War on Opioids: Virtual reality manages pain without pills in the fight against pain has some reaching for a virtual reality headset instead of the pill bottle.

What advance in medical science are you most excited about?

The transition from one year to the next is always a little uncertain – an uneasy blend of anxiety and optimism, it’s also a time of retrospection, introspection, and even a little tentative prognostication. And since the latter is our stock-in-trade at Futurism, we believe now is the perfect time to look ahead at what 2017 has in store for us.

Last year was a remarkable year in medicine. We saw continued development and refinements of CRISPR/Cas-9 gene-editing technology, lab-grown “mini-brains” were created to study the neurological effects of Zika and other disorders, a successful womb transplant was performed in the US, and the FDA approved the first artificial pancreas. Pretty remarkable advances—but 2017 promises to usher in more of the same.

Here’s our list of some of the many wonderful advances in medicine we can look forward to in 2017.

Techno-Medicine

Sophisticated technologies have always had an important role to play in medicine, with each year adding extraordinary new tools to the physician’s medicine bag—2017 will be no exception.

We can, for instance, expect further improvements in the technology of robotic surgery. In addition to the currently available da Vinci Surgical System, look to see competition from the new surgical robot system developed by the partnership of Google and Johnson & Johnson. These new systems will parlay advances in software, miniaturization, and robotics to allow for minimally invasive surgeries on the most delicate elements of human anatomy.

The robotic da Vinci Surgical System. (Credit: Intuitive Surgical)

Another untapped (or very minimally tapped) technological frontier in medicine involves the use of artificial intelligence (AI)—which seems to touch upon just about every field nowadays. IBM’s Watson has already displayed a keen diagnostic eye, and machine learning and deep learning programs have been used to predict everything from when a patient will die to where the next major disease outbreak will occur.

We can expect the application of AI to medicine to only increase in the coming year, when the need to cull through and assimilate enormous quantities of medical data—whether on an individual or large-scale, societal basis—will become critical. Meanwhile, the danger that potentially flawed machine learning programs will supplant rather than merely supplement human medical judgment will also become much more than just an abstruse, academic question for medical ethicists.

A Pharmacological Revolution

But 2017 won’t be just about robots and artificial intelligence. It’s likely that some of the less visually spectacular medical technologies will yield the most astonishing medical breakthroughs. Drug research, for instance, is poised to take off in 2017—especially with immunotherapeutic treatments for cancer.

According to Stanley Marks, chairman of the UPMC CancerCenter, it is these treatments—which marshal the body’s immune system to attack and destroy cancerous cells—that represent the single most promising new front in the war on cancer. Using checkpoint inhibitor drugs and CAR (chimeric antigen receptor) T-cell therapies, it’s become possible to mobilize the body’s own immune system to fight the cancer.

The method involves extracting T-cells from the patient’s own blood, and genetically engineering them to recognize, attach to, and neutralize tumorous cells. It’s already had promising results in fighting some leukemias, so we can look forward to more research on these remarkable “living drugs” in 2017.

Further drug advances to look out for in the coming year include: a vaccine for HIV beginning Phase II trials, the use of the dissociative anesthetic ketamine to target treatment-resistant depression, new drugs and therapies based on the microbiome, and even a new female libido booster that’s up for approval.

Gene-Editing Comes Of Age

The revolutionary CRISPR/Cas-9 gene-editing technology has disrupted biology like nothing else—and bids fair to transform it from a slow, imprecise science to something approaching the precision of the physical sciences. What 2017 holds for gene-editing technology is anyone’s guess—it’s even possible that the Chinese, or some other nation with laxer standards than are currently permitted in the U.S., might begin a more widespread use of the technique in human subjects.

Despite the reasonable ethical qualms, it’s inevitable that the CRISPR/Cas-9 method will be extended to human use, and 2017 will very likely be the year we see this happen. Look for active measures, such as more extensive trials in the cancer-fighting uses of the technology (for example, in the CAR T-cell therapies we mentioned above), or scientists using it to eradicate pathogenic human DNA viruses like HIV or herpes.

But expect passive measures, too, such as simply learning how Alzheimer’s and other neurodegenerative diseases progress, or even non-medical agricultural and industrial uses for the technology. As Nicola Patron of the Earlham Institute sagely observes, “Understanding what DNA sequences do is what enables us to solve problems in every field of biology from curing human diseases, to growing enough healthy food, to discovering and making new medicines, to understanding why some species are going extinct.”

The bottom line: 2017 is looking to be an exciting year, in all avenues of research and discovery, but particularly in medicine. And if all the above wasn’t exciting enough for you—you can look forward to capping it off with what might be the world’s first head transplant.

This has paved the way for several new advances in 2018.

Drones to distribute medicine to isolated areas

With improved technology, remote treatment and better distribution of medical services and medicine is rapidly becoming a reality.

In 2016, it was reported that a start-up company made use of drones to deliver medicine to Rwanda. This practice has since become routine and it is estimated that even more areas will benefit through this method.

Curing diseases through gene editing (CRISPR technology)

One of the big medical breakthroughs featured on Health24 this year was the technique to “edit” embryos to avoid genetic diseases.

This method holds potential for the treatment of many diseases, including retinaldegenerative disease and inherited diseases, such as cystic fibrosis and haemophilia.

It was reported in November 2017 that the FDA is set to approve a gene therapy for inherited retinal diseases. Many experts believe that this could pave the way to treatment for even more diseases.

ASL patients will be able to communicate with their thoughts

Earlier this year, CNN reported on a new technology that could help decode the thoughts of those with functional brain activity in a completely paralysed body, brought on by a stroke, traumatic injury or amyotrophic lateral sclerosis (ALS).

The initial research was published in the journal PLOS Biology. While the research was only in the beginning stages at the time, it holds great promise for 2018.

An artificial pancreas for diabetics

Diabetes is caused by the insufficient production of insulin by the pancreas. It was reported in May 2017 that the first artificial pancreas systems were beginning to infiltrate the market to help diabetics regulate their insulin levels.

As of December 2017, these are still not widely distributed, but we can expect artificial pancreas systems to become more prominent in 2018 and further.

The Hybrid Close-Loop Insulin Delivery System in the first automated artificial pancreas system.

Reduction of LDL cholesterol

When powerful cholesterol drugs known as PCSK9 inhibitors were approved by the FDA in 2015, many experts hailed it as an enormous breakthrough. The study findings were reassuring, but more studies were needed to see whether this would pave the way for a medication with fewer side-effects than statins.

But new studies have reported good news – earlier in 2017, a 20% reduction in LDL was reported in a study group of 25 982 patients. We can expect this drug to be used more frequently in 2018.

Enhanced post-surgery recovery

We know the drill when it comes to surgeries – no eating and drinking beforehand, feeling a bit groggy afterwards and being prescribed pain medication to help with the recovery. But readmissions after surgery remain a problem, not to mention the opioid problem caused by painkiller prescriptions.

New research has been looking at the Enhanced Recovery After Surgery (ERAS) protocol that accounts for various methods to speed up recovery after surgery. This includes post-operative nutrition plans and alternative methods to pain medication to speed up the recovery process.

In 2018, more hospitals will be looking to use the ERAS protocol.

More targeted, precise breast cancer therapies

Breast cancer is a disease that will affect one in 26 South African women in their lifetime. We rely on treatments such as chemotherapy to fight the cancer cells, but these do not always have the success rate we hope for.

In 2018 we could expect to see more targeted treatments for breast cancer that is designed to target the specific characteristics of the cancer cells, such as the protein that allows the cells to grow in a malignant way, according to Breastcancer.org.

Improved treatments for sleep apnoea

Sleep apnoea is a potentially dangerous condition and treatment for moderate to severe sleep apnoea is often evasive and uncomfortable, involving the Continuous Positive Airway Pressure machine (CPAP). This machines blows air into your nose via a nose mask, keeping the airway open and unobstructed.

But a less invasive method was approved by the US FDA in October 2017. The Remede sleep system, an implanted device that treats central sleep apnoea by activating a nerve that sends signals to the diaphragm to stimulate breathing, has been approved by the US Food and Drug Administration.

Following successful trial studies, this could be a treatment that we see more frequently in 2018.

Next-generation vaccines

Developing vaccines for emerging diseases are pricey and time-consuming. It is important to keep abreast of vaccine technology and develop new ways of vaccination manufacturing to keep epidemics under control.

Luckily, innovators will be upgrading the vaccination manufacturing process in 2018. This includes freeze-drying so that vaccinations can be transported to remote areas more effectively. Companies are also investigating faster ways to manufacture vaccinations to make them more readily available.

The first human head transplant

The jury is still out on this one, but deserves a mention. In 2017, Sergio Canavero, a neurosurgeon from Italy, was set to perform the first head transplant. Up to now, there has been no success in animal experiments.

This lengthy 36-hour long procedure will allow the head to be removed and be reattached to a new body, with all the nerve ends and blood vessels reattached and the spinal cord glued with a special bio-compatible glue.

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As there are so many amazing things going on worldwide in medicine and healthcare, a shortlist of some of the greatest ideas and developments would give us a glimpse into the future of medicine. It is always a challenge to detect the projects with the biggest potential to be used in everyday medical practices, but here are the most promising candidates for fulfilling this notion.

Here are the first 10 of the top 20 future medical technologies.

Augmented reality

The digital contact lens patented by Google aims to change the course of diabetes management by measuring blood glucose levels from tears. While the prototype is going through vigorous testing, regulations must prepare to quickly allow this disruptive technology to enter the market and benefit patients. Microsoft Hololens can also change medical education and how we look at the world by projecting digital information onto what we are seeing. A clinic in Germany started experimenting with an application using augmented reality on iPads in the OR. During operations, surgeons can see through anatomical structures such as blood vessels in the liver without opening organs therefore they can perform more precise excisions.

Google Brain

Ian Pearson wrote in his book, You Tomorrow, about the possibility that one day we will be able to create digital selves based on neurological information. It means we could upload our minds to a computer and live on in a digital form. As Google hired Ray Kurzweil to create the ultimate artificial intelligence controlled brain, this opportunity should not be so far away. We might have been looking for the secret of immortality in the wrong places.

Recreational cyborgs

There are already famous examples of real-life cyborgs, and I am truly convinced that such creatures will not only populate the terrain of sci-fi movies, but they will be everywhere around us in the very near future. The ‘cyborg-craze’ will eventually start with a new generation of hipsters who implant devices and technologies in their bodies just to look cooler. Advances in future medical technology will not just repair physical disadvantages such as impaired eyesight but will create superhuman powers from having the eyesight of an eagle to having the hearing of a bat. While a patient wearing implanted defibrillators or pacemakers can also be added to the group of cyborgs, I expect to see more cases when patients ask for the implantation of a certain device without having medical problems.

Medical 3D printing

If guns and other objects can be printed now and the biotechnology industry is working on printing even living cells; why would the appearance of 3D printed drugs be surprising? It will destroy and re-design the whole pharmaceutical world, but regulation will be a huge challenge as anyone will be able to print any kind of drugs that contain patented molecules at home. Bionic ears and simpler organs will be printed at the patient’s bedside.

There are already examples of 3D printing used in medicine. Through the e-NABLING the Future project, a global network of passionate volunteers enable volunteers, doctors or anyone on the field to make a difference by literally “giving a helping hand” to those in need by sharing 3D Printing designs, video tutorials and other information about building prosthetic hands. Success stories come from all over the world: there are now children and adults with super-hero style or more traditionally shaped prosthetic hands in Chile, Ghana, Indonesia and many more countries.

Gamifying behavior change

Adherence and compliance represent crucial issues in improving patients’ health and decreasing the cost of delivering healthcare. Several start-ups have targeted this issue with different solutions such as a pill bottle that glows blue when a medication dose should be taken and red when a dose is missed (winner of the Healthcare Innovation World Cup); or tiny digestible sensors that can be placed in pills and can transmit pill digestion data to physicians and family members. While patients do not like the term adherence as they want to be partners with their caregivers rather than following orders, health insurance companies will use more and more data to check whether the patients comply with their prescriptions to decrease their insurance costs. The wildly popular Pokemon Go motivates people to walk more which might lead to fighting obesity while playing a game.

New diseases

Regarding technological development, there is always a risk for the emergence of so far unknown illnesses and conditions. New types of diseases will appear due to the excessive use of virtual reality solutions in gaming and other industries including healthcare. Examples include virtual post-traumatic stress disorder (v-PTSD) which might be the diagnosis for gamers who participate in large virtual battles wearing VR masks (such as Call of Duty of Battlefield) and experience similar symptoms as those soldiers who fought in real wars. Virtual reality as an extension of online activity and particularly that of gaming might also cause addiction. Expect to see ICD codes assigned to such new conditions.

Real-time diagnostics

The intelligent surgical knife (iKnife) was developed by Zoltan Takats of Imperial College London and works by using an old technology where an electrical current heats tissue to make incisions with minimal blood loss. With the iKnife, the vaporized smoke is analyzed by a mass spectrometer to detect the chemicals in the biological sample. This means it can identify whether the tissue is malignant real-time. Surgeons will love this surgical Jedi knife which can significantly reduce the length of operations.

Holographic data input

While better and better data input solutions arise, we will probably not even need hardware to add data to a laptop or PC as screens and keyboards will be projected on the wall or on the table making it simple and accessible everywhere in the clinical settings. Holographic and virtual keyboards will make us forget about smartphones and tablets. Only small projectors will be needed, while the data will be stored exclusively in the cloud.

Crowdsourcing through social media

Medical communication is something that affects all patients and medical professionals worldwide without exceptions. This is one reason why social media has the potential to become a huge “mind machine” making it possible to transmit, share, crowdsource and store medical pieces of information either for e-patients or medical professionals if such social platforms are used in a proper way. Don’t underestimate the power of digital/medical communication.

Multi-functional radiology

Radiology is one of the fastest growing and developing areas of medicine, therefore this might be the specialty in which we can expect to see the biggest steps in developments. One multi-functional machine will be able to detect plenty of medical problems, biomarkers and symptoms at once. Naturally, artists and movies are already way ahead of us: check out the machine used in the film, Elysium. With one quick check-up it tells you what percentage of your cells are cancer free.