Great medical feats were accomplished in 2011. Dallas Wiens became the first recipient of a full-face transplant in the United States, Arizona congresswoman Gabrielle Giffords survived a gunshot to her brain, and HIV researchers found a way to lower an infected person’s chance of transmitting the virus to sexual partners by 96 percent.
What significant advances can we expect in 2012? Here are five predictions, provided to MyHealthNewsDaily by experts in their fields.
Prediction 1: Medicine gets closer to treating cancer with vaccines.
Radiation and chemotherapy reign as the go-to treatments for cancer, but for 20 years researchers also have been exploring the use of therapeutic vaccines. In 2012 that work may come to fruition.
“It’s an exciting time for cancer vaccine development,” said Dr. Larry Kwak, professor and chairman of lymphoma and myeloma at the University of Texas M.D. Anderson Cancer Center in Houston.
“What’s especially impressive is the diversity of cancer vaccine. It bodes well for what you’re going to be seeing in the future,” Kwak said.
More than 250 clinical trials of vaccines, including 34 for breast cancer, are under way, according to the National Cancer Institute.
Like other vaccines, cancer vaccines use a chemical marker of a disease (in one case, a virus; in another, a malignant tumor) to train a person’s immune system to fight the disease.
But unlike vaccines for the flu or chicken pox, which are preventive, “we almost uniformly vaccinate after cancer is there,” Kwak said.
Some cancer vaccines in development could be administered to many people, while others – including Kwak’s vaccine for follicular lymphoma – would have to be tailored to each patient’s tumors.
Kwak’s vaccine has passed Phase III trials and is moving toward the final steps of regulatory approval. The U.S. Food and Drug Administration approved the first cancer vaccine, called Provenge, in the spring of 2010 for the treatment of prostate cancer. A vaccine for melanoma performed well in the final stages of clinical trials last year.
“What ties them together is they are activating the immune system so it’s primed and ready to fight,” Kwak said.
The National Cancer Institute reports there are ongoing clinical trials for therapeutic vaccines to treat bladder, breast, cervical, kidney, lung, pancreatic and other forms of cancer.
Prediction 2: Malaria vaccine development will advance.
Malaria remains a deadly and debilitating disease. The World Health Organization estimates there were 216 million cases of malaria and 655,000 deaths, mostly in children, in 2010. Communities can curb malaria infections through mosquito control, but no vaccine can prevent it.
Researchers at the University of Oxford caught international attention when they announced this month they developed a vaccine that could stop many strains of the deadliest malaria parasite, the P. falciparum parasite, in animal studies. They published the findings in the journal Nature Communications Dec. 20.
“There is no doubt that malaria has been an extraordinary challenge for vaccine creation,” said Dr. William Schaffner, chairman of the department of preventive medicine at Vanderbilt University School of Medicine, in Nashville, Tenn.
The key to the vaccine’s success is that it targets a crucial stage of the parasite’s development. When a mosquito bites a person (or an animal), the parasite travels through the blood to the liver, and then, in a new form, infects red blood cells, Schaffner said. There the parasite multiplies and changes into two new forms: one that attacks other red blood cells, and one that circulates in the bloodstream, ready to be picked up by another biting mosquito.
“You would think that anything that’s that complicated couldn’t possibly succeed as a parasite, but it is one of the most successful: The illness it creates is often mortal, if not debilitating,” Schaffner said. As the parasite bursts out of blood cells, toxins escape that cause fever and chills. Enough red blood cell destruction causes anemia.
However, the vaccine developed at Oxford interrupts the parasite’s entry into red blood cells. “That is an absolute critical stage. If we can keep it out of the red blood cell, it can’t make you sick,” Schaffner said. Still, he said he is wary of too much excitement, because several malaria vaccines with other tactics to attack the parasite failed in human studies.
Prediction 3: Millions will breathe easier, thanks to new regulations.
In December the Environmental Protection Agency announced new limits for mercury emissions and air toxins that it said will prevent 11,000 premature deaths and 4,700 heart attacks a year.
Coal industry groups criticized the new EPA rules. Steve Miller, chief executive of the American Coalition for Clean Coal Electricity, said in a press release, “This latest rule will destroy jobs, raise the cost of energy and could even make electricity less reliable.”
But health groups such as the American Lung Association hailed the new rules. “It’s going to have a huge benefit for a lot of different people,” said Janice Nolan, an assistant ALA vice president. The new regulations curb carcinogens and pollutants that exacerbate asthma, Nolan said.
The new EPA regulations will limit the amount of mercury that power plants can release into the air, she explained. Mercury settles into water, where it is transformed into methyl-mercury and picked up by fish that people eat. The neurotoxin can injure people even before they are born, while in the womb.
The legislation also will cut levels of more than 60 air toxins, including heavy metals such as arsenic, chromium and nickel, and it targets the gases that contribute to fine-particle pollution.
Fine particles, some only a 30th as wide as a human hair, can lodge in lungs and travel to the heart, Nolan said. Reducing fine-particle pollution will “prevent thousands of premature deaths and tens of thousands of heart attacks, bronchitis cases and asthma episodes,” the EPA said.
Nolan estimates more than 400 power plants in at least 40 states will be subject to the new rules, which set air-quality standards to match the clean-air performance of the top 12 percent of power plants in the country.
Prediction 4: Many crucial drugs will become cheaper.
Several top-selling brand-name drugs in the United States will be losing their patents in 2012. Makers of generic drugs will then have a chance to sell forms of the heart medicine Plavix, the diabetes drug Actos and the autoimmune disease drug Enbrel. Other blockbuster drugs losing their patents in 2012 include Viagra, Seroquel and Lexapro, according to the industry analyst firm EvaluatePharma.
Pharmaceutical companies are likely to lose billions of dollars in revenue, but the shift will lower health care costs for millions of heart, asthma, diabetes and pain patients in the U.S.
Pharmaceutical companies note that patents make it financially feasible for them to develop new treatments.
Dr. Elliott Antman, an associate dean at Harvard Medical School, discussed the costs of research, testing and manufacturing to bring a drug to market. “It used to take $800,000,” he said. “Now it takes about a billion dollars because of the sample size of the trials.”
As drugs become safer and more effective, Antman explained, studies to test a new drug against old ones can require tens of thousands of participants to find a statistical difference in effectiveness and side effects. Coordinating trials of that size, which is essential for a chance to gain FDA approval, is expensive.
“The reason they are doing this is if they know that they can get this drug to market, they will have patent protection,” Antman said.
Antman said the push for generics from insurance companies can sometimes complicate getting patients the drugs they need. But for the most part, generic forms are equivalent to brand-name drugs.
“The advantage of generics to patients is that it’s much less expensive, so it’s highly desirable,” Antman said.
Prediction 5: Legislation will make it easier to choose health insurance.
Entrepreneurs and two-income families have to choose between insurance plans. Wading through insurance coverage lingo can be confusing, and people may not realize what they will owe until they need services.
A provision in the Patient Protection and Affordable Care Act that takes effect in 2012 aims to make understanding and comparing insurance coverage easier. As of March 23, group health plans nationwide must provide a uniform summary explanation of benefits and coverage. The standardized summary must be provided to people when they apply for coverage, and to policyholders when health insurance policies are issued.
As with uniform nutrition labeling, people will have side-by-side details that explain co-pays, prescription coverage, deductibles and other essential information to help them choose a health insurance policy.
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