— This year’s biggest advances are changing the face and future of your health. From cancer and Alzheimer’s disease to eating disorders and obesity, Health magazine reveals 20 breakthroughs you need to know about now.
Controlling appetite with leptin
The hot word in obesity this year was leptin. When a connection between this hormone and weight loss was first discovered in 1994, researchers helped fat, overfed lab mice stay slim. And they believed they could do with people what they did with mice: Inject some leptin, and kiss pounds good-bye. Humans, it turned out, were more complicated. When they lost weight their bodies became stingier with calories consumed and more efficient in retaining existing weight. Not willing to give up on leptin, scientists at Columbia University Medical Center in New York City started looking at the hormone as a possible weight-loss-
maintenance drug. They discovered through scans that brain activity in areas connected to restraint and control declines after weight loss. Hike leptin levels, however, and the areas become more active. Michael Rosenbaum, PhD, and colleagues now see new possibilities for leptin in long-term weight control.
2. Infection control
Cracking the MRSA code
More Americans now die each year of the nasty staph infection MRSA (18,650) than from AIDS (15,000). Fortunately, new prevention and treatment options for the bug known officially as methicillin-resistant Staphylococcus aureus have emerged. One is a protective nasal gel (XF-73) designed to kill the microbes early on, upon contact, with every breath. (Past anti-MRSA drugs focused on preventing bacteria from spreading or stunting the bacteria’s growth.) Also, surgeons began experimenting on animals this year with MRSA-fighting stitches coated with a virus that fights the MRSA bug but doesn’t affect humans. Each tiny hole for stitches is a potential entry point for MRSA or other stubborn infections, so the idea of fortifying dozens of these sites to prevent chances of future infection is brilliant.
Using the ER to help alcoholics
It’s no secret that alcoholics and drug abusers visit emergency rooms more often than the average Jane. So this year the American College of Surgeons (ACS) decided to turn that fact of ER life into something more positive. They unveiled SBI — screening and brief intervention — during which ER docs or counselors conduct brief drug or alcohol interventions right on the spot. The idea stems from the belief that emergency settings offer an ideal place to provide wake-up calls to patients who don’t yet have severe substance addictions. Such interventions have been shown to reduce a return to the trauma or ER center by 50 percent.
Good news for frozen embryos
Freezing embryos allows couples to have several in vitro fertilization cycles from the same egg collection or enables them to hold off for a better time for implantation in a mother who may be undergoing chemotherapy or may have other issues that require her to delay pregnancy. And a new, landmark study from Denmark found that babies born from previously frozen embryos have no increased risk of low birth weight, birth defects, or compromised health, compared with those born from “fresh” ones. According to the research, freezing caused no adverse repercussions, and, in fact, the babies born from the frozen embryos weighed more. That’s good news for moms and babies.
New research for brain diseases
Scientists in England this spring won permission from British medical authorities to create new embryos called cytoplasmic hybrids, eggs from rabbits or cows that have had their nuclei replaced with human genetic code. (The United Kingdom puts far fewer restrictions on stem cell use in federal research than the United States does.) No Frankensteins at work here: The goal is to produce stem cells that will help determine the causes of and find treatments for incurable and debilitating conditions like Alzheimer’s and Parkinson’s.
6. Colon cancer
Targeted treatments may save lives
When oncologists discovered that different genes (BRCA1, BRCA2, HER2) were linked with different types of breast cancer, lifesaving targeted therapies were soon developed. Now there’s similar positive news for people with colon cancer. Until this summer, late-stage colon cancers were treated pretty much the same — but the discovery of a mutated KRAS colon cancer gene has helped change that. As a result, one-size-fits-all chemotherapy is being replaced with more-personalized treatment that could save lives, according to Eric Van Cutsem, MD, PhD, the Belgian oncologist who shared these findings at an American Society of Clinical Oncology (ASCO) annual meeting.
7. Smarter sweets
More reasons to eat chocolate
We know that dark chocolate cocoa powder has up to three times the antioxidants found in green tea, plus twice the antioxidants in red wine; that’s good for your heart. And studies have shown that dark chocolate’s polyphenols affect serotonin levels in the brain; that’ll boost your mood. But this year dark chocolate has gained even more favor in medical circles. In one study, heart-transplant patients showed a decreased risk of clogged arteries two hours after consuming 40 grams of dark chocolate. In another, researchers from the University of Illinois found that subjects who ate a 22 gram CocoaVia dark chocolate bar daily for two months lowered their blood pressure and cholesterol levels. And investigation is underway to see if dark chocolate can be used to decrease PMS symptoms. Sweet news for us all.
How too little hurts women’s hearts
Talk about alarm clocks: After studying both women and men who have trouble sleeping, Duke University Medical Center researchers this spring discovered new links between sleep deprivation and the risk of heart attack. In particular, they learned why sleep problems had more of an impact on female hearts than they had on the cardio systems of men. Turns out women may be more prone to long-term inflammation in their bloodstreams, which results in increased risks of both heart disease and diabetes. In fact, “Women who reported taking a half-hour or longer to fall asleep showed the worst risk profile,” lead researcher Edward Suarez, PhD, explains.
In the sleep trials, Suarez and his colleagues found higher levels of three important signals in the bloodstreams of poor sleepers: C-reactive protein and interleukin-6, both of which are associated with inflammation in numerous tissues, and fibrinogen, a protein that’s associated with heart disease. The study is preliminary but notable because it focused on sleep, disease triggers, and gender.
9. Breast cancer: Another mammo option
A recent Mayo Clinic study of nearly 1,000 women showed that new, gamma-ray cameras detected three times as many tiny tumors (as small as two-fifths of an inch in diameter) as standard mammography in women with dense breasts. This development gives high-risk women another early-detection option besides mammograms and more-expensive MRIs.
10. Breast cancer: An herbal breakthrough
Black cohosh, a plant in the buttercup family, has been shown to stop the growth of some breast cancer cells, according to new research conducted by a French pharmaceutical company and funded in part by the National Institutes of Health. Researchers attribute the cancer-cell death to the agent triterpene glycoside, which is found in black cohosh extract. Should you take it? Ask your doctor. Past research has shown that black cohosh can interfere with certain kinds of chemotherapy and has some adverse side effects. Plus, studies so far have been done only on mice.
11. Breast cancer: One-stop radiation?
For most breast cancer patients who need radiation, treatments typically last up to six weeks. But a new study raises hopes for a one-day treatment known as intraoperative electron beam radiation therapy, or IOERT. Umberto Veronesi, MD, founder of the European Institute of Oncology, shared the findings of an eight-year randomized trial at the International Society of Intraoperative Radiation Therapy conference this year. The results showed that women who received breast-conserving surgery followed by a single dose of IOERT at the time of surgery had a chance of survival equal to that of women who underwent the surgery followed by six weeks of postoperative radiation therapy.
Anti-aging techniques really do work
A landmark review by doctors at the University of Michigan Medical School published earlier this year in the prestigious Archives of Dermatology verified that three leading skin-renewal treatments are all, indeed, medically effective. Carbon dioxide laser resurfacing? Check. Topical retinol products? Check (at concentrations between 0.2 and 0.6 percent). Injections of hyaluronic acid? Check. Each of these three anti-aging treatments can improve skin by strengthening what’s called its “dermal collagen matrix.” The biggest surprise that Gary Fisher, PhD, and his colleagues found? The filler — hyaluronic acid — can also boost the creation of collagen when delivered by syringe; docs had previously thought its value was strictly cosmetic, not medical.
Reduce stress to live longer
Can we relax our very DNA? For years, scientists have studied telomeres — tiny caps at the ends of chromosomes that shrink, shorten, and weaken with stress. Over time shortened telomeres dampen immunity, experts say, giving conditions like osteoporosis, heart disease, HIV, and AIDS a better chance of taking hold. In fact, in animal studies shortened telomeres were linked to a shortened life span.
Now researchers believe emotional stress can take its toll on telomeres, too. This spring, pathology professor Rita Effros, PhD, and her colleagues at the University of California, Los Angeles, bathed donated immune cells of adults aged 25 to 55 in cortisol, a stress hormone, and found that the activity of an enzyme capable of preventing telomere-shortening was reduced. This suggests that emotional stresses like abuse, marital strife, or anxiety can affect both short-term immune function and long-term aging prospects of individuals. While preliminary, the study may lead to the development of drugs that could help prevent damage to the immune systems of people dealing with prolonged stress.
14. Better sex
Enhancement drug for women
Move over, Viagra. Earlier this year, LibiGel, a testosterone-based gel for women with sexual dysfunction cleared another hurdle: Although it will be in trials for a few more years, it has passed Food and Drug Administration safety and efficacy phases. In tests, participants using LibiGel (from BioSante Pharmaceuticals) reported a 238 percent increase in satisfying sexual experiences.
15. Wonder extract
Resveratrol gets the nod
You may have heard the good-for-your-heart news about resveratrol, the anti-inflammatory compound found in grapes and wine: Studies in mice have shown that it fights diabetes
and can extend life span. In 2008 it got an even bigger endorsement when the federal government decided to invest big bucks in grapes-against-cancer research. Teaming with a leading biotech firm, Sirtris Pharmaceuticals, the National Cancer Institute is trying to determine how derivatives of resveratrol can affect cancer-cell development. Human studies started just this year, so it’ll be a while before scientists know the impact it has on larger mammals. In the meantime, get your daily dose of resveratrol from a glass of grape juice or a nice Cabernet.
16. Eating disorders
Brain scans reveal anorexia clues
Docs have long been stumped: Why is it so difficult for patients with eating disorders to learn and to “reprogram” healthy eating behavior? In a surprising study at the University of Pittsburgh School of Medicine, researchers used MRI scans to track the brain activity of recovered anorexia patients and found that the reward centers of their brains were damaged — they couldn’t decipher much of a difference between pleasure or reward, at least in the short term. Researchers hope that this knowledge will help them better understand and treat the millions of women with eating disorders in the United States.
New endometriosis treatment
Add endometriosis to the list of surgeries now being per-formed by surgeons using medical robots. When this technology came on the scene in the 1990s, it was used primarily for prostate surgery and then later in laparoscopic hysterectomies. Now medical robots are reducing the surgery and recovery times for endometriosis treatment. According to Dennis Eisenberg, MD, of Baylor University’s hospital near Plano, Texas, robotic endometriosis-and-fibroid surgery takes an hour or two, and patients can expect to return home one day later; full recovery should take place within one week’s time. Traditional surgeries for endometriosis take four to five hours to complete and weeks of recovery, experts say.
A gentler way to tackle tumors
It’s not always the medicine that counts, but how it gets delivered. For David Cheresh, PhD, and his cancer-fighting colleagues at the University of California, San Diego (UCSD), that led to thinking small — really small. They’ve come up with the first nanoparticle delivery system for pancreatic and kidney cancer chemotherapies. By better targeting the chemo, Cheresh, a professor of pathology at the Moores UCSD Cancer Center, was able to use far smaller doses to halt tumor growth. If you can starve the tumors by cutting off the blood supply, there’s much more precision and markedly less collateral damage, the researchers say. That’s good news for the future of all cancer treatment.
Using fat to fight disease
Fat on your belly or thighs? Rarely considered a valuable thing … until now. The American Society of Plastic Surgeons (ASPS) announced this summer that, compared with fat in other areas of the body, belly and inner-thigh fat contain tissue with higher concentrations of stem cells. Surgeons and researchers hope to use the tissue to build stem cell lines and drugs that might one day treat diabetes, spinal cord injuries, or severe brain diseases. “Adult stem cells, derived from our own tissues, hold strong promise for improved clinical therapies,” says J. Peter Rubin, MD, a member of the ASPS Fat Grafting Task Force and co-director of the Adipose Stem Cell Center at the University of Pittsburgh.
More clear skin ahead
For years oral tetracycline and erythromycin have been the standard for treating acne. Now there’s another option: a prescription topical gel called Aczone, which has antibiotic and anti-inflammatory effects. It was approved in 2005 by the Food and Drug Administration (FDA) but came with all sorts of restrictions for use, including blood monitoring, because of potential side effects. This year, after reviewing the results of trials with 3,000-plus patients, the FDA lifted restrictions. The manufacturer, Allergan, hopes to have the gel on the market in the next few months.
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