The Year in Review 2012: Medicine trying more innovative approaches

By ALEX CUKAN, United Press International   |  Dec. 27, 2012 at 5:27 AM
share with facebook
share with twitter
| License Photo

2012 was not the year for new blockbuster drugs but researchers used existing drugs for different purposes and tried innovative approaches to save patients.

For example, a drug originally meant to treat diabetes may restore memory in brain cells affected by Alzheimer's disease. AC253 never made it to the market but Canadian researchers said the research in animals helped restore memory. Trials, however, are five years away.

Extract of mistletoe -- already authorized for use for colon cancer in Europe -- could either assist chemotherapy or act as an alternative to chemotherapy. One mistletoe species, known as Fraxini, was highly effective against colon cancer cells in cell culture and was gentler on healthy intestinal cells compared with chemotherapy.

The diabetes drug metformin was linked to improved ovarian cancer survival. The Mayo Clinic College of Medicine found 67 percent of those who took the drug had not died from ovarian cancer within five years, compared to 47 percent of those who didn't take the drug. All the women in the study who took the drug were already taking it to treat their diabetes.

Physicians were not only using existing drugs in different ways they were coming up with innovative ways to save the lives of their patients by pioneering new ways of treating illnesses.

A 7-year-old Pennsylvania girl had run out of treatments for leukemia but "achieved a complete response" using genetically altered HIV, her doctor said.

Dr. Stephan A. Grupp of The Children's Hospital of Philadelphia and the Perelman School of Medicine said by using the drug CTL019 treatment, he found the very activity that destroyed leukemia cells also stimulated a highly activated immune response called a cytokine release syndrome. The child became very ill and had to be admitted to the intensive care unit.

Grupp and his team counteracted these toxic side effects by using two immunomodulating drugs that blunted the overactive immune response and rapidly relieved the child's treatment-related symptoms.

Chad Washington, 35, underwent a 7-hour transplant surgery at the Ronald Reagan University of California, Los Angeles, Medical Center that replaced his heart with an the SynCardia Temporary Total Artificial Heart -- a temporary pump that acts as a "bridge" until Washington can receive a donor heart. Washington said he was home with his wife and son to wait for a donor heart.

Dr. Murray Kwon said historically, patients with a total artificial heart had to remain hospitalized while they awaited a transplant because they were tethered to a large machine to power the device.

"Today, however, this device can be powered by advanced technology small enough to fit in a backpack, Kwon said.

"By removing the patient's diseased donor heart, we removed the source of his end-stage heart failure," Dr. Ali Nsair, an assistant professor of cardiology at UCLA, said. "The total artificial heart -- and being off immunosuppressant medications -- allows his body to recover and get ready for a heart transplant ... in a few months."

Screening for cancer to detect the disease early has been drummed into the heads of most Americans, so when the U.S. Preventive Services Task Force, a volunteer group that advises the government on medicine, recommended no prostate cancer screening for any healthy men this year, it was as controversial as when the same group recommended fewer mammograms in 2009.

Dr. Michael LeFevre, co-chairman of the group, said all men deserved to know what the science said about prostate-specific antigen screening: "There was a very small potential benefit and significant potential harms."

Treatments for prostate cancer could include the removal of the prostate, radiation or other therapies, each of which can cause serious side effects including erectile dysfunction, impotence, urinary incontinence or bowel damage. Older men frequently die of other causes because prostate cancer often progresses slowly.

There's a 15.9 percent chance a man will be diagnosed with prostate cancer during his lifetime but most cases have a good prognosis, even without treatment. The lifetime risk of dying of prostate cancer was 2.8 percent. Prostate cancer was rare before age 50 and very few men died of prostate cancer before age 60. Seventy percent of deaths due to prostate cancer occurred after age 75, a statement by the U.S. Preventive Services Task Force said.

The task force concluded many men were harmed as a result of prostate cancer screening and few, if any, benefited -- a better test and better treatment options were needed, the advisory group said.

Elevated PSA readings was not necessarily evidence of prostate cancer and could lead to unnecessary prostate biopsy. Even when biopsies reveal signs of prostate cancer cells, evidence showed a large proportion would never cause harm even if left untreated, researchers said.

Cancer screening detected cancer during the time period that began with an abnormal cell and ended when the patient noticed cancer symptoms. However, some people have fast growing, aggressive cancers, while others have cancers with long pre-clinical phases, or slow growing cancers.

Unfortunately, screening tends to disproportionately detect slow growing cancers and disproportionately misses the fast growing cancers.

Another landmark study in 2012, estimated 1.3 million U.S. women were over diagnosed with breast cancer -- undergoing surgery, radiation and chemotherapy -- in the last 30 years.

Dr. Archie Bleyer of St. Charles Health System in Bend, Ore., and Dr. H. Gilbert Welch of The Dartmouth Institute for Health Policy & Clinical Practice in Lebanon, N.H., said nearly a third of all newly diagnosed breast cancers have been over diagnosed and screening, at best, is having only a small effect on the mortality rate from breast cancer.

The study, published in the New England Journal of Medicine, found fewer women were dying from breast cancer, but this was largely due to better treatment, not screening. Although more early breast tumors were found, the screening and treatment did not result in fewer late-stage cancer deaths.

"Although no one can say with certainty which women are over diagnosed, there is certainty about what happens to them: they undergo surgery, radiation therapy, hormonal therapy for five years or more, chemotherapy or a combination of these treatments for abnormalities that otherwise would not have caused illness," the study said.

As 2012, draws to a close, while there were no blockbuster drugs, no major breakthroughs for chronic illnesses and even cancer screening was no guarantee of lowering the risk of dying of the disease, there was a steady stream of research that showed healthier eating with lots of fruit and vegetables, daily exercise, moderate alcohol use and maintaining a healthy weight reduced the risk of heart disease, diabetes, cancer and dementia.

Related UPI Stories
Trending Stories