"Basically, without nanotechnology, it would be impossible to address this issue," Mihail C. Roco, senior advisor for nanotechnology at the National Science Foundation, told United Press International. Roco also serves as chair of the National Science and Technology Council's subcommittee on Nanoscale Science, Engineering and Technology.
Although nanomedicine has no official definition yet, most experts describe it as using nanometer-sized particles -- which are thousands of times thinner than a human hair -- to detect and treat diseases at the molecular level. Such tiny particles already are being used to enhance drug delivery, but the real goal of nanomedicine is to create medically useful devices that can function inside the body.
Though nanodevices still are being developed and their final form has not been fully established, scientists predict they will not be comprised entirely of metal or plastics, as are today's medical devices, but rather will be hybrids of biological molecules and synthetic polymers.
Nanomedicine aims to use genetic engineering to create proteins that bind to metals or polymers and, likewise, to create polymers that bind to proteins. An essential attribute is that the components self-assemble, because it would be nearly impossible to piece together such tiny components manually.
Once achieved, diagnostic tools and techniques based on nano principles will enable physicians "to detect cancer much earlier and to treat it immediately," before the disease has a chance to cause tumors and other problems, said Roco, who is the architect of the National Nanotechnology Initiative, a federal government-led effort intended to bring together industry, academia and government agencies to spur the field's development.
"Now, we detect cancer many years after the initial event that caused it takes place, so (nanomedicine) could move the initiation of treatment years ahead," Roco explained.
Earlier this year, the National Cancer Institute announced its goal of eliminating suffering and death due to cancer within the next 12 years. The NCI's director, Dr. Andrew C. von Eschenbach, said in subsequent interviews this does not mean all cancers will be cured by that time. Rather, rapid advances in cancer research, particularly in understanding the disorder at the molecular level, portend cures for many forms of the disease while rendering others manageable and controllable.
Von Eschenbach foresees gene screening, imaging techniques, artificial intelligence, supercomputing and nanotechnology all playing a role in the effort.
Roco noted although the goal of eliminating most cancers by 2015 sounds far-fetched, he thinks nanotechnology makes it feasible. "This is not a dream but a vision based on a well-defined strategy," he said.
Jeff Schloss, a molecular biologist and program director for technology development at the National Institutes of Health's National Human Genome Research Institute, agreed with Roco that nanomedicine could have a considerable impact on the treatment of cancer.
Although the details are still being worked out and much science remains to be done, nanodevices could enable the detection of cancer "when there are just a few cancer cells rather than waiting until it forms a tumor," Schloss, who serves as an NIH representative at the National Nanotechnology Initiative, told UPI.
The earliest applications most likely will be devices that can detect circulating molecules in the blood, he explained, but nanotechnologies ultimately could detect events going on inside individual cells, such as defects or problems in tiny cellular structures that can be caused by disease. "Nanotechnology will allow us to get inside cells in ways we really can't do now," Schloss said.
Richard Smalley, a Nobel Prize laureate and director of the Center for Nanoscale Science and Technology at Rice University in Houston, said "a grand challenge of medicine" is the ability to detect cancer earlier "and the answer almost certainly will be nano."
In addition to detecting cancer, nano-based techniques will enable physicians to determine whether a particular treatment is working, Smalley told UPI.
"In the not too distant future -- maybe a decade or two at most -- when you walk into a doctor's office, they will take a swab of the inside of the cheek, and a little time later -- maybe half an hour -- they may not know your entire genome but they will know enough to know how you will respond to whatever treatment," Smalley explained.
Although that sounds like something out of a science fiction movie, Smalley, who was diagnosed with cancer five years ago, said he has seen "a remarkable change just in that time period." He added this gives him confidence the NCI's goal is "quite reasonable. I can imagine we will see many cancers flat-out cured or either become a minor nuisance."
Nanomedicine will have an impact not only in diagnosing cancer but also in developing better and safer treatments, said Shuming Nie, director of cancer nanotechnology at Emory University's Winship Cancer Institute in Atlanta.
Nie, who is working on diagnostics for use outside the body and has founded a company focusing on such products, said, "The immediate application of nanotech will be the diagnostic area."
There is a fortunate reason for this, according to Nie: Nanoparticles can skirt certain regulatory barriers because they can be used outside the body to analyze genes and proteins in body fluids or tissue specimens and thus do not have to placed inside a live patient.
Nevertheless, they will allow researchers to predict which patients will get worse and therefore should receive more aggressive treatment, Nie said. This could be applicable to some of the most common types of cancer, including breast, prostate, colorectal and lung cancer, he said.
In addition, nanomedicine will have an impact on drug delivery and targeting. "It will enable researchers to build structures that can target a drug to a diseased site or cell" and thus lessen the severe side effects of cancer treatments, he said.
"Toxic effects are a major problem of cancer therapy and that is caused by nonspecific targeting," Nie said. More specific targeting, guided by nano techniques, will enable "more efficacious treatments with less side effects, reduced hair loss, nausea, all these kinds of effects," he said.
Nie predicted diagnostics based on nanoparticles probably will reach the development stage in two or three years. They will not be approved, but will be available for experimental situations in academic labs, he said.
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