Dr. Marc Siegel: Miracles await -- 2019 will be a year of amazing strides in medical innovation

Back in October, the renowned Cleveland Clinic hosted a major conference on medical innovation and listed its own top health care breakthrough categories for 2019. With the new year upon us, I am excited to say that I completely agree with the Clinic’s outlook and eagerly anticipate what is coming.

First up on the list are new non-addictive alternatives to pain management. FDA commissioner Dr. Scott Gottlieb told me in a recent interview that exciting research is going on in this area and that new drugs will emerge where a patient’s genetic makeup will help determine the best treatment. This past year scientists at Wake Forest School of Medicine found such a new drug, known as AT-121, so far only tested in non-human primates, which suppresses the addictive effects of opioids while at the same time decreasing pain.

Another drug developed at Purdue University’s College of Pharmacy shows promise in selectively blocking enzymes that are messengers for pain throughout the body.

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Considering that there were more than 70,000 deaths from opioid overdoses in 2017, even though the prescribing of opioids is finally on the decline, these new drugs are most definitely welcome. While many chronic pain sufferers may find relief in non-pharmacological alternatives such as heat, physical therapy, acupuncture, yoga, chiropractic or even weight loss, there remains an enormous need for these non-addictive medications.

Second on the Cleveland Clinic list is Artificial Intelligence, which is really coming into its own with huge upsides as a tool for personalized medicine. Data analysis, algorithms, and population health will benefit enormously from the agility and precise pattern recognition of the computer brain. Multiple medical advances will be based on this precision, both in terms of digital diagnoses and robotic treatments, while concerns about preserving privacy from the all-seeing artificial eye are legitimate and must be accounted for.

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Cancer immunotherapy is another area that is exploding with potential, and it, too, is personalized – based on targeting proteins and mutations on a particular cancer cell. Even more personalized is CAR-T, where your immune T cells are removed and bioengineered to form antibodies against your particular cancer and then re-inserted into the body. This treatment is just evolving but is already showing much promise against resistant lymphomas, leukemia, and other cancers. One major problem is that the treatment is extremely expensive – often more than $300,000 for a single injection – and it is difficult to come up with an insurance model to pay for it. Health insurance in general is based on a one-size-fits all concept of prevention, screening, and intervention that is rapidly becoming obsolete.

Also high on the Cleveland Clinic innovation list is 3D computer organ printing technology, a process which involves making an object by depositing layers of materials, including living cells.  This process has proven useful with prosthetics and bodily implants. Small bits of tissue can be grown and combined with scaffolding to build entire organs. For example, the technology has been used effectively in recent heart surgeries and face transplants. 3D printing won’t take the place of organ transplant any time in the near future, but it will augment it.

Remember when Dr. McCoy on “Star Trek” was able to make diagnoses with a tricorder and perform brain surgery or seal ruptured vessels by simply putting a futuristic band around a patient’s head? That kind of medicine seemed like pure fantasy at the time. Now these solutions appear to be right around the corner.