January 6, 2017
It was a year of exciting developments and discoveries.
Medicine, science and technology took huge steps forward in 2016. Many of the devices and treatments that were developed this past year were once only found in science fiction movies. The dedication and hard work of medical researchers have allowed those with chronic diseases and debilitating illnesses to have hope for a better life as we move into 2017.
1. Wireless/"Leadless" Pacemakers
Pacemakers are essential to restore slow heart rhythms. More than 250,000 Americans have pacemaker implants. Pacemaker implantation requires an invasive surgical procedure, and current pacemakers involve wires or leads that are placed inside the heart. Over time, leads can become damaged or fractured and can also be a source of infection. In 2016, the Food and Drug Administration approved the world's first "leadless" pacemaker. This device, manufactured by Medtronic, consists of a self-contained inch-long device that's implanted directly in the right ventricle of the heart via a catheter. No incisions are required, and neither is surgery. The device has the potential to completely change the pacing industry. Its track record is quite good, and others are in development by industry competitors. I expect 2017 will see a surge in the implantation of the wireless pacemakers and hopefully a much lower complication rate.
2. Bionic EYE
In 2015, the Argus II mechanical "eye" was developed by a private company called Second Sight to help those with blindness due to retinitis pigmentosa see again. It required that the patient have some functioning retinal cells in order to see, as this first-generation device stimulated the patient's remaining retinal cells to restore vision. Now, a new device has been developed at UCLA in collaboration with Second Sight that allowed a completely blind woman to regain sight. The device goes beyond the Argus II system by directly stimulating the brain. The first patient to receive the new implant was blind for seven years. Neurosurgeons successfully placed a prototype device in her brain and tested it in November 2016. The device works by bypassing the optic nerve and directly stimulating the brain's visual cortex. The patient suffered no complications and was able to see colored flashes, lines and spots when signals were sent to her brain via a computer. The implant is part of a bigger "bionic eye" research program known as Orion. This device has the potential to restore sight that has been lost for any reason -- cancer, diabetes or trauma. Due to the success of this initial test, the company will be submitting an application to the FDA in early 2017 to conduct a larger clinical trial. It is likely that within a year or two, the technology may become widely available and may change the way blindness is treated.
3. Personalized Medicine/Precision-Guided Cancer Treatment
Over the last decade, it has become possible to provide genetic/DNA sequencing in a much more efficient and cost-effective way. There's a great deal of ongoing research looking at personalizing treatments to an individual patient's DNA in order to obtain better outcomes. Precision medicine represents an enormous shift in the way doctors treat patients and in the way medical research will be conducted in the future. In 2016, there have been great strides in precision medicine. The White House created a precision medicine initiative, and the 21st Century Cures Act will provide more funding for future research through the National Institutes of Health. There have been breakthroughs in cancer therapies, and nearly 1 million people will be participating in a large trial examining genes and how they affect treatment outcomes. In the next decade, I expect all medical therapies will be based on our genetic code. Through genomics, we will find cures for once incurable diseases.
4. Mobile Stroke Units
Strokes occur when blood flow to the brain is interrupted. The most common cause of stroke is a blood clot in a cerebral artery. The key to successful treatment of a stroke is to restore blood flow immediately -- either with a clot-busting drug or through the use of a catheter, balloon and stent. The recovery of a stroke victim is directly related to the time it takes to provide treatment. In 2016, several medical centers -- including the Cleveland Clinic -- began to develop mobile stroke units to facilitate quicker therapy. A mobile stroke unit contains a CT scanner, a laboratory for blood tests and other tools that allow first responders to determine if a patient will benefit from a clot-busting drug, thus allowing for much more expedient treatment. The availability of mobile stroke units allows medical centers to deploy these units when emergency calls come in. These units have been shown to significantly improve outcomes in patients with stroke, and it's estimated that by the end of 2017, more than 40 percent of all medical centers will have them in place.
5. Arm Transplantation
Advancements in prosthetics have allowed those with traumatic injuries to limbs to better perform everyday tasks. However, all prosthetics have their limitations. In 2016, physicians at Brigham and Women's Hospital were able to perform a successful double arm transplant. The surgery lasted 14 hours and involved a team of nearly 60 surgeons, nurses and technicians. While the patient will face many months of rehabilitation, he is likely to regain feeling and movement in both of his transplanted arms. This type of innovation is likely to completely change the way amputees are treated. While we've made great gains in lifesaving organ transplantation (such as heart and lungs) over the last decade, little has been done to improve the lives of those with traumatic injuries until the last several years There is much research planned in 2017 to continue to advance transplantation science to improve quality of life.
What to Expect in 2017
I expect great things from medicine and science in 2017. With the influx of research funding for the NIH via the recently passed 21st Century Cures Act, I believe we'll continue to move forward and make enormous strides toward finding cures for cancer, as well as better treatments for chronic diseases such as diabetes and cardiovascular disease. In addition, the Cures Act will likely make it easier (and cheaper) to get new drugs and devices through the FDA approval process -- making new technologies accessible to patients who need them much sooner. Dedicated scientists will continue to build on the work that has been done in 2016, and all of us will benefit from the new and exciting discoveries to come.
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