Articles - Articles
- Don’t let Europe’s health sail into the sunset
Today (9 September) the European Commission President, Jean-Claude Juncker, delivered his ‘State of the Union’ address. In between declarations about the Union needing ‘more Europe’, as well as the occasional sea-faring metaphor, the president touched on points of particular interest to those in the health-care industries. “No wind favours he who has no destined port – we need to know where we are headed. It is time to speak frankly about the big issues facing the European Union,” he said.
Juncker went on to mention the “deeply political question, (of) whether you increase VAT on medicines in a country where 30% of the population is no longer covered by the public health system as a result of the crisis. Or whether you cut military expenditure instead.”
- Making the most of the personalised medicine revolution
Personalised (or precision) medicine is a fast-moving field that sees treatments and medicines tailored to a patient’s genes, as well as his or her environment and lifestyle. In a nutshell it aims to give the right treatment to the right patient at the right time, and can also work in a preventative sense. These cutting-edge sciences and ‘omics’ hit the news recently when the US’s President Obama launched the Precision Medicine Initiative earlier this year, sending dollar upon dollar in the direction of research, clinical trials and DNA sequencing. Unfortunately, because we are only at the beginning of the personalised medicine revolution, it is less wide-spread than it could and should be. It is also currently less precise than it will be in the future.
- Four ‘tensions’ for personalised medicine to ease
In the world of health care, personalised medicine is gaining ground at a grass-roots level among health-care providers and, indeed, among patients too. But there are still plenty of barriers, or ‘tensions’. Many common, chronic diseases are progressive in nature, some of whose progression can be slowed or stopped by appropriate care before they go too far to be effectively treated. Obviously, a progressive disease does the patient no good whatsoever, and such a state of affairs is also expensive down the line, as more intensive treatment will be necessary.
- Effective and affordable cancer treatments are one step nearer
Scientists are getting very excited about immuno-oncology (I-O) which its proponents say will revolutionize cancer care. A new class of drug has arrived that is designed to encourage the body’s own immune system to attack malignant cells.
The World Health Organization has predicted that the number of people dying from cancer will rise from 8.2 million in 2012 to 14.6m in 2035, yet these treatments are already coming up with the goods even in advanced melanoma and lung cancer.
- Changing times call for changing relationships
It’s a fast-changing world, especially in health. And, arguably, the rise of personalised medicine – which aims to give the right treatment to the right patient at the right time – is only being outstripped in this arena by the rise of new digital tools and technologies.
The Brussels-based European Alliance for Personalised Medicine (EAPM) believes that, given the arrival of smartphones and other devices that can produce diagnostic results, plus smart pill-boxes that remind us to take our medication and wearables that monitor everything from our heartbeat to our blood pressure, medicine is on its way to becoming more democratized.
- Over-screening for breast cancer brings little benefit to women
An epidemic concerning the over-estimation of breast cancer risk has had the drastic effect that thousands of unnecessary mastectomies are taking place in Europe, the US and beyond. Over-intensive screening is partly to blame for increased stress and worry among women of all ages (but especially the over-40s), leading them – and often their doctors – to imagine, and often pointlessly act upon, worst-case scenarios.
One recent article on the results of a US study, which suggested that aggressive surgical treatment of a possible precursor to breast cancer may be unnecessary, showed that many women had undergone a lumpectomy or mastectomy after being diagnosed with ductal carcinoma in situ (DCIS). DCIS involves abnormal cells in the milk ducts of a breast.
- Data-sharing should include patient too
Genetic research has come on in leaps and bounds over the past few years and has brought with it the potential to change how treatments, medicines and even information to patients is delivered.
At the heart of genetics-based personalised medicine – aimed at giving the right treatment to the right patient at the right time – lies the collection, storage, use and sharing of data. There is now so much of it that it is termed ‘Big Data’ and, while it is vital in pushing back the boundaries of medical research, there are many barriers to its optimum and indeed ethical use. Current research infrastructure, both in Europe and the US, is too compartmentalized which adds cost and slows down the speed of new discoveries.
- Doctor-patient relationships must change to reflect modern era of health care
The times they are a-changing. And fast. In this modern era of ultra-new science in DNA profiling, biomarkers and more, healthcare is evolving and moving forward swiftly. The arrival of the internet, and now, ‘Big Data’, plus the Cloud and super-computing has made much more information much more accessible to much more of the population. Smartphones and other devices, meanwhile, mean that we can get the information we want, whenever we want and wherever we happen to be.
In the world of health care, these exciting developments promised a seismic shift in the way it is delivered. The rise of personalised medicine, as well as fundamental changes in patient-doctor relationships, mean that the promise is already being realized. Modern-day patients want empowerment, and to have their illnesses and the treatment options explained in a transparent, understandable yet non-patronizing manner to allow them to become involved in co-decision.