Category Archives: Commentary from Sarah

Starting with Good News

Growing up in New England, Labor Day marked the end of summer and the opening of school. Since last weekend, my childhood rhythms have been nudging me to get back to work.

To be sure, a lot is happening in health law. Over the next few months, I will look at the Dobbs decision, the implications of the EPA case, controlling drug prices under the Inflation Reduction Act [IRA], and many other issues affecting our health care system and your own health.

But as temperatures start to fall (which can’t happen quickly enough here in Texas), wouldn’t it be nice to hear only good news?

I save stories of breakthroughs and exciting developments in medicine just for moments like this. Here are some of my favorites-

1. A Possible Breakthrough in Early-Stage Rectal Cancer

In June, a drug research trial announced astounding results in patients with early-stage rectal cancer. The study was very small (14 participants), but after 9 infusions over 6 months of treatment, all the study participants were tumor free. “Scans that once showed knotty, discolored tumors instead revealed smooth, pink tissue. No traces of cancer were detected in scans, biopsies, or physical exams.” [source] “I don’t think anyone has seen this before, where every single patient has had the tumor disappear,” said the lead author from Memorial Sloan Kettering. [source]

Not only was the treatment successful, no significant drug complications were reported.

Rectal cancer is treatable if caught early, but the intervention itself can lead to lifelong bladder, bowel, and sexual dysfunction, even if the cancer is cured. Happily, all 14 participants in the study are relieved from the usual follow-up treatment of radiation, chemotherapy, or surgery. [source]

The study will undoubtedly be repeated on a much larger population of rectal cancer patients. However, these early results still warrant hope for America’s third most common cancer diagnosis. [American Cancer Society]

2. Restoring Communication and Control after Long-Term Paralysis
Remembering my patients as a former Neuro/Neurosurgery nurse, I always look for breakthroughs in brain and spinal injuries and diseases. Two stories jumped off the page at me earlier this year:

Brain Implant Allows Fully Paralyzed Patient to Communicate [New York Times March 22ndinvolves a man with ALS (commonly known as Lou Gehrig’s Disease) who had lost all movement, even of his eyeballs, but after an implant in his brain could select and convey letters from a list with his mind! Painstaking as that may be, it allows him to communicate for the first time in years. For more, read the article here.

The Man Who Controls Computers with His Mind [New York Times, May 12th] A 53-year-old man who slipped and broke his spine in 2006 was left without movement below his collarbones. In his own description, he lay for several years in front of the History Chanel. He can recount that memory because, after the implantation of a brain-computer interface, he can now imagine moving a cursor which creates speech. He imagines words, creating “talking” electronically through the computer. As of the publication, he had “played a video game, manipulated a robotic limb, sent text messages, and emails, purchased products on Amazon … all without lifting a finger.” I know you will want to read more here.

3. Creating a New Ear- with a 3-D Printer
I had my first person-to-person encounter with 3-D Printing this summer; it created a jig my husband wanted for his guitar-making business. However, that piece of plastic means nothing compared to the 3-D human ear printed in March.

A 20-year-old woman born with microtia (a rare congenital defect causing a small, malformed outer ear) had the first transplant out of a study looking at the medical possibilities of 3D printing. Half a gram of cartilage was taken from her affected ear. With a scan of her other normal ear, the researchers created an exact match (reversed to accommodate the different side) for transplantation. This new ear looks and feels like a natural ear, and given it is printed from her own cells, rejection of the transplant is unlikely.

When the cells were ready for printing, it took 10 minutes to reproduce the ear, and the transplant required just a few hours (in an outpatient setting). Not only is this a game-changer for treating similar exterior birth defects, but this new technology also holds promise for spinal disks, knees, shoulders, and, perhaps, ultimately, more complex organs. As the first success in tissue engineering, this case “shows that this technology is not an ‘if’ anymore, but a ‘when.’” To learn more about the process of printing this ear, and to see the ear during its creation, go here.

4. Only three people have ever been cured of HIV- the third was cured via an umbilical cord blood transfusion
There have only been two known cases of an HIV cure; both European men had bone marrow transplants from donors who carried an extremely rare mutation that blocks HIV infection. Both men endured “punishing” side effects. A cure may justify the severity of the treatment, but bone marrow transplants aren’t “a realistic option for most patients. Such transplants are invasive and risky, so they are generally offered only to people [who]have exhausted all other options.” [Quote]

Treatment opportunities are worse for women (HIV tends to progress differently in women, so they are not likely to be offered experimental trials). Still, worst off of all are people of mixed race because the precision of the cellular match necessary for a successful bone marrow transplant is less attainable in people with diverse racial backgrounds.

All this explains the excitement when the third HIV cure was announced in February, this time in a middle-aged, mixed-race woman. Her intervention was with umbilical cord blood, an alternate source of stem cells that don’t require the precision of the match demanded in bone marrow transplants. She also avoided most of the difficulties of recovery; she was out of the hospital in 17 days and, as of February, had been off her Anti-Viral HIV medications for 13 months.

Both reports I am referencing, MedPage Today and the New York Times, include warnings from physicians and researchers involved in the case that this one example does not mean a cure for HIV across the board. There are many details in this complicated story I’ve left out for brevity. ) but if nothing else, it demonstrates the potential of umbilical blood as a treatment and “opens up the possibility of curing more people of diverse racial backgrounds that was previously possible.” [Quote]

5. Reversible’ Form of Death? Scientists Revive Cells in Dead Pigs’ Organs
I will admit I greeted this last headline with hesitation; I am personally dubious about the prospect of living forever. But that is just me.

If you are interested in hanging around for another millennia or so, you can read about the pig’s revitalized organs here.

Conclusion
I truly hope at least one of these stories captured your imagination and gave you a sense of wonder for the possibilities that lie ahead for us humans.

It touches me that thousands of women and men across the world– those in bench research, bio-medical development, technology, infectious control, medicine, and all the sciences meant to help people in other lifetimes- show up to work, day after day to achieve what is easy to believe is impossible.

Remember them as you face the challenges of getting kids back to school, schedules adjusted to Autumn, and preparing for the onslaught of the many upcoming holidays.

-Sarah

Want to Know More

1. Good News for Our Planet’s Health
Our health depends on the health of our planet as well. For those of you who are interested in discoveries and developments in nature, I highly recommend these additional articles:

  • In a massive Chinese sinkhole, scientists find a secret forest
    “The hole, which is roughly 630 feet deep and spans more than 176 million cubic feet, could be home to previously unidentified plant and animal species.” Go here for the article and to CNN for a short film to see what it looks like
  • These polar bears have found a way to survive without sea ice
    As sad as it is that they must, it appears some Polar Bears are adapting to climate change and could survive even if we lose our polar ice. Read about it here.
  • A flower was named after its own extinction — then it was rediscovered 
    Previously unknown pockets of rainforest were discovered in Ecuador, including a brilliant orange blossom thought to be extinct since 1991. Read about it (and see its portrait!) here.

2. Looking for more good news?
I posted similar lists of good news stories in health care on November 19, 2020 [Fontenotes #99] and August 29, 2019 [Fontenotes #81]. Check them out and continue the celebration!