Amongst the most promising lines of research currently generating all the hype relates to stem cells. Stem cell research and therapies are undoubtedly at the cutting edge of science, with regular breakthroughs being announced in the field but the subject provokes fear and anticipation in equal measure. Whilst in the long term, this line of research will result in spectacular progress, what can we expect in the short term which will have an equally profound impact?
Alzheimer’s or similar senile dementias
The one area which is, in my opinion, not receiving sufficient funding – I have no bias in this viewpoint – is that relating to dementia especially those experienced in one’s dotage such as Alzheimer’s.
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This disease is pernicious, far more debilitating than a stroke, even more detrimental than cancer. By stripping one of one’s ability to reason, to think, to interact with others as equals, it destroys the essence of one’s personality, the very core of one’s being. Instead one is transmuted into a lifeless shell still with form but with no function.
The two aspects of this affliction are of equal importance: detection and treatment. Currently detection is only possible when significant damage has been sustained but if tests were able to detect the early onset of the disease, what would their use be when no action can be taken to alleviate or prevent the further advance of the disease.
The culprit implicated in this generative disease is a protein by the name of Beta Amyloid. The resulting amyloid plaques are toxic to nerve cells. There is now mounting evidence that by the time the plaques are visible, irreparable damage may have already been done: vital connections between brain cells will already have been severed, and neurons will have been lost for ever.
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In an exciting recent development, a treatment to reverse Alzheimer’s disease could be available in five years, it has been revealed. Experiments on mice have indicated that a new vaccine not only halts the advance of the disease, but repairs damage already done. It could conceivably also be given to patients whose families have a history of Alzheimer’s, to prevent them developing the disease.
This breakthrough will definitely be a saviour of my children’s generation but will its clinical trials be completed soon enough to assist my generation.
Having seen both my mother and my father-in-law succumb to this disease over a lengthy period of time – just less than a decade – this disease transformed them into empty shells without personality and reason to use an old fashioned word.
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Cancer
Cancer must also rank amongst the diseases that I fear most. Of all my friends or acquaintances who have contracted this disease, only one has survived. Despite chemotherapy and radiation all the rest were laid to rest within two to three years of the diagnosis being made. The only conclusion that I can draw from these dismal results is that the odds of survival for at least five years are exceedingly long. The initial notification that one has the disease is an advance warning that one’s death certificate is one its way ceteris paribus.
The excellent news is that stellar progress has recently been made in combating this disease.
The following three breakthroughs provide me with optimism for the future
As a male, the one that I fear most is prostate cancer not so much for causing incontinence – which is bad enough – but for causing impotence, the holy grail of a male’s being. Thus far the corpus of research has not elicited a method of determining the type of prostate cancer. It is crucial to determine whether the cancer is fast acting and will kill the sufferer within three months or its slow acting cousin which could take a life-time to kill the patient.
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Faced with the dilemma of providing treatment which is not required as the cancer is slow acting or providing aggressive treatment to a fast acting cancer, the doctor will select the lesser of two evils and subject the patient to the most drastic form of medical treatment.
In landmark research, British scientists have discovered that based upon their DNA, prostate cancer can be divided into five categories from virulent to benign. This breakthrough will save countless men from being subjected to unnecessary treatment while simultaneously permitting the correct treatment to save lives.
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Currently what treatments are in the arsenals of the oncologists? Radiation and chemotheraphy. Both are poisons designed to attack and by chance kill cancer cells or at least slow their growth. If ever there was a shotgun approach to medical treatment, this is it. By using this approach, the treatment attacks not just cancer cells but healthy cells too. Patients suffer deleterious side-effects in addition to the mayhem that the cancer itself is wreaking in one’s body.
Imagine suffering from nausea, becoming emaciated and weak while simultaneously losing one’s hair and one’s palour! Combined with indeterminate prospects, it is no wonder that many people refuse to be subjected to this treatment and instead resign themselves to a rapid death.
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The next revolution is imminent. The purple rays of an approaching sunrise can be discerned in the east. It is entitled molecular targeted therapy. Eponymously known as designer drugs this treatment consists of drugs designed to attack the cancer at the molecular level. This requires a tailor-made drug which is unique to every particular type of cancer.
This is not as daunting as it is first surmised. Whereas previously the types of cancers were categorised by their location and not by their molecular cause or structure, it has now been determined that many “types” of cancers have similar molecular origin. By understanding the critical abnormalities that drive a cancer, scientists can target the cancer with an effective and non-toxic therapy.
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Even more exciting is a recently announced discovery. Scientists have found a code for turning off cancer. Unlike conventional drugs, which work by killing the cancer, the US work aims to disarm it and render it harmless. The breakthrough is targeted at a protein called PLEKHA7 that assists healthy cells to clump together. PLEKHA7 acts as a “brake” on the cells, preventing them from multiplying non-stop and forming tumours.
Research at the Mayo Clinic Florida has determined that this key protein is missing or faulty in a range of cancers. When this happens, key genetic instructions to the cells are scrambled and they turn cancerous. A research team led by Panos Anastasiadis – or Nick the Greek as I would call him – was able to reset the instructions, thus switching off the cancer. Experiments in a petri dish showed that human cells from highly dangerous bladder cancers can be made normal again. One wonders whether the fact that Panos’ own father died of bladder cancer played a role in his career choice.
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This treatment would apply to most cancers except those relating to the brain and blood cancers.
In yet another breakthrough, in a paradigm shift researchers have embarked on a quest to harness one’s own immune system to destroy or contain the cancer and prevent its metastasis. This treatment is known eponymously as immunotherapy. Tumours of various types of cancers including the most intractable such as bowel and ovarian have been shown to respond favourably to treatment over the past decade. The two drugs with the most promise are nivolumab and ipilimumah with the former scheduled for general release in 2016.
The treatment using a cocktail of both of these drugs has been demonstrated to have a success rate three times that of one of these drugs alone.
South African patients have been guinea pigs in the testing of these drugs. In the one case reported in the Star, a woman with stage 3 terminal cancer with months to live was provided with four treatments of an immunotheraphy drug at the Sunninghill Hospital last year. The latest tests show that she is still cancer free and her chances of long term survival are rated as excellent.
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There is just one drawback – the cost. According to that article, the Star is quoted as stating that the cost of one treatment is R 250 000 with a minimum of four treatments being required and some cases five sessions. Other articles are quoting figures of R 1.9 million before the collapse of the Rand.
In retirement, medical expenses are the bane of one’s limited budget. As the chances of contracting cancer as 30%, one has to set aside at least a few million Rands to cater for this eventuality. Instead of bequeathing it to one’s children, lavish it on oneself as they probably have ulterior motives when the attempt to dissuade one from undergoing such expensive treatment.
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Self-inflicted diseases
These afflictions all relate to life style choices that are made normally in one’s youth.
The one life-style choice which creates the greatest harm relates to smoking. After mudding the water with dubious research, deep pockets and outright lies, the tobacco companies have lost the fight.
And not too soon.
With no benefits except perhaps to the fiscus, the tobacco industry is now treated for what it is – a vendor of a dangerous product with no societal benefits and justly cast as a pariah. Even the supposed windfall to the fiscus is hugely offset by the costs of treatment – both direct and indirect – and a healthier population. Such wasteful expenditure proportionally falling on the impecunious will now be diverted to other job creating activities other than giant cigarette manufacturers with their automated plant.
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In addition the productivity of the general workforce will be improved in not having to sneak outside ever now and then to inhale their nicotine.
Having toured a cigarette manufacturer in Heidelberg some 25 years ago, I found it highly ironic that smoking was not allowed in the manufacturing area.
The single greatest inducement not to smoke especially in the west is societal pressure. Instead of the fifties and sixties where it was de rigeur and fashionable to smoke, this trend has largely reversed except within the lower social strata and the youth.
Also aiding the trend has been the harsh taxes imposed upon tobacco products. Aside from social trends, this has been the greatest source of pressure against smoking. What has been demonstrated especially in countries such as the UK, is that the tax levels can be substantially ramped up without a significant reduction in consumption. What this has highlighted is that addicted public will by and large still continue smoking whereas the non-smoking youth cannot afford to take up the habit.
What the youthful smoker does not appreciate is that once hooked, it is only after at least 20 years of smoking that they will have any success at quitting. By then substantial damage would have been done especially to their lungs.
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A recent email by my brother highlights this fact:
My years of smoking have finally caught up with me
I went to the Lung Institute at the UCT Private Academic Hospital yesterday. The good news is that I don’t have cancer or emphysema. The bad news is that I’m never going to run the 4 minute mile or even come close no matter how motivated I were to be.
I have been diagnosed with COPD (Chronic Obstructive Pulmonary Disease/Disorder). It is moderate at this stage but it is very close to the severe designation. Essentially I have lost the elasticity that keeps the small airways open during exhalation. They collapse thereby trapping a certain volume of air in my lungs, hence I always feel slightly bloated. For my age and size I should be able to inhale 4.85lt. I inhale 4.1lt – not too bad. However, in the first second of exhalation I should be able to exhale 85% of that namely 4.13lt. I can only manage 0.53%, namely 2.17lt. (50% and lower puts me in the severe classification so I’m close to the borderline) My x-rays show that my diaphragm sits approx. 1 rib lower than in healthy people indicating the air volume that is trapped in my lungs and cannot be utilised.
I completely accept that I am to blame for my malaise however I do have some issues with the medical/tobacco complex. For the last 22 years I have smoked the lightest possible cigarettes. These have a nicotine and tar rating 10x lower than standard cigarettes. I realised that although I was wrong, I thought that I was at least better off than the average smoker by a long way and that I would be, relatively speaking, OK. I always hoped that I could give up one day and, if I hadn’t got cancer by then, I would regain most of a non-smokers lung function over time as my much reduced tars were slowly expelled out of my system.
Unfortunately, the doctor pointed out that the damage that my lungs experienced was due to the VOC’s (volatile organic compounds) and unburnt hydrocarbons. No matter how light the cigarettes were that I smoked, the VOC’s and HC’s remained the same!
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Being a grade A student, I would have thought that what was elaborated in the last paragraph would have been apparent to him years ago.
Such as the delusions of smokers
Post script
Other possible long-term developments arising from stem cell research will be designer babies. Of more importance in my view will be the ability to regenerate body parts such as missing limbs. If lizards can regenerate limbs, surely mankind has the wit and resourcefulness to replicate this process.
Two of my most sought after cures are not even on the horizon; preventing aging or at least the effects of aging but of paramount importance for me is a weight reduction programme that does not require starving oneself or eating the most bland of food.
I will keep on hoping.