needs to be immune centric. You maybe heard me say this before, but the focus needs to be on the immune system. Don't just slow the cancer down, which Is a lot of what these smart drugs do. They're cytostatic but design the care to help the immune system take out the cancer. In modern oncology, a lot of drugs manage cancer, they slow it down. It's actually more profitable to do that unfortunately. But to push towards a long term remission, the plan should be immune centric care. Making that cold tumor hot, Giving the immune system what it needs. Remove the blockades. Why? Because your immune system knows how to fight cancer. It's your God given strength ability to do that. Your natural killer cells. This is how you fight cancer in your body. What can cause your immune system to be in trouble? Chronic infections, chemical toxins, heavy metals suppressed tumor neighborhoods, low oxygen acidic pockets. Immune suppressive cells that come from the bone marrow and around the tumor. All of these things need to be put into the plan in treating. So how do we wake them up and guide them? We activate the natural killer cells and dendritic cells. We can REM breaks and the blockades. We can train them using damps, damage associated molecular patterns and go way beyond just the PD1 inhibitors that most people think is the only immunotherapy out there. Remember I've said it before. These immunotherapies like PD1s only work on 19% of the patients long term. And that's from frontiers in oncology. Genetic targets are critical, but the immune design is the difference between short term response and durable control. And custom built immunotherapy is a key. And this is what I've seen in my clinical experience over 25 years. When the immune system kicks in, it makes all the difference in the world. Good drugs in the wrong place, at the wrong dose, at the wrong times don't work. So sometimes patients are given high dose chemotherapy with the hope that that's going to help, but in fact destroys their immune system. Once we have the right targets, we can build an immune centric plan with the algorithms. Custom design the drugs and deliver them to the patients to help them. Microdose target, genetically targeted fractionated chemotherapy. Rectal tumor, interventional radiology oncology which is so neat, it's image guided surgery using not the size of the hair. Get to a tumor, kill the tumor, seal it come out and an immune system response that goes to the rest of the body. Autoglass, adoptive immunotherapies, where your own immune system is built to fight cancer and trained to do that. So balancing all these combinations is so important and it isn't easy, but when it's done correctly, it makes a world of difference. And it's just opened up tremendous options for each patient because it's custom built for each person. The next part is we want to track the success and if there's something off, we can fix it. So we monitor this with adaptive real time monitoring. Circulating tumor cells, methylation scores, vesicle scores. This data tells us way before a tumor were to develop or spread or continue growing, whether the treatment is working or not. And that's so important because if treatment's working, we continue and we go into remission. If it stops working, we modify it just a little bit, get that immune system engaged and help it move to remission. This is the power of precision oncology. If the pathways light up, we pivot. If resistance appears, we block it. No more watch and wait, treat and hope, but actually precision targeting throughout the care. This is where oncology's off today. They're not doing enough of monitoring and enough of this n of one custom build for each patient treatment. They're still using population health. In my clinical opinion, this will be the way the cancer improves tremendously. With a custom design for each person, deep learning patterns, data sets that guide care. So these are some of the questions you may want to ask to your oncologist. How's my plan personalized to my exact tumor? What's my not just DNA, but what's my RNA transcriptomics, immune spatial biology, and how is that all being targeted with immunotherapy at the center of my care? What's the goals to getting my immune system to fight cancer? How will you activate my natural killer cells and dendritic cells to help overcome my tumor evasion? How are you delivering treatment so you can avoid side effects, Help me to get the right targets to my body and help my treatments respond better. Can you go direct to tumor? Can you microdose my chemotherapy? Maybe 10% of the normal dose. See, these are good questions because the answer will usually be, we don't do that, we don't understand that, or it's not something we provide here. We just do standard of care. And that way you understand that you're doing standard of care, which to me is like socialized medicine, the one that everybody gets, the one size fits all. And you're not dealing with the resistant pathways, the IMM system, the adjuvant care, going beyond the standard of care to get the results that we see in clinical care. So adaptive monitoring is also important. You can ask them, how are you going to track my cancer? How are you going to pivot if we need to and do that in real time. So we want to go from being a passive patient to an informed patient, knowing what we're doing, getting the right care. You don't have to accept a plan that's built by the averages, but demand deep mapping, Demand a plan that's immune centric, that aims for long term remission. But you have to know what to ask. And knowledge is power. That's why I started by saying that if you have the knowledge, you have the precision, targeting it makes all the difference in the world. And this is the key, in my opinion, to helping many complex cancers have a far better response. Dare say remission. This is the goal. I hope this was helpful. And may the Lord bless you on your journey to healing. Sam.
