Evolution of Care

With dementia rates soaring and cancer proving difficult to combat, you could be forgiven for thinking it’s all a bit gloomy

There isn’t much that captures the eye more than medical innovations, except perhaps celebrity gossip. Whether it’s hope for dementia, a way to slow MS or a new treatment for cancer, these headlines make us pause and read on; we all know someone with a medical problem that needs treating, and we do love to hope.

Many of these attention-grabbing headlines seem to fade to nothing, we don’t see any follow ups, and people are still getting sick. But behind the news stories are thousands of people working on medical innovations to banish a myriad of diseases. Sometimes newspapers publish too early to encourage sales while there still needs to be years of medical trials - some treatments can fall at the next hurdle and are never heard about again as they have proved ineffective.

From antibiotics to vaccines, modern medicine has saved countless lives, increased longevity, and prevented millions from suffering long-term consequences of childhood illnesses. There are still many challenges facing us and medical science. Our longevity leads to increased cancer and dementia rates; there’s been a rise in obesity and related illnesses across the globe; antibiotic resistance and aging itself.

Cancer survival rates vary considerably, but there have been great improvements in many cancers - in 1971 there was a 25% survival rate for prostate cancer which is now at 84%! When people refer to a cure for cancer, it is not very helpful, as there are so many different cancers (200 in fact), and the outcomes are affected not just by medicine,

but early detection rates and type of cancer. Research is being directed into targeted cancer therapies that ignore healthy cells and just attack cancer cells. Many researchers are looking to immunotherapy, a new class of drugs that use the body’s own immune system to attack cancerous cells. According to Otis Brawley, MD, chief medical officer of the American Cancer Society (ACS), there are currently over 800 trials on new immunotherapy treatments taking place. MUC1 is an immunotherapy treatment currently on trial that has the potential to treat 80% of cancers, almost the general ‘cure’ that we keep seeing mentioned. Looking further ahead, nanotech and the gene-editing tool ‘CRISPR’, both offer promises of new treatments and cures. These are a long way off, but one treatment with carbon nanotubes is already being tested with mice, and developments by CRISPR are already being used in research.

For dementia the best defence is a good offence. Eating right, keeping fit and active, getting enough sleep and continued learning will all improve your chances of staving off this disease. In many cases though, you can’t beat genetics, and our increased longevity means that there are more of us living to an older age than ever before, increasing our risk of developing a form of dementia. A breakthrough this year has shown that a drug reducing amyloid in the brain slows the reduction of cognitive decline by 30%, but this is a way of managing the condition, rather than a cure. An ongoing study is currently taking place on an extended family who have a genetic condition that means they are susceptible to early onset Alzheimer’s, with the goal to prevent the disease from getting started.

There are five target areas being looked at with drugs for them currently undergoing clinical trials, and three studies to prevent dementia.

Antibiotic resistance is a tough one, and much of it (the saturation of commercial animals, like cattle, with preemptive antibiotics, for one) is outside our individual control. There are some things we can do though, starting with not insisting on antibiotics if your doctor says they will be ineffective, and always finishing a course of prescribed medicine, reducing our need for antibiotics later on.

We have already seen great strides this century. The average life expectancy for someone born in 1911 was 53 years in the UK, and someone born in 2011 is expected to live to see their 81st birthday. This was fuelled first by improvements in healthcare for young people, for instance vaccinations and improvements in midwifery, and then by developments for health problems associated with older people, including statins and heart surgery. The next wave of healthcare improvement will be brought about by treatments for our modern lifestyles and an improved quality of life in our dotage.

Although many of the challenges we face, like dementia and cancer, can seem insurmountable on the surface, new treatments are being developed all the time. In the UK at the beginning of the 20th century, there were 300 deaths per million from measles, and an infection rate in the hundreds of thousands. Reducing these figures must have seemed like an impossible task to many. However, before 2006, the last death from acute measles in the UK was in 1992, and less than 2,000 cases were reported in 2016.

Our technology will soon catch up to the diseases and health problems that we face today, as it always has. We just need to remember to do our part – not insisting on antibiotics for colds, taking full doses of medicine given out on prescription, and by donating to research charities or fundraising. And if you want to stave off dementia, remember to try and get enough sleep and you could do worse than learning an instrument!

Links to references are available in the full online version of the magazine.