Medical research continues to result in advances in care, largely as a result of improved technology and more sophisticated understanding of human physiology.
Consider these recent medical breakthroughs, and you may share my sense of optimism as we contemplate the future:
Artificial vision technology. The Argus II Retinal Prosthesis System, now approved for use in the United States and Europe, is intended to restore vision to the blind, specifically in the case of retinitis pigmentosa. Argus II conveys information from sunglass-mounted receptors to electrodes in the eye. Implanting the system reportedly costs up to one million dollars, however. Future systems being currently researched may involve deep brain stimulation to restore vision.
Improved hepatitis C treatments. Up to 3.2 million Americans are infected with the hepatitis C virus. New drugs, such as the recently introduced sofosbuvir, improve the success rate of treatments to as high as 95 percent. Moreover, these advances may obviate the need to use interferon, which is poorly tolerated by many patients. A 24-week course of sofosbuvir may cost as much as $168,000, however.
Preventing heart attacks. Trimethylamine N-oxide (TMAO) emerged in a Cleveland Clinic study, published in the New England Journal of Medicine, as a possible marker for increased risk of heart disease. This compound appears to be of intestinal origin, deriving from the metabolic activity of gut bacteria. Coming on the heels of previous studies linking heart disease to inflammatory markers in the blood, this suggests that there may be immunological aspects to heart disease, perhaps related to specific bacterial agents harbored in the human body. More research is necessary to parse out issues related to the specific clinical utility of these observations.
Better cancer treatments. Antibody-drug conjugates are being developed as “smart bombs” against cancer. An example is Kadcyta, a drug approved for the treatment of metastatic breast cancer. This compound penetrates tumor cells and releases targeted chemotherapy. It identifies the target cells by binding to a specific cellular marker, called HER-2.
Cancer diagnosis improvements. For breast cancer screening, 3-D mammography may emerge as a useful tool. A study of 25,000 women revealed early detection of breast cancer using this technology. The FDA also approved a device for detection of malignant melanoma skin cancers. The MelaFind system combines imaging of skin lesions with analytic paradigms. This would not, of course, replace the need for a dermatologist’s expert opinion.
Early diagnosis of dementia. Although a neurological examination is critical, we are seeing a greater role for early detection of brain damage. For example MRIs are being used to find early subtle signs of brain atrophy in both Alzheimer’s and fronto-temporal dementia.
Universal red blood cells. Only type-O is a “universal donor” for blood transfusions. Stem cell research is emerging that may result in the production of O-negative blood cells in clinically useful quantities. Indeed, stem cells may emerge as a more effective strategy than organ transplantation for replacing a variety of diseased or damaged body tissues.
Joint replacement sensors. Wireless sensors, measuring load strain, temperature and other parameters, are being developed for the purpose of monitoring replaced joints for signs of early failure. We are moving toward more effective monitoring of these joints, which should benefit patients in years to come.
The debates surrounding the Affordable Care Act dominated the news in 2013. Leaving politics aside, health care costs will continue to challenge our society. As I see it, preventing disease is generally a cost-effective strategy. For example, it makes sense to prevent skin cancer by minimizing sun exposure and using sunscreen. If prevention fails, however, it is comforting to realize that better diagnostic and treatment options are emerging.
Here’s wishing you a happy, and healthy, New Year!
Scott T. Anderson, M.D., Ph.D. ([email protected]) is clinical professor of medicine, UC Davis. This column is informational, and does not constitute medical advice.