My spinal tap and the future of medicine

There is nothing like a stay in hospital to reconnect one with life and how fleeting it can be. I found myself the other week undergoing surgery on my lower spine, carried out by a man whose incalculable knowledge and sleight of hands I can only bow to.

Those wonderful traits and modern science — that the procedure was by way of micro-surgery — saw me discharged from hospital the next day.

Recovery mode has given me time to consider the wonders of modern medicine, in that much of what we take for granted today in health care was an unknown 20 or 30 years ago, even a decade ago. We have come leaps and bounds in the diagnosis and treatment of many once-thought incurable illnesses in the fields of cancers and cardiology, muscle and nerve regeneration, and in the fields, too, of transplants and artificial body parts.

Consider the American David Bennett who, at 57, has became the first person to get a heart transplant from a genetically-modified pig, after a seven-hour procedure in Baltimore. The cross-species surgery — xenotransplant — has been cited a “game-changing moment in the history of medicine” and raises hopes of clinical trials for humans with kidney failure.

Now, consider, too, the year is 2040. You go into hospital for routine surgery but, unlike today, this is performed by a surgeon operating remotely from a different continent, using new blood generated inside your own body without the need for a donor, and using medicine specifically designed to match your own DNA.

These are just some of the ways futurologist Ray Hammond envisions healthcare will change in the next 20 years and beyond. Although impossible to know the extent of that change, the eminent British scientist, who has written some dozen books on the future world, sees a tomorrow in which medical care is increasingly personalised, digitally focused and data-driven.

Hammond predicts five main ways the healthcare landscape might change: personalised medicine, stem-cell medicine, nano-scale medicine, gene therapy and digital-driven health care.

Although these advances are already having an impact on healthcare, they are still at their early stages but, due to advances in Artificial Intelligence (AI), the decreasing cost of gene sequencing and ‘personalised’ medicine, they are fast becoming key parts of diagnostics, drug development and patient care.

In the last decade, healthcare has become increasingly focused on what cutting-edge technology can offer patients and physicians. In the next 20 years, the current ‘one size fits all’ approach to medicine could be replaced, thanks to advances in personalised or ‘precision’ medicine. Analysing individuals’ DNA may mean doctors can start to treat patients with drugs tailored to their unique DNA.

By 2040, medical science can expect to have collected DNA sequencing data from tens of millions of patients, shedding light on links between particular genes and diseases. By then, too, Hammond predicts every newborn baby will have their DNA routinely sequenced.

Stem-cell medicine, which is still at early stages, will become an important tool in everyday medicine. For example, rather than relying on donors human, organs will be grown on demand from stem cells in a lab.

Medical care could also be taking place on a ‘nano-scale’. The use of minute materials for diagnosis and drug treatment will have advanced beyond the early stages it is at today. Scientists, also, may be able to manipulate cells at a molecular level, allowing for an even greater level of personalised treatment and cure.

Although still an ethical grey area, gene editing, in which the genes responsible for certain medical conditions are deactivated or rewritten, will likely remain an ongoing debate in the coming decades.

In arriving at my need for my routine spine surgery, consultants also discovered that I have the potential for, or disposition to, developing aplastic anaemia, whereby my bone marrow is hindered in creating healthy red blood cells vital to life. Only the potential, mind you.
“It just needs ongoing monitoring for now,” says my haematologist. “Old age will likely get you before it does.”

Sitting in the sterile consulting room, I say: “My Mother had aplastic anaemia. It eventually developed into a secondary cancer, leukaemia, of which she died 22 years ago.”

The consultant smiles. “That was back then. Nowadays, we have a drug to treat aplastic anaemia, a derivative of a drug which enhances an athlete’s performance. We’ll have you running a marathon yet!”

And, so, I live in hope…

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