Posted on Nov 07, 2005, 8 a.m.
By Bill Freeman
Not only in the medical industry but also in the world at large, two terms are already such buzzwords today that it is impossible to imagine that they will not play a massive, massive role in healthcare in the future.
The vast potential of both is evident even today. Nanoparticles, being smaller even than human cells, can actually enter a human cell and make modifications - a prospect that is still remote today but that, once achieved, will revolutionise the way medical science and clinical research is performed. They can serve, for example, as little vehicles for customisable, targeted drug delivery, or as probes to understand cancer and carcinogenesis.
When gene therapy makes similar advances, nanoparticles can ferry therapeutic genes specifically into malignant cells, eliminating many of the unpleasant side effects of cancer treatments today. One theory even postulates that nanoparticles can act as little heat rays within the body; once injected and guided to a malignant cancer cell, a magnetic field can set the embedded iron within the particles to oscillate rapidly, becoming hot enough to kill unhealthy cells.
Gene therapy's other prominent use will come in genetic testing, where tests will determine the actual DNA sequence in genes to diagnose disorders. Already laboratories offer around 900 types of genetic tests, and this number will rise sharply by 2010. Individuals with family histories of breast cancer or Huntington's disease can assess their susceptibility.
Genetic testing can also figure out how well - or poorly - somebody will respond to a particular line of treatment, for ailments such as heart disease and asthma. As these lines of research evolve, we could enter a new era of preventive medicine, with widespread health benefits for everybody. No doubt there will be ethical concerns - whether, for example, such genetic technology is used to discriminate or harm.
Many analysts also foresee a future of robotic surgery. Already one American clinic has performed the world's first robot-assisted laparoscopic surgery, and in one famous case, a doctor controlled a robotic surgery unit right across the Atlantic Ocean. The human element is still critical, for only human beings can assess the progress of a surgery and make ad hoc improvisations. But the precision and stability of robotic units, especially for routine and delicate surgeries, will be a big part of a hospital's array of services in the future.
But the really gigantic strides will come, most probably, from the world of stem cell research. These little prototype cells - which have not fully developed and taken on the characteristics of specific cells - can be manipulated to form any type of tissue - blood vessels, heart tissue, bone marrow, organs, you name it. Research has already shown that injecting neural stem cells into the brain has cured cancerous tumours in rats, and spinal cord injuries have been mitigated. One patient in Korea, who had not even stood up for 19 years following a spinal cord injury, began to walk, albeit with considerable difficulty.
If stem cells are to work such miracles in the future, though, they will do so only after years of fierce ethical debate. Even the scientific community is in considerable ferment about the pros and cons, the advantages versus the possibilities of misuse. Scientists will then have to battle the Church and other religious leaders, and conservative politicians, if they are to fully explore this exciting new realm. That battle may not be entirely over by 2010, but it would certainly have begun in earnest.
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