Murphy: The future is now for healthcare advances

This is a commentary by Mark Murphy, a local author and physician. He is a longtime contributor to the Savannah Morning News.

I recently attended the American College of Gastroenterology meeting in Vancouver, B.C., and I was struck by the astonishing pace of change in healthcare. I saw a presentation about using artificial intelligence (AI) to identify deadly pancreatic cancers in PET CT scans up to a year before diagnosis. A simple $1,000 blood test (unfortunately not yet covered by insurance) can screen for more than 50 different malignancies. A handheld portable ultrasound device can be set up via Bluetooth with one’s iPhone for use at the bedside. All of this made me wonder what the next medical innovations will be.

Here's what I found out is on the horizon:

The broader use of mRNA vaccines is just beginning. MRNA vaccine technology first gained widespread attention during the early phases of the COVID-19 pandemic, when that technology was used to develop effective vaccines with unprecedented speed. Doctors Drew Weissman and Katalin Kariko won the 2023 Nobel Prize for their efforts in this area. Other mRNA vaccines are under development for Hepatitis C, HIV, influenza, malaria, TB, Clostridium difficile, and genital herpes (HSV).

However, developing vaccines for infection is only the tip of the mRNA vaccine iceberg. For example, mRNA vaccines can be created to treat specific cancers. The preliminary results from a study of unresectable head and neck cancer patients have been promising. Scientists are studying mRNA treatments for genetic diseases such as sickle cell anemia and cystic fibrosis and for familial hypercholesterolemia, a leading risk factor for heart attacks and strokes. There is also an investigation into the use of mRNA technology in treating neurodegenerative diseases such as ALS (amyotrophic lateral sclerosis, also known as Lou Gehrig's disease) and frontotemporal dementia.

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Artificial Intelligence (AI) will be ubiquitous. In my office, we have used an AI-driven program to help improve the detection of colon polyps and cancers during colonoscopy for more than a year now — and it works, enhancing the detection of such colon lesions by up to 25%. For most of my professional life, the quality of imaging results such as ultrasound, CT, or MRI has mainly been contingent upon the skill of the interpreting radiologist. However, artificial intelligence can dramatically improve the quality of all imaging modalities, greatly expanding the detection of radiographic abnormalities. Specialty-specific AI-driven diagnostic programs will aid clinicians in making the correct diagnoses and formulating the proper treatment regimens. The result? Better patient care overall.

Wearable technology will change both diagnostic and therapeutic approaches. Most of us are familiar with devices such as the FitBit, which tracks steps, heart rate, etc. I’ve had one since 2014. Now, such devices can track cardiac arrhythmias, monitor blood pressure and glucose levels, and provide real-time feedback on many medical conditions requiring close monitoring. More than 91 million Americans are using wearable technology of this sort in 2023. Expect that number to increase.

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Telemedicine is here to stay. Before the COVID-19 pandemic, most insurance companies would not reimburse doctors for telehealth visits. The pandemic changed all that — and the telehealth genie is not going back into the bottle. Given that much of the U.S. is underserved by medical professionals (particularly specialists), telemedicine visits are anticipated to become more and more commonplace. Moreover, such visits save money: A study by the employee benefits consulting group Willis Towers Watson estimated that increased use of telemedicine in the U.S. could save employers up to $6 billion annually.

Biologic therapies are the future of pharmacology. At UNC-Chapel Hill, I worked with a physician named Dr. Balfour Sartor to develop medications for Crohn’s disease and ulcerative colitis (collectively termed inflammatory bowel disease, or IBD), which specifically targeted cytokines. These tiny biological messengers help to govern various components of the inflammatory process. One of the early drugs of this sort was infliximab (brand name Remicade), which revolutionized the treatment of IBD after it was first approved in 1998. Now, 25 years later, biological agents are used for myriad conditions, including rheumatoid arthritis, ankylosing spondylitis, psoriasis, numerous cancers such as glioblastoma, lymphoma, leukemia, breast, cervical and lung cancers, and eye disorders such as macular degeneration and diabetic retinopathy. These agents allow targeted treatments that can limit the extent and spread of disease and sometimes cure previously untreatable diseases.

The rate of change in healthcare during my lifetime has been extraordinary. When I was born in 1962, antibiotics had only been in widespread use for 20 years or so. Cancer therapy was primitive and highly toxic. Organ transplantation was the stuff of science fiction. Ultrasound imaging was in its infancy, and the CT (1971) and MRI (1977) scanners had yet to be invented.

We are indeed on the brink of a remarkable revolution in healthcare. The burgeoning advances in medicine will impact all of us, improving the diagnosis and treatment of multiple diseases in future years.

This article originally appeared on Savannah Morning News: Murphy: Medical advances are bringing the future to the present