Soon, might a courier from Uber show up to the operating room to take your cancer tissue?

I’ve been learning a lot about how important tissue is for many cancer patients. In this era of molecular medicine, it’s often more important to know what mutations your cancer has (e.g. ALK positive) than what organ it happens to be in (e.g. lung cancer). That means a piece of your lung cancer tissue not only needs to be looked at under the microscope, but also tested for mutations. The basic tests we used to run were done — and done well — at every lab, including the one at the hospital where you had your cancer surgery or biopsy. These new molecular tests, however, are evolving quickly. In many cases, you might want a piece of your tumor to be sent to another medical center or a private lab that specializes in molecular testing. Here’s where it gets interesting.

The medical center that performed your surgery or biopsy has your tumor sample, and they are required to send a piece of it to another testing center if you request that they do so. But they don’t have much of an incentive to do this. They might prefer that you get more testing done at their lab or might prefer to keep as much of your tissue as possible for their researchers. Or they simply might not want to invest in making it easy for you to take your “business” elsewhere. This issue is going to get bigger as private testing companies and select medical centers are the ones investing heavily in next generation testing.

So maybe we need a new entity here, which I’ll call Uber for Tissue Banking, or just Uber for short. The incentives for this Uber are set up so that they focus exclusively on:

• Handling your tissue professionally so that as much of it as possible is preserved for the tests you are most likely to need
• Sending a sample piece of your tissue, when and only when you request, to the testing center(s) of your choice
• Upgrading their technology for storing and preserving your tissue in the ways needed by the most current and promising testing centers
• Alerting you of relevant new testing opportunities
• Avoiding conflicts of interest, e.g., not setting up exclusive or preferential relationships with any testing centers

I’m not sure if I want Uber handling my tissue anytime soon, but I do think this is yet another area that is ready for some disruption.