We’re on the cusp of an era where patients receive personalised treatment, diseases are prevented and there’s more choice of treatments than ever before, says Jose Francisco Tomas, Bupa Medical Director, Europe and Latin America.
The pace of innovation in treatment is as fast-moving as the transformation taking place in diagnostics.
Innovative new ways of making and delivering treatments, whether it’s surgery performed by robots or organs made from 3D printers, are pushing medical boundaries. Meanwhile, advances in tailored treatments and preventative care, and the increase in treatment options, are changing the way doctors treat patients and the relationship between them.
Instead of treating patients on their own, as they did 25 years ago, doctors are part of a multi disciplinary team of clinicians. Patients are also better informed. They visit the doctor knowing the latest treatments and what they want, which means doctors spend more time explaining different options and helping patients choose the right treatment rather than telling them what they need.
Driving this rapid change are three core trends, which will enhance patients’ lives and require doctors to adjust their minds to a new therapeutic era.
1. Individually tailored treatments
The one-treatment-fits-all approach that has characterised the last 50 years of medical thinking is on its way out. It’s being replaced by individual, personalised treatment for patients based on genetic profiling, which will become part of the information we carry on our passport in future.
It will revolutionise the way breast cancer patients are treated, for example. In the past, they would receive a histological diagnosis and standard chemotherapy based on best practice, but the treatment had only a 40% chance of being effective. Genetic tests can now help profile the effectiveness of a drug on a patient’s tumour and whether toxic side effects and any possible mutations are likely. This gives doctors the ability to tailor treatment plans and achieve a better, more effective outcome for patients.
2. Preventing disease
Pioneering gene therapy will also transform treatments by moving medicine away from treating symptoms, which we do now, to interventions that prevent diseases like haemophilia from occurring in the first place.
Last year, the first successful results using gene therapy for haemophilia were presented at the American Society of Hematology (ASH). In the trial, patients with haemophilia B who lack the blood clotting protein factor X (FIX) were infused with a new gene therapy product called SPK-9001. Their clotting reduced dramatically and the patients are now doing normal activities without FIX infusions. It could be a game-changer for improving quality of life – not just for haemophiliac patients.
3. Different treatment options
In the future, more information about different treatments and the hospitals and doctors delivering them will be available to patients. They’ll be able to choose which orthopaedic surgeon they want to see based on patient reviews, the number of procedures they have completed and how many complications there were. Already, companies like Crowd Clinical are gathering positive and negative comments on social media to give patients a picture of a particular service.
Alongside these core trends are three key innovations bringing lifesaving benefits to patients and transforming the future of healthcare.
First is groundbreaking ways of developing new devices, such as 3D printing. Biomedical Engineering Professor Scott Hollister and Glenn Green MD, Associate Professor of Paediatric Otolaryngology at the University of Michigan, have already designed a 3D splint created directly from a CT scan of a 20-month-old boy’s trachea/bronchus. The patient, who has severe tracheobroncholomalacia, was off a ventilator within 21 days of treatment and hasn’t had any trouble breathing since.
Innovations like bio-electronics and nanobots are also going to revolutionise treatment delivery. Nanobots are self-assembling robots that enter the bloodstream to target and destroy cancer cells and bacteria without affecting healthy cells. Bio-electronics are a long way off, but aim to tackle many chronic diseases by implanting miniature devices in the body that modify electrical pulses along the nerves to stimulate the body and avoid the need for pills or injections.
Further automation will come about with advances in technology that are pushing the way we live with machines. The da Vinci robot, which is a slave unit operated by a surgeon using a console, has been in use for around 10 years. But it isn’t the only robot to be used in medicine. Another exciting field is mind-controlled bionics, where brain implants or sensory reinnerration allow bionic arms to respond to human thought and for amputees to feel through a robotic prosthetic.
Although many of these treatments are some way off, rapid change is coming. The natural history of one malignant disease – Chronic Myeloid Leukaemia (CML) – has already changed thanks to a new molecular treatment. In 1982 patients with CML had an 8% survival rate. The treatment when I started practice was stem cell therapy - it improved patient survival to 60%. But, by 2001 there was new hope for patients. A drug which targeted the specific genetic mutation that drove the growth of the cancer cells - increasing patient survival rate to 92%.
At Bupa, we’re already preparing for the transformative changes that are on the horizon and explaining the benefits of even more choice to patients.
Watch Jose's full presentation on treatments below:
This blog is part of the series ‘The Future of Healthcare’ where Bupa’s Chief Medical Officers from around the world, shared their views on how technology and innovation will have an impact on healthcare, deep diving in four key topics: diagnosis, treatment, data and systems of care.