Personalized Medicine and Cancer

The discovery of multiple genes for colorectal cancer will lead to diagnostic, prognostic and therapeutic targets for the disease. In about two years, we may expect to have available a test for post-surgical colon cancer recurrence that will identify which patients might benefit from chemotherapy.

We can expect a tsunami of new cancer tests in the coming years, and we can also expect many new therapies for various forms of cancer, such as an infrared light source that activates a cancer drug only when it attaches to the target cancer cells, sparing damage to normal cells. The therapy worked on mice with skin cancer, but it may take several years to get through human clinical trials.

Regenerative Medicine

The same is true of another kind of therapy: regenerative medicine. Heart muscle destroyed by acute myocardial infarction (a heart attack) has been made to regenerate in mice using the protein oncostatin-M. However, the therapy may exacerbate chronic heart disease, and much more work is required before this could become a standard therapy in humans. So too with regard to a new way to turn skin cells into immune cells to fight cancer.

Eventually, our patience and our patients will be rewarded. Pituitary glands engineered from mouse embryonic stem cells then transplanted into mice with pituitary-related conditions, cured them. And dopamine-producing neurons efficiently made from human embryonic stem cells (hESCs) have repaired damage in mice with Parkinson-like disease.

Digital Medicine

Microsoft and other computer hardware/software companies are extending the human–computer interface beyond the keyboard, mouse, and spoken word to include gestures. When this is perfected, we will be close to achieving near-natural “whole-body” communications with and through computers. This will have important applications in medicine. For example: It may change the way clinicians interface with EMRs; how patients interface with health websites; and how computers monitor patients.

The human–computer interface grows more important as computer-driven machines and devices increasingly interact with us. Added recently to the list of technologies that do so are a wireless mattress pad that tracks heart, breathing, and movement during sleep, and an EEG to communicate with vegetative-state patients (which we can already do using MRI, but EEG is much cheaper and can be used to diagnose and communicate with many more patients.)

Robotics

Digital medicine in the physical form of (say) a robonurse has some way to go yet, but it is making progress. Toyota has been showing off its current robot line-up, designed very much with serving the needs of Japan’s aging population in mind, and it is not hard to imagine Honda’s new and improved Asimo wearing nursing scrubs. Our robotic prowess extends to the molecular level also, with the creation of a single-molecule “electric car.” The car is irrelevant; the key advance is the ability to design single molecules at will, something that surely is of great interest in medicine.

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Thanks for reading. We’d welcome your comments (below).

David