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Prevention magazine shares the remarkable innovations that promise to revolutionize how doctors prevent, diagnose and treat both common conditions and diseases.
Breakthrough that could stave off cancer naturally
In 2009, the American College of Sports Medicine certified its first group of cancer exercise trainers. The new program reflects fresh thinking about how physical activity can help prevent and treat cancer. "Oncologists who once thought cancer patients should take it easy are beginning to prescribe exercise as a form of medicine," says exercise physiologist Richard Cotton, ACSM's national director of certification. Research finds that exercise can lower recurrence rates and boost survival among women who have had cancer. One review found that moderate activity, such as brisk walking 3 hours a week, reduced breast and colon cancer deaths by about 50%. Bottom line: Exercise is a potent weapon against the disease both before and after diagnosis.
Breakthrough that could thin blood more safely
For decades, the blood thinner of choice for people at high risk of stroke has been warfarin (Coumadin), a tricky drug that doctors must monitor carefully — often with weekly tests — because it interacts with other medications and increases risks of bleeding. Now, a new drug called dabigatran prevents more stokes with less bleeding than warfarin, according to a study of 18,113 people with atrial fibrillation, a key risk factor for stroke. The study, published in the New England Journal of Medicine, marks the first time in more than 50 years that a new blood thinner has been found that is considered more effective than the existing gold standard, says study leader Stuart Connolly, MD director of the division of cardiology at McMaster University in Ontario. "It's a triple win because the new drug is also easier to use," he says. "It doesn't interact with many other medications, so you don't need to constantly test and adjust the dose." Dabigatran is available as Pradaxa in Canada and Europe; FDA approval is pending.
Breakthrough that may protect the world against HIV
Researchers at the International AIDS Vaccine Initiative and the Scripps Research Institute in La Jolla, CA, have discovered two new antibodies, produced by a minority of patients, that offer hope for an HIV vaccine. Because the new antibodies are "broadly neutralizing," they cripple many different strains of the deadly virus. Four other broadly neutralizing antibodies are known to exist, but the new weapons are more potent, latch on to their targets more easily, and are the first to have been isolated from patients in the development world, where 95% of new AIDS cases occur. Researchers are now working on developing an active ingredient to put into a vaccine that would stimulate the production of these antibodies.
Breakthrough that could prevent heart attacks in high-risk patients
Omega-3 fatty acids have been upgraded from nutritional supplement to bona fide heart medicine: Lovaza, a prescription medication, purifies and concentrates 3 to 4 times more EPA and DHA into pills than fish oil capsules contain and is FDA approved to treat high triglycerides. Now a 2009 review of four major studies (many using Lovaza) shows that omega-3s help treat the highest-risk heart patients — those who have had a heart attack or heart failure.
"These patients were already being vigorously treated with other therapies, and omega-3s lowered their risks even more," says Carl Lavie, MD, medical director of cardiac rehabilitation and prevention at the Ochsner Heart and Vascular Institute in New Orleans. His review also found that EPA and DHA lower risks of at trial fibrillation and atherosclerosis. "Yet few doctors seem to realize there's so much impressive evidence supporting omega-3s for cardiovascular protection," he says. His review in the Journal of the American College of Cardiology recommends at least 800 to 1,000 milligrams of EPA and DHA combined a day for heart patients — an amount many experts recommend for healthy people too.
People with high blood pressure or cholesterol are at increased risk of heart attack, but doctors haven't been able to predict who among that group is most likely to have one. Now, a device that clips onto your finger can tell by sensing lack of elasticity of your blood vessel lining, a condition called endothelial dysfunction. "A poor score is a stronger warning than the usual risk factors because it indicates that cardiovascular disease has already begun — but at an early stage when you can more easily control your risks," says Amir Lerman, MD, a cardiologist at the Mayo Clinic in Rochester, MN. The device, called the Endo-PAT, has been FDA approved since 2003, but a new 8-year study by Lerman and his colleagues shows that half of people whose scores indicate endothelial dysfunction go on to have a heart attack or stroke, proving the test to be a powerful forecaster of individual risk. A similar system called VENDYS is also available. "It's an extremely important test," says Lerman, "especially for women, who are more prone to have endothelial dysfunction without other risk factors."
Breakthrough that could lead to a cure for Alzheimer's
A reliable test for Alzheimer's disease has never existed, but in 2009, multiple labs around the country broke through that diagnosis barrier. A new method of analyzing MRI images developed at the Mayo Clinic pinpoints changes in the brain with up to 80% accuracy. At UCLA, researchers have developed a blood test for AD. But the most accurate and promising technique is a skin test developed at the Blanchette Rockefeller Neurosciences Institute at West Virginia University: With the prick of a finger, it detects defective enzymes involved with memory function that are found in both brain and skin cells. Test results proved 98% accurate at detecting Alzheimer's, says Daniel Alkon, MD, the institute's scientific director. Even more remarkable: The researchers discovered that low doses of the chemotherapy drug bryostatin reactivate the defective enzymes. "We can actually rewire broken connections in the brain and restore memory," says Alkon. "That's extraordinarily exciting because it could be used to reverse the dreadful consequences of many brain diseases." Clinical trials in people will get under way in 2010.
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