Latest / Rad Chat / E218: Dr. Aruni Ghose - Health Inequalities, AI in healthcare and Entrepreneurship

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E218: Dr. Aruni Ghose - Health Inequalities, AI in healthcare and Entrepreneurship · Rad Chat

• Naman Julka-Anderson (00:00) Hello everyone and welcome to Rad Chat, founded by me, Naman Julka- Anderson. Jo McNamara Rad Chat Host (00:04) and me, Jo McNamara. So Rad Chat is a forward thinking global knowledge hub where healthcare professionals can advance their expertise in radiotherapy and oncology. Unlike traditional academic resources, we blend real world experience, expert insights, best practice, and of course, most importantly, patient perspectives. Naman Julka-Anderson (00:23) We make advanced knowledge engaging and accessible, supporting continuous learning and professional development without compromising patient care or personal time. By providing insights into both technical skills and career development, helping you progress confidently in your field and shape your professional future. Jo McNamara Rad Chat Host (00:39) Just to let you know, our episodes may contain sensitive and difficult topics that you may find distressing or triggering. Naman (00:01.154) This is episode two one eight, which is part of the Living With and Beyond Cancer series, where we'll be hearing from our guest, Dr. Aruni Ghose about his career as a medical oncologist on OncoFlow and entrepreneurship. Hi Aruni, how are you? Dr. Aruni Ghose (00:13.871) Hi, Hi, Naman. What a pleasure to be here today and excited to kick off on Rad Chat. It has been a long time coming. Naman (00:22.988) Yeah, great to have you here, for our listeners who maybe haven't heard of you, could you just introduce yourself, please? Dr. Aruni Ghose (00:28.473) So hi, I'm Aruni, popularly known as AMG in the cancer world. I'm not an oncologist but I am a specialty doctor in oncology at the Velindre Cancer Center. Still a student of oncology I would say. A researcher in cardio-oncology at UCLH London in the Hatter Cardiovascular Institute. So not only a clinical as well as an academic but also an NHS clinical entrepreneur at Oncoflow I was the chief medical officer still am and that was an AI cancer co-pilot system that we sort of brought in. I also sit as the director of operations at the International Urology Cancer Summit and a collaborator of the Lancet Commission and Lancet Oncology Commission of Cancer Control in the Commonwealth recently concluded hopefully this gets published this year. And how can I forget London Global Cancer Week and UKI Global Cancer Network Cancer Health disparities chapter. Naman (01:30.751) Surprised you remembered it all. Dr. Aruni Ghose (01:32.377) Yeah. Jo McNamara (01:32.584) gonna say sound really lazy Naman (01:37.667) There was a time last year at the London Global Oncology thing where you mocked me for my signature. I feel like I can do the same. Yours is definitely longer than mine now. Dr. Aruni Ghose (01:47.343) Well, I try my best to keep all of it despite, you know, having severe ADHD and also transforming that towards the strength of getting all things together. And also, you know, looking at the small, the big and the medium sized picture of patient care. So, and that would transform us beautifully into the next lap of questions if we can go on and I'll tell you all about it, how I integrate. Jo McNamara (02:22.023) AMG, can I ask you, what made you want to be a doctor in the first place? Talk us through that kind of career pathway, because obviously you're doing an awful lot now, but how did you get there? Dr. Aruni Ghose (02:32.664) So I'm first of all a third generation medic of a family which has been close to two nations, the UK and India, from my grandfather's time and my dad's time. So it was kind of, you know, kind of like, you have to be a doctor. So kind of an Asian thing of, you know, pressure is over there. I didn't know what else to do, to be honest with you. So kind of sidelined, wouldn't say force into exams, my dad would be really angry at me. But yeah, kind of did those exams and just got into the thick of it in an Indian government medical school. And then came back over here to join the NHS workforce and then stepped up from foundation year training into internal medicine training and onto oncology doctor. But what made it rewarding was the patients that I saw every day, was the teams that I worked with every day, and the hierarchy of the teams, the multidisciplinary nature of the teams. And that's the single most factor, valuing the people more than processes. That's what got me going towards an outcome. Because at the end of the day, you've got a patient on the other side that's another person on the other side and there are situations where you're the only one, you're probably the last hanging straw that they're holding onto. So that trust which comes and trust comes with people more than processes. I think that's what's got me going. I think when I was a medical student, I didn't really understand why I was a doctor, but having five years and six years of experience in the NHS, I'm proud I made the right choice. Naman (04:32.289) Are you gone down the same path as your granddad and your dad with specialty? Dr. Aruni Ghose (04:36.751) No, my dad's a surgeon, he's a urologist and my granddad was also a general surgeon so I come from very surgically oriented aggressive surgeons I would say. So I tried to do surgery, it didn't work out for me so you went on the opposite side. Not that they were pleased about it but yeah. Jo McNamara (05:02.333) Tell us a little bit about your research and the academic side of the role that you do. Dr. Aruni Ghose (05:07.183) So, speaking, there has been a considerable output in the research scheme of things, but if you look at... If you look at my life in the last five to six years, I've never been a formal academic. I've never had a QMUL.ac.uk or imperial.ac.uk, UCL.ac.uk account ever. So all of my time is the questions that I've asked in the reaching year training or in term medicine years and even now. And the questions that I ask, and those are the questions not only I ask, but my team asks, but the patients as well. So it's all centered around real world oncology, to be honest, real world improvements, etc. So all my research has been centered around the questions which are asked in the real world scenario, to be honest. So anything that I would want to improve in, let's say, how is this service going to improve? What's the innovation in this service? Or how do we equalise inequalities in such a situation, be it in diagnostic trend, be it in therapeutic trend, diagnostic, well, written, how would this change the system? How would this transform the system? In terms of being credible, terms of being accessible, in terms of being affordable, because it's... Dr. Aruni Ghose (06:45.751) It's amazing to invent new drugs and discover new drugs. It's amazing to get them out into the market. Sorry, talking from a medical oncology point of view. But what's the impact if it only affects 20% of the population and the rest 80% of the population don't have access to it, you know, are not affordable? And yes, that doesn't generate impact and I don't think that sits in right with me. Why would there be that disparity, etc. And I think you've got my answer that most of the research that I've done in oncology, in immuno-oncology, in cardio-oncology the new and happening things. Are all the questions that I've asked myself and I haven't got the answer. other than having fancy titles, other than having fancy academic titles or protected academic time, it was always a Friday evening or a Saturday evening. It did come with a lot of sacrifice. It was always a switch on 24-7-365. At the end of the day, I was thinking about the patient. Naman (08:00.849) So you talked about a couple of other specialties there, so immunotherapy and cardio oncology. For any of our listeners who don't know what that is, could you give them a little bit an idea? Dr. Aruni Ghose (08:09.039) So, immuno-oncology is, or immunotherapies and oncology, that's the new game changer being talked about from traditional chemotherapy or cytotoxicity, where we've entered a sort of medication, sort of therapeutic advancement where the body's own immune cells would destroy your cancer cells. And that's where we are pioneering. So we've seen the rise of various sorts of immunotherapy, like, for example, drugs like immune checkpoint inhibitors or even cancer vaccines. Back in the day, they were preventative vaccines. And now we're talking about therapeutic vaccines, treatment vaccines to be honest, know, specific T cell engages, know, going a bit medical, you know, those are, you know, the varied spectrum. So we've increased the spectrum of those, those, you know. treatment agents over the few years. Well, having said that, does have a lot of its side effects, to be honest with you. It does cause inflammation of many organs in your body, chiefly the heart. And one of the most serious side effects is immune checkpoint inhibitor-related myocarditis. And that entity was the one which actually got me interested in cardi oncology during my very first cases. That was around two or three years ago when I was in Barts Health NHS Trust. And Barts had the... Dr. Aruni Ghose (09:51.279) The Barts Cardio-Oncology department with the UCLH had a very big cardio-oncology MDT, very varied cases that's the connection. So oncology to immunocology to cardio-oncology, that's the step ladder. And cardio-oncology is all about cancer treatment related cardiovascular side effects, to be honest, with your cardiovascular adverse effects, to be honest. and that's very different from rare tumors in the heart to confuse know cardio-oncology with that but it's nothing to do with tumors of the heart, it's to do with cancer medicine side effects in plain and simple language. But the spectrum's changed and the spectrum was very cytotoxic heavy, very very, we still have cytotoxic but you know very chemotherapy heavy to which normal cells and cancer cells are both killed but now you know only cancer cells are killed, normal cells are not killed, but they're just inflamed and it's the body's own immunity working towards. And I think the spectrum has changed in the sense that you had chemotherapy-induced cardiac effects and now you've got immunotherapy-induced cardiac effects. A lot of that is known and a lot of that is unknown. know, we're trying to develop consensus. It's an exciting, emerging landscape, emerging field, both of them, if you join that together. Naman (11:18.845) Yeah. Jo McNamara (11:19.773) So tell us a little bit about Oncoflow. What is it? Dr. Aruni Ghose (11:23.759) Well, actually Oncoflow's got a bittersweet take to history, to be honest. So when I was doing Foundation here at Medway and then got into parts, I was constantly involved in going to all the conferences there were because of that excitement of how is this system going to change? How is this service going to improve? So was constantly rattling around oncology service improvement innovation, to be honest, real world impact, et cetera, et cetera. And then in around 2024, that's where the AI wave in healthcare, in oncology started to pick up and it started to grow, to be honest. And there was one fine conference, I think it was the NHS ConfedExpo, or the NHS... Something to do with NHS Convensus group conference, which takes place in London Excel I think Namman can correct me if I'm wrong and that was where I actually met Mariam who is who was my co-founder at Oncoflow to be honest. So she was she was the Gen Z, you know, very AI driven, etc. So she wasn't AI generated she was human and And then you had me who was constantly trying bits and of how do we streamline services, especially the cancer MDT, which is a very heterogeneous space, or the tumor board, as they call it in the US and other parts of the world. Because everything's sort of a mishmash. And how do you use artificial intelligence not to replace, but to augment the system and streamline it, make it faster so that you can clear the cancer backlog, to be honest? Dr. Aruni Ghose (13:14.335) And, you know, with these two, you know, personalities at both ends of the spectrum, I still don't know how we got to work together. So it was a dream match, to be honest. And both the talents, I think, came into being. And we were both driven as to why can't we do this today? Why do we need to wait for tomorrow? And to be honest. And we were always in a state of urgency that we need to get this product out, people need to use it. And so, you know, it was just that we didn't care about the destination. We cared about the journey and that mattered. And I got into the NHS Clinical Entrepreneurship Programme as well because of the idea. We went on to build our proof of concept with, we were actually one of 300 enterprises in the UK along with three others to get into the world's first AI as a medical device regulatory sandbox environment with the MHRA. Neetan Suri was the other, Automedica was the other, we're still great friends. And that was a very important regulatory framework which the FDA learned from. EMA learned from the insights which were published in 2025. That was a very historic moment. So was one very important high. When we did the real world experience about the time it saved the NHS and the cost it saved the NHS, like for example, in the breast cancer MDT, it would save a whole trust, you know, £50,000 as an annual saving. So if you save £50,000 just by the MDT structure, you know, look at 10 Dr. Aruni Ghose (15:00.401) group MDTs that would save one single trust 500,000 pounds to be honest and the NHS actually spends a minimum of 300 million pounds on MDT as an infrastructure to be honest and that's just only cancer MDTs. So if I'm talking about one trust you can do the math go out to the 200 trusts out there to the different cancer reliance and that's just only in NHS England to be honest. So that's the impact that we generated presented that in in San Antonio Breast Cancer Summit and got two awards, one for our time and one for our cost, to be honest with you. So we reached regulatory high, we reached service improvement wise high, and that's what I was really proud about, that I reached that service improvement high. Marion's proud about the AI which we use, were initially one of the first ones to use multi-agentic AI, which a German group used as well and an Oxford group used as well. So really proud of the impact that OncoFlow generated, to be honest. Naman (16:13.055) If you had to explain what OncoFlow is to a patient, how would you do it? Dr. Aruni Ghose (16:17.823) OncoFlow's a clinical decision support tool, which gets all of your information into one cocktail and only your information, your scans, your pathology reports, your everyday information, and puts your choices and puts everything out to your group of physicians and surgeons who decide about your case, your situation and then maps it along treatment guidance or clinical trials etc. All the options which are there and provides a personalised, as best a personalised, clinical decision which is then validated by the tumor board or validated by the cancer MDT team. So it's not an AI first, it's an AI assistant. With regarding to preparing a case for the MDT, you take a lot of time. It would decrease that time. So the amount of time... that you put in into a simple case, say for example, you can streamline simple cases and you create that value, you create that time for complex cases to be discussed. And that streamlining is important because a simple case which is bread and butter, and I appreciate all cases are different, but something which is red and better and something which is more likely towards the standard Dr. Aruni Ghose (18:05.353) needs lesser time for discussion rather than something which you've never come across, something which is complex and needs more time because there's hardly any evidence behind that, to be honest. So that's what Oncoflow did. Jo McNamara (18:20.141) It it implemented in lot of NHS trusts now. Dr. Aruni Ghose (18:24.099) So, you know, talks were going on and are going on. It's a lot to do, you know, with the financing as nothing comes for free and the engineering and the licensing does cost a bit, which we are looking into. But yeah, the financial implications are always there, to be honest. And the cancer MDT is a really heterogeneous space. So a lot of the times you're not sure about the budgeting, whether it comes from the cancer fund or whether it comes from the surgeons or whether it comes from the physicians. loads of people have tried to get into the MDT and gone out. It's a really challenging space because there's always that debate. Is it going to be from... the clinical teams or is it going to be from the information, the clinical information officer or digital officers team and stuff because the other problem is that you've got, so the NHS England systems as in your electronic health record systems are not unified, know, and I don't want to go into, you know, the NHS federated data platform or cancer 360, that's another story, but looking at that, you know, different regions, would use different electronic health records. On one side you've got EPIC, which is not Open EHR compliant, and then you've got all the other ones built on Open EHR. So all that data, all that infrastructure. And then you've got those data firewalls as well. So it's very difficult to do it in England, whereas it's easier to do it in the other three countries, like for example, Scotland, Wales, and Northern Ireland, which have got only one electronic health record too. to do. And special mention to the University of Glasgow, David Low's lab, which helped us a lot in trying to secure grants. Special shout out to them. And Ben Lam and Tiana Secoup-Turner's in Imperial, they also tried their best to get Oncoflow implemented in NIHR funding. Naman (20:41.431) Aruni, I know you're interested in health in inequalities, inequities. When it comes to immunotherapy and I suppose kind of related to cardiac toxicity as well, what have you noticed across different backgrounds, heritages and things like that? Dr. Aruni Ghose (20:55.855) So, that's an interesting question. I'll give you an honest answer. I haven't. And that's still under question because a lot of... The real world, so the Virtual Cancer Inequalities Lab, which I started with Bookie, Akash, fantastic three students, Jocelyn from Manchester, Disha from Buckingham, and Liv from Keele. Fantastic, so that all started with doing breast cancer inequalities. What we wanted to do is, on one side there was ethnicity, and on the other side were drugs of the same class. So we did study in in melanoma and we did a study in renal cell cancer as well. So in renal cell cancer it was ipilimumab and nivolumab which were two immunotherapies which you give in the first line setting to the clear cell renal cell cancer which is the most common type. Same in metastatic melanoma as well. The insights that we found were the real world drug access to be honest with you. We did not have enough data to produce statistically significant results. Not that our methodology wasn't rigorous, but there was a common element to it and a recurring theme to it in certain ethnic groups all around the world. And I'm not talking about clinical trials because clinical trials don't have an ethnicity-based overall survival or an ethnicity-based progression-free survival or an oncological endpoint. Dr. Aruni Ghose (22:43.435) And that needs to, I think that needs to change. In bilateral cancers, in let's say for example renal cell cancer, which can happen in a male and female, we don't have, and I'm not just arguing renal cell cancer, I'm just saying, you know, people with, know, with sexes on both sides of the street who can have cancer, there's nothing called... a man-induced or male-induced overall survival or male-related overall survival, female-related overall survival. And if we don't have this in the first place, so diversification in the LGBTQIA+ community where we have differences, where we have inequalities, we can't equalise those inequalities because the primary thing is not equalised. Similarly, when we have a look at the ethnic inequalities we benchmark ethnicities with comparative drugs. The recurring theme was a certain ethnic group did not have much representation in the drug world when it came to real world access. As a result of which you can't even make that benchmark, you can't even make that comparison, to be honest. There was a huge load of underreporting. And those were recurring themes which we found in breast cancer, in melanoma, in renal cell cancer. Just with conventional chemotherapy, targeted therapy. So immunotherapy is even more niche, to be honest. We wanted to do the cardio-oncology work, but we haven't started yet about the ethnic inequalities, but that's something which we were trying. And it should be done, you know, watch the space in the latter half of this year or beginning next year, because we've only started. Jo McNamara (24:37.745) You said earlier about how you obviously are lucky to be able to go to lots of conferences and lots of events and having that experience, what do you think is coming next in healthcare? What's the kind of look out for? Dr. Aruni Ghose (24:54.567) I think The next thing which is coming in the oncology world is multimodality of data. Multi-omic-y data. It's called multi-omics, but I love multi-omic-y of that data. Computational oncology. I think because all these... are substrates for artificial intelligence to work. I think artificial intelligence is overhyped, being an AI and Enterprise co-founder myself and being a big advocate for it. I think it's overhyped. I think what's important is the domain-specific expertise. I think what's important is the data, because if there's no grass, there's nothing for the cows to eat. Right? So your... Output is only as good as your input or else it's just garbage in garbage out. AI just is an intelligence layer which processes that, streamlines the output, makes the predictions, but the data has to be there. So what's next is in the precision oncology world is getting as multimodal and as 360 degree data as possible because you see a lot of AI predicting outcomes of 20 years, 10 years. And my question to those enterprises are, well, you haven't seen them for 20 years. You haven't followed them up for 20 years. And you can't just have a magical crystal ball. You know, life, we try to make it as Harry Potter as possible, but you don't have that crystal ball to look at, you know, 20 years if you've never been trained on seeing the data. Yes, you can, but you need to see the data from. And the context is very important. Is it single contextual or is it multiple things to the context? When I see a patient, I look at radiology, look at histopathology, I look at how they are, you know, do they have any sort of comorbidities Dr. Aruni Ghose (27:14.189) in the sense that do they have any other illnesses, they have any other drugs, medications that they take, how fit are they, what is their performance status, I just don't look at age, I look at performance data, how do they perform. But intelligence models just look at one layer, just look at their cancer. So you've got to look at the seed and you've got to look at the soil, you've got to look at the host and you've got to look at the tumor. So the next layer of precision and oncology is that match between genotype and phenotype, to be honest, between what's going on inside and what's going on outside. And that's why multiomics, multimodal data, intelligence, that's not gonna replace, that's gonna assist in better clinical decision-making and more precision drugs, more biomarkers. But that's not where it stops because the discovery phase is amazing. Access is important. A lot of ethnic groups, a lot of countries were suppressed in their data. We don't even have the data. of the data, most of the trial data, you know, comes out, you know, from European countries and Asian, from Europe and USA and now recently Australia. There is a big conglomerate out there in the African nations and the Southeast Asian and South Asian nations where, you know, we need to look at data because the most heterogeneous populations reside in that belt and we don't have the data. If we had that data, we had better drugs, better equalisation of inequalities in terms of treatment response. Inequalities doesn't just mean access or geographic inequalities. Inequalities also means how, you know, two kinds of cases, how does this one differ from the other? So getting more things into context is important. Dr. Aruni Ghose (29:20.289) And really, the next generation of healthcare administrators need to figure out what's accessible, what's affordable. Can you scale it or not? So scalability is very... In the entrepreneurship world, you just can't burn investor money. You need to find a way to democratise it. Democratisation of new technologies is key. Yes, initially, you know, if, you know, when I, when the, when iPhone 14 Pro came into being, you know, it was expensive. But when people started to buy it, it became cheaper. The quality was the same. So if you introduce a new test, if you introduce a new drug, it will be expensive. But if many people use it, If you increase the access, you can control the affordability and you can influence the outcomes. But context-specific biomarkers or context-specific drugs are very important. You've done a trial and that trial is not representative of the people in that region. I don't think that works in 100 % of the populations and this is something we need to talk about because this was not talked about. I was in India as a medical student. Learning principles of medicine by Harrison, which was from the US, had no ball bearings in the Indian populace, but I was still learning that. We need to equalise inequalities. Naman (30:57.511) How do we encourage better data collection then? Big question. Dr. Aruni Ghose (31:02.423) Very significant question, Naman. I think the best data is obtained from clinical trials. Clinical trials, as I said, result in access to around 20 to 40 % of the populations. Number one is widening access to clinical trials in terms of geography, in terms of ethnic groups. Number two is what happens after a clinical trial? You're into the real world space. Real world data also means reporting. Real world data also means electronic data capture. Whether it's in the form of data repositories, data registries or biobanks, et cetera, there needs to be a mechanism by which the real world data is streamlining of adverse event reporting, mean, when we have an eye related. colitis or bowel inflammation, we just said, your diarrhea is better. Yeah, fine. You come down on the steroids, but we're not sort of grading that as, know, did you go from grade three to grade two? You see, you're not sort of quantifying that. So the way you see data, the perspective through which you see data, how was it yesterday and how was it today, but did you grade it or not? Did you quantify that? That the way we collect data needs to be more objective, less subjective. And that's how we revolutionise the way we see data. The thing which needs to be revolutionised further is the way how we capture that data, how we collect that data. And if we keep the data in data silos, we keep the data locked in fragmentation, then... Dr. Aruni Ghose (32:59.983) And if we don't, you know, just free, just become free from the data firewalls. I don't see how that data sitting there would be converted into clinically actionable insights, to be honest. We need federated data. We need federated data learning platforms, to be honest. That doesn't mean, you know, data stealing or you know sending data off elsewhere data's in but it's still federated Jo McNamara (33:35.858) How do you see then kind of the patients reported outcomes then feeding into kind of that data? Because that's definitely something that we've absorbed in terms of kind of clinical research data. It's very data heavy in terms of outcomes, but doesn't necessarily then think about, well, what was that perceived outcome from a patient's perspective? Do you think that's something that we can feed into clinical trials more as well. Dr. Aruni Ghose (34:07.501) I think they're already in clinical trials. I think we've gone into the age of patient reported outcome measures to patient reported even experience measures, so PROMs, PREMs, EPROs, electronic patient reported outcomes. And the spectrums. Jo McNamara (34:26.035) Again though, AMG, that just shows you don't know how many different types we're using. You can see even just you explaining it, how it's so difficult because everyone does something different or invent something and goes, this is the new thing. And it must be really frustrating for someone like you who is so good at the data in thinking, it'd be so easy if we all use the same system and we all reported Dr. Aruni Ghose (34:31.789) Yes. Jo McNamara (34:56.009) data in the same way, just think of the farming of that, that you could then utilise the AI to then give you better clinical outcomes for everyone. Dr. Aruni Ghose (35:05.055) And in the cancer world, and that's a really important point that you came across, Jo and Naman. And I think that's where you need, you know, a patient's best advocate. You're affected with cancer and not trying to signify, signify ties cancer. It's serious, whether it's metastatic, whether it's early, it is serious. It is more serious than, you know, heart disease. It's more serious than congenital disease. You can't just say, okay, you've got this, now deal with it. It means a lot. All right. It's a lot to take in. Okay. So when they're reporting, you've got to understand that they're under a certain duress that if I go and report this immunotherapy related to first effect, they'll hold my immunotherapy and I won't get my immunotherapy. And I've seen patients with that. And then... And then the challenge is, and what I want to learn in the future is how do we increase the rates of re-challenging these medications and getting them through that journey. So, immunocollegy, cardio-oncology, these are not emerging, but emerge thanks to Ricky Fraser and Alison Brown in Immunocollegy Clinical Network, thanks to Arjun and Steve Kaselli at ICOS. Advocacy is key. And in the UK, we are privileged to have Macmillan, who are the patient's best advocate from the time they've got that cancer to people living and beyond cancer. And I think we should utilise our strengths to be the patient's advocate. There needs to be streamlining of pros and prems and proms and, you know, just one system. Because the brilliant minds, they innovate in pots. But if those pots came together and simplified the already infopedic life that these people have to go through, because ultimately they're not patients, they're people like myself. That would be way, way easier. We would capture that outcome documentation way, way better. Dr. Aruni Ghose (37:28.727) We already do, but we need to be better on that on so many fronts. And then the other thing is that how do we look at that data? How do we interpret that data? That's another story in itself. And what do we do after interpreting that data? You know, what are the actionable insights? You know, what are the different forms of analysis? You know, are there any ethnic considerations? Are there any comorbidity based conditions if you have this other illness other than your cancer, it affect or not? So what are your stimulating factors? What are your non-stimulating factors, et cetera, et cetera, and all these associations. So it's about getting that data and it's about seeing that data is how I feel. And streamlining comes in a big way and you can't streamline it alone. You need advocacy for streamlining. You need empowerment. Only empowerment is through knowledge, the only empowerment is through that education. education needs to be at both fronts and that's why you know people like Rad Chat, people like Macmillan are doing a fantastic job as you know medical jargon and you know lay summary, we're trying to unite that together, we're trying to create the bridges which maybe never existed in the past, building that bridge, equalising those inequalities. Because ultimately, it's not just about, I've got 30 patients in clinic today, I've got 20 patients to see. You're meeting 20 different... people, you're meeting 30 people, putting the people as people and not treating people as part of processes. And then that's how I want to see myself and I already see myself as if I can't make your life better as a doctor, can I make your life better as an academic? Can I make your life better as an entrepreneur? Dr. Aruni Ghose (39:43.757) So people ask me, are you the doctor speaking? Are you the academic speaking? Are you the company person speaking? And I just go and say, I'm a Aruni And I have hashtag and cancer. Yeah, the destination is the same. The roads are different, but we all have that same destination to reach. How can you, you're faced with 99 storms, how can I make one storm lesser? If you've got that intent right and if you've got that motto right, then whichever road you take, it will lead you to that. Naman (40:27.114) Aruni we've come to the end of the episode. We always like to end with top tips. What have you got for our listeners to take away from your episode? Dr. Aruni Ghose (40:34.351) I think the first tip is whether you're a doctor or whether you're a patient, you're ultimately people. Value people more than processes. Second tip is we're constantly innovating. There's a huge round of infopedia. Advocacy, education, building bridges, shared learning, shared decision making is the way to empower. Number three, we are living in a very high data data environment and times. We're living in a very high AI end of our spectrums. Yes, it's overhyped, but these are tools. Let's use these tools responsibly and effectively. It will just empower us. So yeah, they're not here to replace their friends. Yeah, that's all that I need to say. Naman (41:45.815) Thank you very much for joining us. It's been amazing. Long time coming. Dr. Aruni Ghose (41:49.411) Thank you so much, long time coming guys. Naman (41:52.376) Thanks everyone for listening to Rad Chat with me, Naman Julka-Anderson and Jo McNamara. And Thanks very much. Take care. Naman Julka-Anderson (41:54) You can use this episode as part of our free, continual professional development, accredited content, which offers flexible learning that fits your busy schedule. Just check out the show notes for the reflective questions, links to literature and resources, and a link to complete the form to receive your accredited certificate. Jo McNamara Rad Chat Host (42:10) Stay up to date with the latest radiotherapy and oncology advancements by liking and following us on social media channels and hitting subscribe wherever you get your podcasts. Naman Julka-Anderson (42:20) Join a supportive community designed by professionals who understand the unique challenges of radiotherapy and oncology. Check out our website www.radchat.co.uk. Together we're actively working to improve our profession and make a lasting positive impact on cancer care. Jo McNamara Rad Chat Host (42:36) It goes without saying that we can't achieve this alone. It takes all of us working together to create real change. That's why we value every voice and every contribution. We ask that you listen and learn, spread the word, share your story and if you need to, contact us. Naman Julka-Anderson (42:52) If you like what we're doing, buy us a coffee, keep us caffeinated, go to our website to find out more. Thank you all for listening and take care.