Why More Drugs Don't Mean Better Cancer Care

In this presentation Dr. Dino Prato argues that the biggest obstacle in cancer treatment is not a shortage of drugs but the lack of a systematic, precision‑oncology architecture that identifies the right biological targets for each patient. He critiques the current protocol‑driven, fragmented oncology model—where patients are asked “what’s the next protocol?”—as being driven by hospitals, insurers, and pharma rather than by the patient’s tumor biology. Dr. Prato outlines a comprehensive approach that starts with deep, multi‑omic testing (DNA/RNA sequencing, ctDNA, CTCs, methylation, immune profiling, metabolomics, proteomics, etc.) to map the tumor’s mutations, pathways, and immune environment. Using this data, clinicians can design custom combination regimens—targeted drugs, off‑label agents, immunotherapies, and integrative supportive therapies—delivered in the optimal sequence, dose, and timing. He describes three “care paths”: (1) a basic path where patients receive standard care without deep testing; (2) an intermediate path with spot‑treatments guided by molecular data; and (3) a full‑service path with longitudinal monitoring before, during, and after treatment, using real‑time biomarkers to adapt therapy. Dr. Prato emphasizes that integrating nutrition, lifestyle, and organ support restores immune function and improves quality of life, turning cancer care into a dynamic, data‑driven process rather than a static protocol. He calls on patients to demand this precision architecture, seek doctors trained in molecular targeting, and push for broader access to the necessary testing, arguing that doing so can dramatically improve response rates, progression‑free survival, and overall survival.
Chapters
One of the biggest problems to most people's cancer treatment isn't that there isn't enough good drugs or treatments or integrative agents that can help you. It's a bigger problem, one that most people are missing. It's finding what are the right targets. The problem isn't that you're missing the right drug or you don't know which one it is. There's just too much noise and not enough signal. It's distracting the correct path for healing. And I see this no matter where people go, top cancer hospitals in the country or integrative centers, whatever they're doing, they're missing this key question because patients Patients are stuck asking, what is the best protocol? It's not the protocol. That's the wrong question because that's what the hospitals want you to ask. That's what insurance companies want you to ask. That's what big pharmaceutical companies want you to ask. But actually, the better question is, what is the right target? What do I need to help me get over this cancer or target it correctly? See, the wrong question, especially the one that comes from patients that have advanced metastatic resistant refractory, all those words that tell you cancer isn't working. What's the next protocol? That's not the answer because your cancer is not a protocol. It's a living biological system. It changes, it adapts, it develops resistance, it creates immune evasion where your immune system can't fight the cancer. It can have multiple mutations, multiple signaling pathways that are off, different populations of cancer cells within the same patient. And so an immune environment that isn't ideal to getting rid of the cancer. And this is the biology that's causing the metastasis. And this is what we need to take care of. So today I wanna introduce you to what I believe is one of the most important things. One of the things that if you can put this into action, you can make a major change for your cancer, your family, the journey you're on, because it's, it's not an easy one to do alone. And it can help you greatly improve your oncology journey no matter where you're at. Early diagnosis, middle, late stage, difficult, whatever you might be. So what we're talking about here is changing the entire architecture of your cancer treatment, the entire care. Assume for a moment I'm correct. Okay? We've treated I've treated thousands and thousands and thousands of cancer patients over the last 26 years who have failed some of the top cancer hospitals around the country, who've tried everything, integrative care, traveling around the world, and then they come. And what I see is an incredibly fragmented cancer system. Patients don't know what's going on. Decision-making isn't sharp. Oh yes, we're going to take your information to the tumor board. Well, what, 30 minutes, an hour to discuss palliative care? Where is the orchestration of the care? Where is the deep testing? So we're gonna move from asking what is the next cancer drug that you need to a better question. What is the patient's cancer biology actually doing right now? And how can we build an intelligent treatment to overcome it or help it so that a patient can live longer with a better quality of life? That's what I mean by shutting off cancer. It's using the key information. I'm not telling you that there's a magic switch that guarantees a cure for everybody, but there is better targeting, which leads to significantly better quality of life and outcomes. I'm talking about a systematic program of identifying the targets, understanding what are the right treatments and custom building them for the patient, and then delivering them clinically actionable targets that help patients respond better to care. That's strategy. That's what my team and I have been doing for, you know, 26 years. And that's what I want to share with you because patients that have complex, difficult cancers or Maybe they're early on in the diagnosis. They don't have good planning. I've seen this, and I would say 98, maybe 95% of the time our team sees that when people come in, this testing does not exist. I don't care where they go. It doesn't exist because they're not running it. They're not looking at it, and they're missing so much. So I want you to make sure that when you're listening to this program today, it's to encourage you and to help open your eyes to something that you're missing. Now, before you change anything, make sure you're working with a doctor. Let's get started. So the problem isn't That we don't have the right treatment, or there's a treatment that needs to be discovered for your cancer. That's where I think everybody's focused on. The problem is the architecture. You're missing a lot of treatments. On-label drugs that are already approved. Okay. Off-label. These are drugs that may have been discovered before. They're old. A lot of doctors don't use them. They may even have had a different purpose, but they're a good match for your targets. Integrative, which work adjuvantly supporting, combining, right? What are the right targets? And key immunotherapies. This changes the game. Most people are not getting optimized cancer treatment. And when I mean most, I mean a lot. Now, if you got an early-stage cancer, it gets surgically removed and it goes away. That's what we want. Great. But that's not what I'm talking about here. I'm talking about a patient who's frustrated in the middle of care. They're not feeling well. The treatment is too toxic for them, and they see that the markers aren't going in the right direction. They don't know what to do. Modern oncology has produced, yes, extraordinary drugs. I mean, pharmaceutical companies have made 'em, some targeted therapies. We've seen immunotherapies come to market, new combinations. Most of them are cytostatic. They're designed to slow cancer down, not eliminate it. Now there's new radiation technologies, ultrasound, which is becoming fantastic. Cellular therapies. These are the ones I'm excited about, these immune system cells that help your body fight cancer specifically for you. Interventional oncology, like what we do. But all these advances only matter if you know which to give and in what order. And here's the problem. You don't have access to this. You can have an excellent individual tool, but it's incomplete in the strategy of helping that cancer get treated correctly. You can have a good chemo that works for a little bit, some shrinkage, and then the cancer returns. No matter where you are in your cancer journey, you need the right navigation targeting in your care journey. So let's talk about this for a second. This is called a care path. I want you to think about this. Let's say a patient is early diagnosed. They're at their local hospital, local oncologist, maybe a top cancer center, and they're in the hands of these doctors hoping things work, right? That's care path 1. But you don't have anybody doing all of this higher-level testing to predict outcomes, to look at if the current treatment is gonna work or not, helping you change diet, lifestyle, to target your immune system, even test the drugs they're doing to see if it works. That's care path 2. So that's care path number 1, and that can easily be done for anybody in all over the, all really all over the world or throughout the United States with just working with the right tele-oncology component. That's something that we offer for some people, but that's the introduction. Okay. Second care path, the patient is responding well, but things aren't going very well and they need to come in and do a spot treatment. Something that's the laboratory testing shows if they do a targeted directed tumor, like I both talked about, you take a catheter the size of a hair, you go right into the tumor delivering a custom designed treatment, not one that's an off-the-shelf immunotherapy. Or an off-the-shelf chemo, but it's targeted based on their genetics and immunotherapy, and then that is used to shut that tumor down and create a scopol effect or an immune system response to the body. Or where maybe their immune system is built outside of their body, mingling it with the tumor to attack the tumor, teach it how to actually know what the antigens are. See, these are just little highlights I'm giving, but you don't know that or what are the right combinations or even the right low-dose chemotherapy with the right adjuvant supportive agents that work on your metabolomics and are low dose. So a patient. can actually exercise, hike, have energy, not feel run down, and their cancer is improving significantly. See, this is the difference. Cancer treatment has become so fragmented today. One physician may start one thing, finally looking at maybe one mutation. Finally, for years, I'm going back 7, 10, 15 years, it was difficult to get standard oncologists to run genetic next-generation sequence testing, these DNA tests. Now it's becoming more popular, thank goodness. But this is only one layer. So they're looking for one drug that can affect one mutation. To help buy time. That's what it is. It's a cytostatic. It's slowing things down. But what are you doing in the meantime? Even if you're on a smart drug, let's call it, what are you doing? Are you incorporating the immunotherapy? You're shutting down the pathways. Are you getting to the root cause of the cancer? See, this is your opportune window to build those other components and finally look deeper at not just those mutations, but the roadmaps for the mutation to escape, the immune system to function. So you need to look beyond just the scan. Just the radiation treatment, and you have to look beyond just the basic immunotherapy checkpoint inhibitors. You have to see the laboratory data and measure the signals. What are these signals? I've heard this many times: a patient has cancer, they get surgery, they were told it's going to go away, that a 90% chance or high success rate, and the disease returns a year, whatever, six months, two years later. And that actually could have been identified before the surgery. And you're saying, Dr. Prado, how's that possible? Why didn't my doctor run that? Because they're not. Running leading indicators. Why? Insurance doesn't cover it, and they're not crazy expensive, but they're just not covering it. Number 2, it's not in the system yet. That's the way oncology works. But we've been running that testing for many, many years. We can tell methylation scores, CTC, circulating tumor cells, ctDNA. Those algorithms tell us immediately response, no response. You can do that for anybody. That's simple. We, with other testing, what markers are correct and not correct, what treatments to build. This is the data. We need to go beyond tumor markers. You know, if you, if you're in the world of cancer, you know what I'm talking about. There's a tumor marker sometimes related to your cancer or imaging, but who's doing this deep testing of thousands of markers, mapping the combinations, and then building a precision algorithm and pathways to treat the cause, the drivers, the immune system related to your cancer? Nobody. I've traveled the world. I look at all the top clinics, all the major cancer hospitals. This stuff is only being done on fringe areas, maybe with a little bit of research to discover a new drug. But this is what we need to do so that we can shut cancer off once and for all. Get the pathways, understand the direction, and logically shut it off. So that's what's important. You have to put these pieces together and create the precision modeling. So when I'm talking about precision oncology, I'm not talking about a smart drug, one drug for one target. I'm talking about an architecture. That becomes like a symphony to treating the cancer and a constant monitoring. So in the beginning, it's like, okay, you're responding great. Continue responding. Even when you go home, monitoring with simple blood work, diet, lifestyle, keep those numbers down. Great. One month leads to two and six months to a year and one year to three. That's how we stay ahead of making sure we don't have a new mutation, resistance, immune evasion. See, what oncology wants to call precision oncology is the new big pharma drug. New drug comes out. It's very exciting. Gets tons of media. It goes all over the news. I mean, you'll, you'll see it. It's on your feed. It'll be like, oh, new drug, exciting. But it's maybe extending life by 6 months. Let's be honest. And that's a blockbuster drug. It's slowing things down. It's buying time so we can do other things. And nobody's doing those other things that I'm talking about. Establishing immunity, go direct to the tumor, shut it down. This is a precision oncology architecture that goes beyond one drug. So we found a mutation and there's one drug for that is not enough. That Is not the precision medicine I'm talking about. And sometimes, yes, one drug can produce an extraordinary result in a smaller population, but maybe by a couple of years or work longer. Fantastic. But when you understand that there are more actionable targets, that becomes wonderful because we can maybe do it in a nontoxic way. And maybe we can have these additional pathways addressed that include the RNA transcriptomics, the immune profiling, the immune spatial biology, the things you hear me talking about all the time. And now once and for all, these metastatic diseases can, by the grace of God, shut down because we're getting to the engine of what's driving them. That's the goal. So what if the tumor's immune system and the environment of the suppression of the immune system is not dealt with? Or what if a doctor just says, hey, I'm going to go to one of these places like abroad and do an immunotherapy that's not targeted and just build some cells or inject the body with these immunotherapies, hope they work. You can overstimulate the immune system where you might have an initial response and then more inflammation and then more progression. See, everything requires deep testing, cuz when you do that, you can get out of poor planning and into precision. That's what I'm talking about. It's like a puzzle and you putting all the pieces together. That's what you want answered by your doctor. What are the right combinations for the biology of your cancer? What is it? And then, doctor, what is the best targets? What are the combinations at the right doses stimulating the killing of the cancer, building my immune system, restoring my body so I can be healthy. Health and cancer can go together, but you'll see a lot of people, they'll talk, oh yeah, integrative medicine doesn't work. Or, you know, supportive adjuvant care is what we call it because that's the legal term. But integrative care is sometimes extremely important because it's the part that's helping you restore your vitamins, minerals, enzymes, nutrients, liver function, immunity alongside treatment. Because if you just do treatment and nothing else, he's like, well, go home and eat a good diet. Okay, that's good. Take some vitamins secretly so your oncologist doesn't and see you doing it. That's not what we need. We need timing and precision. So we're strengthening the immune system because a lot of patients become immune exhausted with a lot of the drugs today. A lot of these smart drugs and immune system treatments, their immune system becomes exhausted, run down, fatigued. How do you restore that? That's where nutrition comes in. It's not everything, but it's critical. How are the organs functioning? And then we can target the cancer treatment while healing the person's vitality and energy. That's why I've always loved the integrative part of precision oncology, because we don't just end at drugs and immunotherapy and direct a tumor and building beautiful cancer cell vaccines. It's the beginning. The end is restoring the health to the patient, giving the body what it needs to heal, giving the body what it likes to have more energy. I mean, patients after cancer treatment, fatigued, run down, hair loss, sarcopenia, loss of muscle. That is where integrative medicine shines. And that's why the combinations are so powerful. And you need to know how to combine those. And that is the algorithms that I've been working hard with my team over 26 years. To master algorithms of precision to restore health to the body and remove the disease. That's what I want for everybody watching here and/or your family members. That's my prayer for all of you, is that you find those combinations by the grace of God that allows you to respond better, not just fall into a system that you feel like a number, like no one's helping you. I mean, think about it this way. A GPS system doesn't, you know, just drive the car on its own without it being connected to a supercomputer that knows How and where to take you. So the information is coming in, but then there's a computing system that's moving you through the traffic signals and the. I mean, we got this crazy the time where cars can drive themselves. The precision oncology is the same way. First of all, we have to get the data, which the data isn't being taken in, and then we need the algorithms, a supercomputer, the ability to map the disease out with doctors that are trained in precision molecular targeting. Molecular targeting is the key to oncology, and immunological targeting goes hand in hand. See, when you identify those key vulnerabilities and you prioritize care, cancer treatment correctly, you have an entirely different treatment. You can see now which treatment the patient can tolerate better. So they're energetic while receiving care to the best of the ability, establishing measures and strategies that succeed for the patient. See, this changes cancer. We're shutting it off. We're using the right information to shut the cancer down correctly instead of guessing. Now, what happens is patients will do care. Let's say go to standard of care, which is typically where they'll start, and they'll do a round of chemo, maybe 2, and then they'll look for care. And, you know, we're very busy because there's a lot of patients that fail this care that reach out to us. We're very busy. And what is interesting is the more that they've done care, we have more work to do because there's more resistance, there's more weakness of the immune system. The sooner a patient uses precision oncology architecture like I'm talking about, moving to the right targets at the right doses, not only is response even better, But their quality of life is better. I mean, think of it this way. When you do a test, let's say you run a test at any doctor's office, you're just getting a photograph in that moment. And then you run a test and you wait, you know, whatever, a few months, and you do imaging again, 3 months. But cancer is not just a photograph, it's a movie. It's always changing, especially with advanced cancers, like some of the difficult ones, the dirty cancers. Those are mutating every 4 to 6 weeks. And even though you're applying treatment pressure with the chemotherapy, it finds ways to evade it. If you do not have complete mapping, if you don't restore the patient's immune system, give them the right combinations, phytotherapeutic combinations that go with the right drug combinations. So you give the cancer less of an ability to survive. I mean, you even have cancer cells that have cancer stem cells that are just like, we're going to try to survive anything. So you have to have tools to go to those stem cells. You have to have tools to shut down those pathways. That's what I'm talking about with deep planning. Most of cancer treatment today is done through double-blind placebo clinical trials called the standard. The National Comprehensive Cancer Network guidelines done by almost every oncologist. Doesn't matter where you go, it's going to be similar. Same insurance billing codes, same whatever's going on, same big pharma programs. Right. But sure, they can have importance. But follow me here for a minute. These organizations are basing their care on a general population that has your type of cancer. And for that drug to get approved or that regimen, it helps a little bit more than it did in the past and it didn't do very good. So we're still using, even though we have some beautiful new drugs coming to market, 1990s technology from an architecture standpoint of treating these cancers. I'm talking about moving into the future where we look at all the pathways, look at the patient's ability to metabolize the drugs, look at their immune system, and then build the care with intention. I know it sounds simple, but it's powerful. Intention to your biology, not intention to just a tumor. And then when you have that, you can design care, not just a snapshot, but longitudinal care where you're monitoring the methylation, CTC, ctDNA. We can monitor the cancer in the middle of care, before care, Aftercare, even when you're home, and we hope you know patient goes home, they have remission, or they have a good response, or they're responding well, they're in a good direction. We want to be able to continue to monitor and guide because time helps us as people continue to hold good responses. And we do that not by hoping, but by using the data to guide. So there's these care paths. There's a care path when you go home. You should have total guidance. If you're in an oncology center and you go home and it's like, "Oh, we'll wait for imaging," you need to get a care path. You should be working on diet, lifestyle, what caused that cancer. You should always be working and monitoring that CTC. CT-free DNA. So you make sure you get 1-year, 2-year, 3-year. Because when you heard, hey, the cancer was removed and you have a 90% chance of it not coming back, there are patients and we are treating them that where that cancer came back. Why? Because the cause was never dealt with and these tests were not run. And so they caught them blindly. And then the images showed more things came back and then they started the long line of chemo, failed the first regimen, the second regimen. We don't need to do that. That is, in my mind, archaic. Patients need to have this type of line. So that's the first care path. Second care path is you can spot treat. So where you need this type of architecture, And then you can get a specific architecture to come in, in a specific area, can come in and help you and give you like an immune system care that you need or a direct tumor response that you need, which is very precision. And that's another care path. Third care path is, you know, the ultimate care path where you're getting full care from A to Z and everything's being monitored before, during, and after. And that's what I really believe every patient deserves. But this is the key to oncology. It's not just immunotherapy. It's not just give this drug or just go to this center where they're going to take your cells, give it back to you, or go to this Cancer center that's got this new clinical trial. These are all good ideas, but without the deep architecture and planning, it falls on its face. We see these patients all the time. So what I wanna say today is I'm not saying, you know, we can't fix this. To shut cancer off, we have to have an honest conversation. Is everybody doing this deep mapping? No. That's an honest conversation. Is your doctor likely to do this? We hope so. But where and how? And are they really doing that? Right? That's the number one. Likely not. These are honest conversations. And if we need these treatments and we need this testing because it can save, extend, or improve somebody's life, that should be made available to them. Because now we get out of guesswork and we get into targeting. So that's where I'm talking about. That's where oncology is going. And it's actually there now. It's just patients need access to it now. That's the important conversation. You know, we literally can multiply the results. We can take a 1 plus 1 figuratively and turn it into an 11 because we have actionable targets. We have deeper testing. We know the vulnerabilities of the tumor. We know the patient's immune system and where it's going, that gives us such an advantage. Delivery options, how the treatment's gonna be delivered, the timing, the sequence, all to fit the best match strategy for each patient. See, this isn't wishful thinking. This is happening now. And my dream and my goal is for everybody to be getting this wherever they're going, at least have this testing alongside whatever they're doing so they can get the benefit of this care. And I know it takes a while because it's a very slow road in oncology. It's very rare that things move quickly. But this is my hope. And I see the technology. I see where everything is going. It's very powerful. It's very intelligent, but I want everybody to have it now. That's exactly how I feel. You know, years ago that you have studies, you know, people ask where this is coming from. Well, years ago, we've been doing this work for a long time, but groups like iPredict and Winter and True, all these different studies have been doing this targeting and matching at a lower level, but the results have been always better when the matching is there. So the more you match, the better. And obviously we've published in our papers the same thing. It's extraordinary. The more matching, the more targeting, better quality of life, length of life. That's what we see clinically. So I'm not saying you abandon what you're doing, but to recognize that targeting and deeper mapping is where oncology is going. It's what patients deserve access to. And we can get there if we can ask the right questions, push the technology for, you know, oncology should not be run by big pharma. Big pharma should make drugs fine. Should not be run by big hospitals. They should be able to provide services. It should be run by Doctors who are trained in molecular targeting can see the whole picture and have the freedom to prescribe what is best for the patient with the goal of a superior outcome, a better quality of life, better progression-free survival, better overall survival. That's the goal. Better effectiveness. And we are not going to do that in large population health because it's a one-size-fits-all, and cancer is not a one-size-fits-all. Two people, same types of cancer, exact same place, different biological markers. The more testing you do, poly markers, you know, poly targeting, multiomics, all these different tests are going to give you the architecture. So we can stop asking what's the protocol and start asking how's the patient responding and how do we just tweak the care in the right direction to keep advancing the body's ability to heal itself. And I say that very clearly because at the end of the day, no matter what you do, it's your body that does the healing. You might kill the cancer, but your immune system has to You have inflammation, your body's got to deal with that. So your body is intelligently designed by the grace of God to heal. And we always ask as doctors, can you illuminate our path for the healing of our patient? And we do that with testing, targeting, and mapping. That's the key. The architecture, the philosophy, the testing, and then the custom design of care is the key instead of static protocols and watching and waiting. And I don't have enough time to talk to my doctor. I don't know what the next step is. I think some of that, and I say that respectfully, is purposeful. Because what are they going to say to you? We've tried this and this is the next round. But if we have deeper testing, we can have deeper conversations that can help people heal. We can dare to ask the questions. What does a patient need to get well? Yeah, sure. Clinical trials can be helpful. This is helpful. But what do you need? What does the patient's immune system sitting in front of me need? What does the patient need? What are the right maps and targets for that person so we can help them respond? Help them have a longer-term response. Can we do that? And that's the key. That's precision oncology. So I don't want you to get lost when you hear that term somewhere. That is the orchestration of DNA, RNA transcriptomics, next-generation sequencing, immune profiling, immune spatial biology, biomarkers, metabolomics, proteomics, all this data to select the right drugs, deliver them correctly, integrative medicine, tolerance, response, not averages biology. And in a way that helps people bond. So if you take anything home from today's message, I want to encourage you: this already exists. Ask your doctor. If they can't do it, find another doctor. But I want you to recognize that this data is available. Testing matters. Selection of care matters. Building the best fit strategy for you is different than anyone else. And until that architecture of precision is made available. you are missing things. You are missing options that can be very important. You might be even on the wrong medicines. Look, here's a classic example. Patient comes from a high-level cancer institute and we run testing. The testing shows that the current medication they were put on was only working at maybe 20%. Then we run testing, we find agents that are running 80 or 90 or better matches, or genetic mutations weren't even touched, or immunotherapies were never even done. We adapt those in at the right micro amounts, not enough to harm the patient, but Bring it into the care. And now we move away from fragmented care where we're trying one thing or another, and now we're orchestrating precision and we see the difference. Now, that is what I mean by shutting off cancer. It's not a magic bullet. It's not a switch. It's not a cure promise. It's an architecture for attacking one of the most complicated diseases in medicine and having the best ability for that patient to respond. That's the key. And the end of that pathway and the end of That immune system direction needs to be to help the patient heal. It can't just be one drug. It's the combinations and understanding how to treat. So ask your doctor deeper questions. Don't be afraid. It's okay. You're not hurting their feelings. That's what they're there for. And I just want to encourage you to not give up. Keep asking the questions, even if you're in remission or your family member, somebody you love, keep learning. Why did you get this? How do you build a better immune system? How do you become healthier? Yes, there's genetics involved, but there are things we can do Epigenetics, diet, lifestyle changes, nutrients that can keep us healthy. If you're in the middle of the fight, get the testing. I would do it in any of those stages. I would want to work where I'm constantly being tested, constantly being monitored, because that's going to give me the best chance, the best opportunity to get the precision care that's going to make the most difference in the long-term longitudinal outcome for the individual patient. I hope you found this episode helpful, and may the Lord bless you on your journey to healing.
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