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Hearing that two people have the same type of cancer often leads to one assumption: they'll receive the same treatment. However, modern oncology has moved far beyond the one-size-fits-all approach. Today, doctors recognise that even cancers originating in the same organ can differ significantly in their genetic makeup, molecular characteristics and behaviour, requiring highly individualised treatment plans.
Advances in genomic testing, molecular diagnostics and precision medicine have transformed the way cancer is diagnosed and treated. Rather than relying solely on where the cancer began, such as the breast, lung or colon, oncologists now examine the tumour's genetic mutations, biomarkers and protein expression to determine the treatment most likely to be effective. Alongside tumour biology, factors such as a patient's age, overall health, co-existing medical conditions and personal preferences also play a critical role in shaping therapy.
According to the World Health Organization (WHO), cancer remains one of the leading causes of death globally, accounting for nearly 10 million deaths in 2022. As cancer cases continue to rise, personalised medicine is becoming increasingly important in improving survival while minimising unnecessary side effects. Here's why two patients with the same diagnosis may receive entirely different treatment plans-and why that's often the best approach.
Cancer Is Not Just One Disease
Although cancers are classified based on where they begin, every tumour is biologically unique. "Two patients with the same kind of cancer are usually thought to be treated the same way by most people. But today's cancer care is highly personalised - after all, no two cancers are the same, even if they are of the same type. Cancers of the same type and stage can be very different from one another at the genetic and molecular level, which may affect how the tumour behaves and responds to treatment," says Dr G. Vamshi Krishna Reddy, Director - Oncology Services, Consultant Medical Oncologist & Hemato-Oncologist, Yashoda Hospitals, Hyderabad.
Researchers now understand that cancers can harbour different genetic mutations, hormone receptors and molecular markers that influence how quickly they grow, spread and respond to treatment. Oncology today is basically an approach that uses information about a person's genes and the molecular features of their tumour to guide diagnosis and treatment.
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The Role Of Genetic And Molecular Testing
One of the biggest advances in cancer care has been the use of molecular profiling.
"Treatment decisions are now made based on the molecular profile of the cancer and where it originated. Genetic testing helps doctors pinpoint specific mutations in the tumour, enabling them to select treatments that are more likely to work, like targeted therapy, immunotherapy, chemotherapy, surgery, or a mix of these. This precise method improves treatment results and helps to avoid unwanted side effects," explains Dr Reddy.
For example, in lung cancer, identifying mutations such as EGFR, ALK or ROS1 can allow doctors to prescribe targeted therapies instead of conventional chemotherapy. Similarly, breast cancers are routinely tested for hormone receptors and HER2 status, which determine whether patients benefit from hormone therapy, HER2-targeted medicines or chemotherapy.
Why Two Patients With Breast Cancer May Receive Different Treatments
Cancer treatment is increasingly determined by tumour biology rather than the diagnosis alone.
"Take breast cancer. Two women might each be told they have it, but their treatment plans may look nothing alike. One could do well with hormone therapy, while the other needs a targeted medicine or even chemotherapy. It's a similar story with lung cancer; some patients have specific gene mutations that let doctors use tailor-made drugs that work better, and are often easier to handle, than traditional chemotherapy," says Dr Anand Mohan, Consultant - Surgical Oncology, CK Birla Hospitals, Jaipur.
Biomarker testing has become an essential part of treatment planning for several common cancers because it helps identify therapies that are more likely to benefit individual patients.
The Patient Matters As Much As The Tumour
Personalised medicine isn't only about genetics. Doctors also consider several patient-related factors before deciding on treatment.
"Treatment planning is also influenced by several patient factors. These include age, general health status, kidney, liver and heart function, pre-existing medical conditions such as diabetes or hypertension, nutritional status and stage of cancer. Aggressive therapy may be tolerated by younger patients who are in good health, but an older patient or one with multiple medical problems may require a different approach. Patient preferences, quality of life and access to specialised treatment are also considerations that influence decision making," says Dr Reddy.
For instance, an elderly patient with heart disease may not safely tolerate intensive chemotherapy, while a younger patient with the same cancer may benefit from a more aggressive treatment strategy.
Personalised Medicine Means Better Outcomes
The goal of precision oncology is to improve effectiveness while reducing unnecessary treatment. "Instead of just treating the 'type' of cancer, doctors really look closely at the individual tumour. With tools like genetic profiling and other advanced tests, oncologists can now zero in on treatments that are most likely to help, while skipping the ones that won't. This isn't just about improving survival rates-it means patients aren't dealing with unnecessary side effects from treatments that wouldn't even work for them," explains Dr Mohan.
Modern cancer care is also increasingly multidisciplinary. Surgeons, medical oncologists, radiation oncologists, radiologists, pathologists and genetic specialists often work together to develop the most appropriate treatment plan for each patient.
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The Future Of Cancer Care Is Precision Medicine
The field continues to evolve rapidly as researchers identify new biomarkers and develop therapies that target specific genetic changes.
"The aim of personalised cancer care is to offer the right treatment to the right patient at the right time. Precision oncology has progressed to the point where treatment can be adapted based on the biology of the tumour and the overall health of the patient. This individualised approach is helping to improve survival, reduce treatment-related complications and give a better quality of life for patients with cancer," says Dr Reddy.
As technologies such as next-generation sequencing become more accessible, experts believe personalised treatment will become the standard of care for many cancers.
A cancer diagnosis may sound similar on paper, but no two cancers, or patients, are exactly alike. Advances in molecular testing, genetic profiling and precision medicine have enabled doctors to move beyond traditional treatment approaches and tailor therapy to each individual's tumour biology and overall health. This personalised strategy not only improves the chances of successful treatment but also reduces unnecessary side effects, allowing patients to receive care that is both more effective and more compassionate.
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