6 New treatments that could save your life

In the past, some disease diagnoses used to strike fear in all of us. But today, thanks to medical advances, this is no longer always true. Today, vaccines protect our families from once deadly diseases. Antibiotics vanquish infections that used to kill tens of thousands. Cancers that were once eminently lethal are now more like chronic illnesses that people can live with for many years. We can all take heart from these amazing advances in prevention and treatment.

 

Approximately 14 million Europeans are infected.

THE GOOD NEWS: Now there is a cure

HOW IT HAPPENED: In 2013 a new class of anti-viral drugs became available

It was the early 1990s, and Leigh-Anne Maxwell had no idea why, for years, she’d felt so awful; neither did her doctors. They’d tested for mononucleosis, anemia, and other obvious causes. Nothing. She was exhausted. She was nauseated. Active for most of her life, the 62-year-old enjoyed exploring the woods on Mayne Island in British Columbia, where she lives.

No one connected her symptoms to the emergency surgery she’d undergone years before. It wasn’t until she tried giving blood that she finally got a diagnosis. The Red Cross had begun testing donors for the hepatitis C virus in 1990 and notified her she could no longer be a donor. She was infected. Because hepatitis C is transmitted by blood, she knew immediately that the transfusion that had saved her life had infected her. 

As Shruti Mehta, an epidemiologist with Johns Hopkins in Baltimore, Maryland, explains, although some will clear the infection on their own, about 70 to 85 per cent of those infected go on to develop chronic infections, “Which puts them at risk for all sorts of long-term complications associated with liver disease, primarily liver cirrhosis, liver cancer, and end-stage liver disease.”

While most people with the virus can be asymptomatic for many years, this wasn’t so for Leigh-Anne. And, the only treatment available offered just a 50 per cent success rate, and Leigh-Anne wasn’t a candidate. Then, in 2013, newer drugs became available that were “nothing short of revolutionary,” says Mehta. But they were costly, and only worked against certain strains. Again, Leigh-Anne wasn’t a candidate. Then, in January 2017, she was offered a chance to try a brand new medication, Zepatier. “Within a week there was a profound difference,” Leigh-Anne says. She now has the energy to do all the things she’s been missing.

Today there are treatments for all strains of hepatitis C, and costs are coming down. But because the disease can hide in someone’s body for years, one of the biggest remaining challenges is finding the people who are in need of the treatment.

 

Strokes and heart attacks account for 3.9 million deaths each year in Europe.

THE GOOD NEWS: Eighty per cent of early deaths 
are preventable

HOW IT HAPPENED: Lifestyle changes and better treatments have greatly reduced the number of premature deaths from heart attack and stroke

Although this continues to be the top killer of men and women, up to 80 per cent of premature deaths due to heart disease and stroke are preventable, says the World Health Organisation (WHO). Finland offers a great example.

“Coronary heart disease mortality in working aged population (from 35 to 74) in Finland has declined by more than 80 per cent, from the top figures in the early 1970s to 2015,” says Dr. Veikko Salomaa, research professor emeritus of Finland’s National Institute for Health and Welfare.

“Until the mid-1980s almost all of the mortality reduction was explained by declines in the levels of three major risk factors: blood cholesterol, smoking, and blood pressure.”

Since then, says Professor Salomaa, Finland has seen an even greater improvement in survival, thanks to advances in the treatment of cardiovascular disease.

Stroke treatment, too, has made great leaps. Quick treatment is still important to survival, and to limit damage to the brain. But a newer treatment called Solitaire, a device that’s designed to trap and remove a brain clot, can extend the window for treatment and make treatment for patients safer overall.

With Solitaire, stroke can be treated effectively as late as eight hours after onset. And in a very small but dramatic study, injecting stem cells into the brains of stroke victims allowed about 39 per cent to recover meaningful function as long as three years after suffering strokes.

Along with treatment, lifestyle changes have helped prevent countless deaths from heart disease and stroke.

An international study published in The Lancet confirmed that just 150 minutes of moderate physical activity a week decreases your heart risk by about 20 per cent. And the more active you are, the better your heart.

Eating healthily and lowering stress is important too. A 2014 study found it decreased heart disease risk by as much as 22 per cent.

Aira Kuronen of Lappeenranta, Finland, now 65, believes work stress almost killed her. She knew her heart disease risk was high. Her mother had died of a heart attack at 51. Aira led a healthy lifestyle, but, in her career she struggled with “busy schedules, unpredictability, difficult and challenging tasks.” She didn’t realise that it could be affecting her health until the summer of 2000.

“I was alone in the garden when I collapsed due to intense pain in my whole body.” Aira recalls. She rested up, and put it out of her mind.

It was about six months before she told her doctor about her tiredness and pain. He sent her for a stress test at the local hospital. “The supervising doctor interrupted the exercise test. He informed me that I had one or more clots in my coronary artery and asked if I was ready for an operation.”

The doctor ordered an immediate angioplasty, Aira went home the following day but she needed a second angioplasty six months later, and three more after that.

Today, she’s retired and her heart is under control thanks to medication and a tension-free lifestyle.

 

There are more than 3.7 million new cases of cancer each year in Europe.

THE GOOD NEWS: Even with advanced cancers, people are enjoying longer survival times

HOW IT HAPPENED: Newer immunotherapy drugs and very old drugs can sometimes help

The most promising news in cancer treatment today is immunotherapy, which encourages the body’s immune system to rally its own forces against disease. And the newest advance in this field is CAR T. In the lab, a person’s own t-cells (a type of white blood cell) are re-engineered into impressive cancer-fighting machines. The first such therapy was approved in the US in August 2017 (the European Medicines Agency is expected to approve the drug this year) to fight acute lymphoblastic leukemia in children and young adults. In a clinical trial, 83 per cent of those receiving CAR T therapy experienced remission within three months. It’s also being used to treat certain non-Hodgkins lymphoma patients.

Several other immunotherapy drugs are currently being used against cancer, sometimes with dramatic results. But most immunotherapies only work for a small percentage of people. Usually, a biopsy of the tumour is required to find out whether the patient is a good candidate and for which immunotherapy. But now, a new blood test, called a liquid biopsy, is being studied by researchers to determine whether, by looking for DNA markers in an individual’s blood, they can quickly and easily determine which immunotherapy will help which patients.

Liquid biopsies might also be the future of early detection of cancer, according to an August 2017 paper in Science Translational Medicine. Already, they’re used to detect genetic changes linked to melanoma and lung cancer, and may help detect cancer recurrence.

A January 2018 paper shows that such tests can screen for certain cancers, including those of the ovary, liver, stomach, pancreas, and esophagus.

One very different type of immunotherapy is a vaccine for lung cancer called CIMAvax. It has significantly increased survival times in patients in Cuba, where it was developed, and is now being tested in clinical trials in the US. What makes CIMAvax unique is that unlike most immunotherapies, which are only effective against very specific cancer sub-types, CIMAvax suppresses a “growth factor” called EGF in the patient’s body, and numerous different types of cancers require EGF in order to proliferate.

“The possibility is that this vaccine would be useful in a large number of cancers,” says Dr. Kelvin Lee, professor and chair of the immunology department at Roswell. Among those cancers are breast, pancreatic, colon, and head and neck. Already, he says, Cuban researchers are “exploring whether the vaccine might also be effective in treating prostate cancer.”

Another piece of good news involves a very old, very available drug. A low-dose aspirin a day might help keep certain cancers away, including colon, liver, and pancreatic. But you should check with your physician before taking it on a regular basis.

 

According to WHO, colon cancer is the second most common cancer in Europe (with 447,000 new cases reported in 2012) and the most deadly.

THE GOOD NEWS: Many more people are surviving today

HOW IT HAPPENED: More widespread screening allows doctors to catch it early

The most common screening, the fecal test, couldn’t be simpler: your physician sends you a test kit and you send it back with a sample. If the test detects blood in the stool, a colonoscopy can locate and remove growths in the colon or rectum, and samples sent to a lab will determine whether or not they are cancerous.

In some countries, colonoscopy is becoming the preferred method of screening because it’s more accurate, and growths can be removed during screening. “There’s very good data in Germany that colonoscopic screening is working,” says Professor Dr. Joachim F Erckenbrecht, a gastroenterologist from Dusseldorf. “It reduces mortality and the rate of new cancer.”

And more widespread screening could more than double the rate of cancer survival.

 

There are approximately 500,000 new cases 
each year.

THE GOOD NEWS: Twenty-two per cent of breast cancers discovered early will not need treatment. Survival times are greatly improved

HOW IT HAPPENED: Genetic testing now allows doctors to pinpoint which treatment will work best for which cancer.

About one in eight European women will get breast cancer, and 2012 saw half a million new cases. But a breast cancer is no longer a death sentence. A good portion of breast cancers don’t actually need treatment at all. Most small (under two centimeters) tumours will never grow large enough to lead to death, according to a study in the October 2016 issue of The New England Journal of Medicine.

Improved treatment is responsible for at least two-thirds of the reduction in breast cancer deaths from 1975 to 2012, and a good deal of credit goes to the discovery that one treatment doesn’t fit all.

Using the right treatment for an individual’s cancer subtype both saves lives and prolongs the survival times for as many as 80 per cent of women.

 

Too few people donate organs after their death to keep up with the need. 

THE GOOD NEWS: From 2004 to 2013, living EU donations increased 86 per cent

HOW IT HAPPENED: More people understand that most of us can live with just one kidney; live donations of livers are even lower risk

Farra and George Rosko’s baby girl, Talia, was slowly dying. Born in 2015 without a functioning gall bladder, bile had backed up into her liver, causing cirrhosis. Surgeons had run out of options, and she was put on the waiting list for a liver. But finding a match among donated organs is difficult. Talia was likely to go into liver failure at any time.

When Talia’s mum needed to return to work in order to maintain the family’s health insurance, the Roskos searched for a nanny who could care for a then nine-month-old baby with a feeding tube. They found the perfect person in 22-year-old Kiersten Miles. And, over the next months, Kiersten fell in love with her little charge.

Without telling anyone, Kiersten made the important decision to get tested to see whether she might be a donor match.

Most transplanted organs must come from deceased donors, but kidneys and livers can also come from donors who are alive, which vastly increases the number of transplantable organs available.

There are, of course, risks. Although people generally do fine with a single kidney, the donor might eventually suffer a loss of function in the remaining kidney. The liver, by contrast, has amazing powers of regeneration. If a portion is removed, it can grow back to full size within just two months. The portion transplanted also grows to normal size in the recipient. Donors typically recover completely without suffering any permanent damage.

A healthy, athletic young woman, Kiersten was thrilled when doctors told her she was a match. In January 2017, Talia and Kiersten underwent the delicate dual operations to transfer a part of Kiersten’s liver to the baby. Today, both are doing fine.

What was once a death sentence is now often curable. And tomorrow? With ongoing research, each passing year brings better news.