A Lot of Really Good News – Some Here Now, Some Almost Here – is at Our Door
Progress in Many Areas
2022 was one of those years in which it seemed medical advances, even breakthroughs, were happening regularly. Most such advances, of course, are based on years of work – the particular breakthrough just came through in the last calendar year. As promising as all these are, most still have a ways to go to become mainstream, but the potential, and the hope for people who need the help, can be breathtaking.
Let’s look briefly at 10 such advances. They are in no special order, and I would not claim these are the top 10 for the year, but at least some of them surely would qualify for such a rating.
The Magic of mRNA
Not too strong a term, “magic.” This process, the one that provided most of the success (so far) in dealing with COVID has almost limitless possibilities to be adapted to fight other diseases. Work is underway, for example, on aids and on malaria. As an American, it easy to forget what a curse malaria still is in much of the world. To banish it would be life changing for so many people.
Work is also underway on tuberculosis. It is possible that before long we will have a flu shot that works on every flu variation, not the 1-2 we must guess about every year. All of them treated with one vaccine – thanks, mRNA. Even the common cold (a ferocious version of which is with us this year) may be conquered by this amazing drug.
There is a complication: much of the knowledge and technology around this is covered by patents owned by two companies. Somewhere between awarding innovation and research and making this technology available to everyone, there must be a path forward.
Improved Gene Editing
There have been several successful gene editing efforts over the last few years that seem to cure terrible diseases that otherwise dominate and shorten human lives. Long term tests are still being run, but in some cases, results are still good after 10years.
The rub is that the costs are phenomenal, even though in the long run they are cheaper than a lifetime of treatment. Still the numbers are eye watering. Take hemophilia for example. For most patients they need treatment every week for the rest of their lives. Costs run around $127,000-$300, 000 a year.
Enter gene editing. One shot, one time and its over. Oh – forgot to mention the cost for that one shot is $2.8 million. Whether or not insurance will take this on is unclear at this point.
We need a better system of cost and payment management. This technology is too important to make it too hard to obtain. Many diseases perhaps could be eliminated (vision loss, spinal diseases, for example). Literally hundreds of gene editing treatments are in various stages of development, also at phenomenal costs. If we can balance out the economics – and this really is complex, not just a matter of greed – the impacts could be enormous.
This is very early in the validation process, but after decades of failure, scientists may be about to have a cancer vaccine for several versions of the disease. One such effort, when combined with other cancer treatments appears to cut the risks of death or serious consequences by almost half.
Having a treatment that specifically and completely attacks a tumor is not here yet but seems to be on the horizon. One reason? The efforts are using mRNA. There it is again.
The Fight Against Alzheimer’s Gets a Small Success
In a clinical trial of nearly 1,800 people with early Alzheimer’s disease—the most common form of dementia—an antibody drug slowed the rate of cognitive decline by 27 percent in patients treated for 18 months. A figure of 27% does not sound like much – unless someone you love has the disease. Besides, earlier efforts had only the most minor effects, if any at all.
This has been a decades long exercise in frustration. The new treatment at least makes measurable improvements, even considering the risks of serious side effects. As we learn how it does this, more progress is possible. Fingers crossed. Dementia is unmatched in its cruelty. We could use a breakthrough.
The First Pig-to-Human Heart Transplant
This seems an old-school, almost medieval thing, in some ways. The transplant took, although the patient died of other complications within two months of the transplant. Remember the first mechanical heart transplant? Barney Clark lived only a few days, but it was a first step. Perhaps this could be a similar first step.
People die every day waiting on organs. Since we are on the subject – if you are not an organ donor, why not? I would have hoped that by now we would be further along with 3D printing to simply manufacture organs and other components we might need.
There is progress being made, but not fast enough. So, while we wait for 3D printing and/or more donors, it appears we need to sacrifice animals to get us through the needs. Bummer.
Spinal Implants Enable Paralyzed People to Walk
A few people with severe spinal injuries took first steps within hours of neurosurgeons implanting nerve-stimulation devices into their spines. Some advance to running and swimming. Progress in this area is a fascinating mix of medicine, technology, and engineering. Work is also being done on intelligent exoskeletons.
I expect we are some distance from the day when the idea of someone not being able to walk will seem unreal. It cannot come soon enough. I know too many people who cannot walk today for this one to be a theoretical matter. The fact that this will likely be more engineering and AI than biology gives me hope we might get there sooner rather than later. We have already seen the outer edges with special Olympics athletes running like the wind. Bring it home, soon please.
Percentage of Americans with Health Insurance Hit an All Time High
The Biden administration is putting effort and funds into making insurance available to people and ensuring they knew how to get it. The result? An impressive 92% of eligible people are covered.
Our medical and insurance constructs are still an embarrassing mess, but what is being accomplished makes a huge difference. Now, if only the last six states without expanded Medicare (including the one I live in now) would get their policy heads out of their political asses, we could close the books and get an important standard in place nationally.
Bio Engineered Camera Provides Improved Eyesight
Some impressive work broke ground in 2022 with cameras that replace eye components, with encouraging results. More to come and hopefully similar work could be done for hearing, a notoriously complicated human sense to work on with biotechnology.
Lab-grown Meat Is Cleared as Safe to Eat
OK, you caught me. This one is not exactly medical news, but it has important implications in several directions. Being able to provide meat without raising and slaughtering animals has great environmental, economic, and moral implications. A plant based diet is a great thing, but the world is not going to forego meat on a global scale anytime soon.
If we can find a better way to meet that demand, and perhaps develop healthier meat for the consumer at the same time. Let’s do it. This first approval by the US Food and Drug Administration of a cultivated meat (chicken) for human consumption is a benchmark. Many companies around the world are in hot pursuit to join this new market.
The 10th Example? A Mystery
I elected to leave the last entry a blank. In part, I do so because I have about 20 candidates. But also, as a way to remind us that for every such breakthrough of which we are aware, there are hundreds, thousands even, more under way that we are clueless about ourselves. Many will fall short; some will change life as we know it. All of these require years of work and dedication.
I wonder what will come our way in 2023?
Happy New Year, everyone. On a side note, today is the day the House Republicans are scheduled to choose the next Speaker. Get some popcorn. This might be quite the show.
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5 replies to Let’s Start the New Year With Good News in Medicine
Thank you for your blog. I don’t comment very often, but I subscribe via email and I always enjoy reading. Thanks again!
Thank you! Appreciate the support, and know that your comments are always welcome.
Bill. Wonderful blog! As you note, mRNA offers great possibilities in the treatment of many diseases, including Malaria but few, if any, can afford these marvelous “disease cures”, as you have so wisely note. There is an amazingly effective, cheap method for addressing the major disease of Malaria–It is called a “Mosquito Net”. It has been estimated that 663 million cases of Malaria were averted between 2000 and 2015 with Mosquito nets.
How many people in the world can, or could, afford a Pig Heart? And is it ethical to raise a pig for that purpose? (I guess it even raises the question of whether it is really ethical to raise a pig to eat.)
Keep up the thoughtful conversation
Good observations, Luther. As a helpful note, I think we are closer than many may realize to 3D print organs, tissue, and other live components for transplants. Similarly, many would wish to see more of the world as vegetarian, but trends are not especially moving in that direction. The processes now being used in developmental stages to produce meat without killing an animal or using all those resources to grow them show great promise.
Bill. 3D print organs and tissues for transplants is certainly evidence of amazing technical advances that were beyond our comprehension just a few years ago. It does raise all sorts of ethical and practical issues, however. Who can afford a 3D organ? Who is eligible–even if he/she can afford it? What would be the cut-off age for eligibility? Life expectancy in the USA was 46 years for men and 48 years for women in 1900. In 1966 when Medicare was enacted it was 66.7 years for men and 73.8 years for women. (Limited Medicare payout was expected!–Wrong); 1998 it was 73.8 years for men and 79.5 for women; 2023 projected to be 76.3 for men and 81.4 for women. By 2060 the projections are 82 for men 84.7 for women. Also by 2060 the anticipation for the number of centenarians in the US is 589,000; today 82,000. About 80% will be women. That is the US and is probably reflected in other advanced society countries. Third world, poor countries?
I guess this is a long way to beg the original questions: Who should eligible to get a 3D organ? Assuming they can be printed cheaply some day what should be a cut off age? Who is going to take care of “old” folks wanting to live “forever”. Where do folks who live in third world countries whose life expectancy is shorter fit into the artificial organ scheme? Countries where clean water, adequate food and shelter, basic health care can extend life currently without resorting to 3D organs?
I ponder this every day.