Promising new breasts grown from their own stem cells to women who have undergone mastectomy has been on the cards, since the last decade of the last century. Back in November 2008 newspapers reported that it would be a reality for women in 2009. Nine years on – in January 2018, women are still waiting. The reality? It’s still on the cards. Meantime,women have to make do with silicone implants that have to be replaced and very often leak silicone gel into the body.
This is just one of the cruel bits of medical misinformation so persistently and carelessly inflicted, in the main, by the media on far too many men and women hoping for a new treatment or cure for the condition that afflicts them.
It is not just the gutter press that offends in this way. The ‘quality’ media in practically any country you care to name will report that some breakthrough drug or procedure is imminent or “on the cards”, but a lot less forthcoming as to when it will actually come to pass. In late 2017 for example, the Reader’s Digest, scooping the National Enquirer, reported that head transplants were now a serious reality. While I wouldn’t exactly describe the RD as quality media (once upon a time it used to fine its journalists for inaccuracies), it’s interesting to note that it’s now about as loopy as the Republican party, whose spirit it embodies.
There are a number of reasons why the media as a whole act in this irresponsible fashion; the two main ones are – first, it makes a good headline; and second? There is a swagload of money riding on getting the news out there. The truth is that it will take a decade at best, or more likely anything up to four decades before the reported “breakthrough” becomes commonly available to the average patient in need.
There is a natural process of attrition involving tests, trials and research before any new drug or procedure becomes available to patients. And quite right too. But this is a very expensive process and if left entirely up to the private sector to decide where this money should be spent, we can hardly be surprised if it goes to medical ventures providing the biggest and quickest profit to the investor, irrespective of medical need.
The tantalising reality is that there is such a body of medical science and research already out there, almost certainly containing the answers to most of the existing medical scourges of man, and with more being added by the day, that it would take an Amazonian basin of quantum computers to sort it all out. Doesn’t mean we shouldn’t at least try to prioritize the application of resources, but to leave it all up to private investors, heavily subsidized by public money, is not just unfair, it’s actually insane. We could and should order things better than this.
Given this reality what can we do to inform ourselves? One flawed but helpful source is the Cleveland Clinic in the US, who for fourteen years have held their Medical Innovation Summit, which each November publishes their findings as to the top ten medical experiments in the coming year that will change patient care forever. It is as good an assessment as we can get, showing where the smart money has gone and what will really be on the market any day soon.
Here are their picks for 2018 in order of importance:
Using the microbiome to prevent, diagnose & treat disease
Microbes in our body interfere with the way food is digested, which medicine is effective and how disease progresses. Biotech companies, once focused on the genomic market, are pivoting to the microbiome potential developing new diagnostics, therapies and probiotics to prevent dangerous microbial imbalances. Experts now say the microbiome is the healthcare industry’s most promising and lucrative frontier.
Diabetic drugs to reduce cardiovascular disease & death
Half of patients with Type 2 diabetes die from complications of cardiovascular disease. By age 65, those odds increase to 70%. Two medications, empagliflozin and liraglutide, introduced in 2016 have reduced mortality rates significantly. Experts expect a complete shift in medication targeting Type 2 diabetics and its effects.
Cellular immunotherapy to treat leukemia & lymphomas
One of the first immunotherapies for leukemia and non-Hodgkin lymphomas is on the market. Chimeric antigen receptor T-cell therapies treat a patient’s immune system when T-cells are removed and genetically re-programmed to destroy tumour cells. An almost 90% success rate with acute lymphoblastic leukemia will trigger a wave of FDA approvals for other blood cancers and lymphomas that in time may see immunotherapy replacing chemotherapy.
Liquid biopsies to find circulating tumour DNA
Such tests reveal signs of actual ctDNA in the bloodstream and sales of this cancer test are expected to top US$10 billion in 2018. Experts believe catching and treating cancer this way will soon be as routine as an annual checkup.
Automated car safety & driverless features
With more than 38,000 fatal car crashes in the US in 2015, car accidents are a leading cause of death and diability with annual medical costs at nearly $23 billion. New rules and safety features designed to remove hunman error from the equation as driverless cars enter the market are attracting heavy investment.
Fast healthcare interoperability resources (FHIR)
Given the sheer diversity of IT systems sharing patient data between healthcare providers, efficiency has been a huge problem. FHIR will bring “instant“ compatability to differing healthcare systems in two phases: first, by focusing on clinical data, images and medications; and second, on admin data, billing, etc. Let us pray that the latter leads to clear and fair pricing.
Ketamine for treatment-resistant depression
For one third of US patients with depression existing medication does not work, as witnessed by nearly 43,000 suicides a year. Since 2013, ketamine, a drug used for anaesthesia was found to inhibit NMDA receptors producing rapid reduction of symptoms in nearly 70% of severely depressed patients. The FDA in the US has fast- tracked approvals and the drug is now becoming available.
3-D visualisation & augmented reality for surgery
Surgeons rely on micro oculars and other camera systems, while still operating heads down. Following success in two of the most intricate fields, neurosurgery and retinal microsurgery, surgeons will increasingly operate headsup on-screen in hi-res 3-D on stereoscopic systems more efficiently and effectively.
Self-administered human papillovirus (HPV) test
Most sexually active women contract HPV. Certain strains of HPV are responsible for 99% of cervical cancer. Despite strides in the prevention and treatment of HPV, benefits have been restricted to women with access to HPV tests and vaccines. A simple self-administereed test represents the biggest means of prevention of cervical cancer to date, so experts claim.
Every year 600,000 Americans have metal stents put in their coronary arteries to treat blockage. There they remain, useful or not. So now a bioabsorble stent has been decreed and will be on the market this year with sales of $2 billion p.a. expected within 6 years.
That’s ten reasons for those working or investing in the healthcare industry to be pleased. For some of us too, it’s good news. For others, it is useful information to store away in the back of our minds in case it becomes useful.
What is clear from this list is that the findings are almost entirely governed by which development is going to make the most money. By no stretch of the imagination does that mean this list defines the ten most important medical developments likely to save lives.
That could well be a very different list, but for now… just follow the money.
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