FREEDOM AND SAFETY
In the 1970s, an American TV show, “The Six Million Dollar Man”, showed us the future of medicine in the shape of an astronaut who had been “rebuilt” after suffering serious injuries, giving him superhuman strength and senses.
The idea of a “bionic man” remains science fiction, but rapid technological advances in medicine are having amazing results, meaning the TV show’s catchphrase, "We can rebuild him; we have the technology," is no longer as impossible as it once seemed.
Engineering genetics to make the body kill cancer, growing artificial organs for transplant, and pills that can ‘talk’ to you: these are all examples of how the Fourth Industrial Revolution will radically change medical treatments by “blurring the lines between the physical, digital, and biological”.
“The Fourth Industrial Revolution is transforming health and medicine due to the lightning-speed advances in genomics, genetic engineering, synthetic biology, nanotechnology, data science, AI, robotics, to name just a few,” reads a newreport by the World Economic Forum’s Global Future Council on the Future of Health and Healthcare.
Here are some of the report’s highlights.
When your knees get creaky with age, the worn-out cartilage – the connective tissue that helps joints move smoothly – does not regenerate so there are only two options: painkillers or an operation to replace the joint. In the future, stem-cell technology might be able to help cartilage and other parts of the body to regrow.
That could help vast numbers of people: severe osteoarthritis is expected to affect well over 25% of the adult population by 2030, the report says.
"Regenerative medicine is promoting the move towards 'cells as pills'. It refers to the branch of medicine that develops methods to regrow, repair or replace damaged or diseased cells, organs or tissues."
“Regenerative medicine” has much wider application, making it “a game-changing area of medicine with the potential to fully heal damaged tissues and organs”.
The technology could help repair hearts damaged by heart attack and could mean body tissues or organs for transplant can be grown in laboratories.
Patients on regular medication can find it difficult to remember if they have taken the right dose at the right time. A new pill has been created that contains a tiny sensor that records when it is taken – information transmitted to a patch worn by the patient and then sent on to a smartphone. Patients and doctors can ensure the medication is being taken as needed, an innovation already being used in the treatment of schizophrenia and other mental illnesses.
That is just one idea making up the “internet of medical things (IoMT)” – using networks of connected devices to sense vital data in real time. Other applications include “telemedicine” – where health care can be provided at a distance via phones and IT. Patients can use devices to measure blood pressure, monitor glucose levels and test for conditions from blood samples - and send the results in real time to their doctors.
"The internet of medical things (IoMT)...
[means] it is now possible to join the dots between personal digital devices, connected medical devices, implants and other sensors."
Melanoma skin cancers are not easily identifiable by sight and highly trained clinicians may sometimes get it wrong.
A computer trained using images of skin cancer and the corresponding diagnoses achieved a 95% detection rate, well above the 87% success rate of human doctors, according to research published in the Annals of Oncology.
Between 2 and 3 million non-melanoma skin cancers and 132,000 melanoma skin cancers occur globally each year, according to the World Health Organization. “One in every three cancers diagnosed is a skin cancer and, according to Skin Cancer Foundation Statistics, one in every five Americans will develop skin cancer in their lifetime,” the WHO says.
"Through its ability to sift through large amounts of information… AI can help health professionals with complex decision-making, and point out clinical nuances that they might have missed."
A Californian company says smart phones can diagnose mental health problems by analysing how people tap, scroll and click – behaviour that can predict range of cognitive traits and mood states. Phones can also deliver support to mental health patients via apps.
More than 300 million people around the world suffer from depression and almost 800,000 people die due to suicide every year, the second leading cause of death in 15-29-year-olds, according to the World Health Organization. Fewer than half of those affected by depression receive treatment and in many countries the figure is less than 10%.
As well as spotting depression, AI might be able to help alleviate it. A trial involving Woebot, a chatbot designed according to the principles of cognitive behavioural therapy, showed that it was effective in treating the condition, the report says.
Immunotherapy is the next big breakthrough in cancer treatment and, according to the report, “will become the cornerstone of oncology and, impressively, will likely apply to almost all types of cancers”. By stimulating or suppressing an immune response, the therapy uses the body’s own immune system to fight disease.
Lymphoma and leukemia have been treated by using antibodies that attach to certain proteins on cancer cells, enabling the immune system to recognize and destroy those cells more easily.
"Progress in the understanding of cell biology and cancer have clearly demonstrated the ability of the immune system to eliminate naturally occurring cancer cells through a phenomenon called immunosurveillance."
“Precision” or “personalized” medicine – where treatments are tailored to consider the genetic and biological make-up, the environment and the lifestyle of each individual – will replace “one size fits all” therapies where the same amounts of the same drugs are prescribed for all patients. This is particularly promising in the treatment of cancers whose genetic makeup vary widely.
Rapid advances in genome mapping mean medical treatments could be tailored to match each patient’s genetic makeup.
"Technological advances have also dramatically reduced the time (now feasible in a few hours) and cost (now less than $1,000 per genome) of genome mapping, leading many to believe this could be done in regular practice to inform decisions," the report says.
Genetic mutations are the cause of more than 10,000 diseases in humans – so techniques to correct faulty genetic information may be a way to tackle conditions previously considered incurable.
Sickle-cell anaemia, where a genetic mutation inside red blood cells prevents circulation of red blood cells, which can damage organs and provoke stroke and even death, is one disease that could be treated by such gene therapy. The approach involves taking a patient’s stem cells, genetically altering them in the laboratory and then putting them back into the body to create healthy blood cells.
Gene therapy could finally treat this disease which affects millions around the world: every year, more than 300,000 infants are born with the condition in sub-Saharan Africa.
"Phase 3 clinical trials now under way should help determine benefit/risk/cost ratios to hopefully move gene therapy towards clinical practice."