Experts Review Top Medical Advances

ST. LOUIS — A vaccine that prevents cervical cancer is the consensus pick by some medical experts as the top medical advance of 2006.

While it’s not exactly a cure, it’s a roadblock to one of the deadliest cancers in the world, they say.

The new vaccine prevents the strain of the human papillomavirus that causes 70 percent of cervical cancers. That same virus causes a bunch of other problems, and they, too, can be prevented with the vaccine, researchers say.

SMALL STEPS

Breakthrough medical treatments or cures have been sparse in the past few years. But experts say that’s not a bad thing. It means highly contagious diseases such as polio and smallpox are gone and other contagious diseases such as HIV and AIDS are no longer guaranteed to be killers.

“We’ve stopped the diseases that used to (wipe out) large sectors of the population,” says Tim McBride, professor of health management and policy for the St. Louis University School of Public Health. “When you look at medical care, just look at what we can do. We’re at the leading edge of making what look like smaller changes.”

Now researchers target diseases such as diabetes, HIV, cardiovascular disease, cancers, mental illnesses such as depression and neurological illnesses such as autism and Alzheimer’s disease.

WHERE IT HAPPENS

The place to watch for breakthroughs will be private industry, McBride says. As public funding for research drops, the private sector is picking up the task, he says.

“The National Institutes of Health has had a flat budget for the last two years,” McBride says. The NIH is responsible for millions in research grants.

From one point of view, private companies have gobs of money. The flip side, experts fear, is that they’ll put most of their money in search of high-profit drugs for lifestyle diseases _ such as obesity, Type 2 diabetes, smoking cessation and stress _ and ignore diseases that wouldn’t generate a profit worth the research costs.

As a result, many of the new advances in medicine may come in the form of new pills.

WHAT DOCTORS SEE

From the point of view of physicians, medical advances aren’t the only major steps forward.

More and more, patients are taking greater control of their health care, says Dr. Thomas Wright, an internist in Wentzville, Mo. He attributes this to the Internet and the easy access it provides to evidence-based medical information.

“Patients visit my office knowing nearly as much about their conditions as the doctors,” Wright says.

THE SHORT LIST OF ADVANCES

Following are medical advances for 2006 identified by area experts. The list is confined to breakthroughs that consumers can use now. They’re in no particular order other than the unanimous selection of the HPV vaccine as a mammoth advance in fighting cancer.

_HPV vaccine

The top medical advance for 2006 _ hailed by physicians and organizations alike _ was the vaccine that fights the human papillomavirus, the only proven cause of cervical cancer.

The U.S. Food and Drug Administration approved the Merck & Co. vaccine in June under the name of Gardasil. It protects against the virus that causes 70 percent of cervical cancer and 90 percent of precancerous genital lesions and genital warts. The vaccine was approved for girls and women ages 9 to 26.

HPV is the most common sexually transmitted infection in the United States. About 6.2 million people become infected each year. More than half of all sexually active men and women become infected at some time in their lives. And although men can infect women, the virus goes undetected in men.

Individual immune systems clear up most HPV infections, but the virus can leave behind damage to the lining of the cervix. Years later, the damage can develop into cancer.

On average, the virus causes about 9,700 cases of cervical cancer and 3,700 deaths in the United States each year.

The vaccine will have more benefit worldwide. Globally, cervical cancer is the second most common cancer in women. Health monitors estimate 470,000 new cases and 233,000 deaths each year.

_Personalized cancer therapy

Doctors hail new gene profile tests that can help design cancer therapies unique to individuals, especially in the early stages of the diseases, when therapy helps the most.

_Knee replacements for women

A new device is attuned to women’s physiology. No more one-size-fits-all.

_Atripla

Bristol-Myers Squibb Co. and Gilead Sciences have cooked up a once-a-day pill for people living with HIV. Although it’s expensive, it’s much better than taking the popcorn bag full of pills and shots every day.

_Silicone breast implants

The FDA allowed silicone gel-filled breast implants back on the market last year after years of research and legal wrangling. Researchers, under scrutiny by the Food and Drug Administration, found that ill effects from implants, even leakage, were not substantial enough to keep them off the market.

_Emsam

The FDA approved a skin patch to treat major depression. The advantage is that the patient doesn’t have to remember to take so many pills. The manufacturer still recommends against foods with tryamine, a chemical that shows up mainly in aged and fermented foods and drinks.

_Better vaccines

A new and improved vaccine for whooping cough was included in the vaccination panel for children before they start school.

_Trans fats

Nutrition experts finally convinced governmental policymakers that trans fats are bad. Many manufacturers of prepared foods have begun to eliminate trans fats from their products.

Trans fats damage blood vessels, increase the levels of bad cholesterol and increase the risk of heart disease.

_Stem cells

Missouri voters recognized stem cells as the therapy of the future in a vote last year that opened the doors to more research. Researchers hope discoveries will offer therapies and cures for all forms of disease, especially neurological conditions.

_Smoking cessation

Pfizer has a drug called Chantix that prevents side effects of nicotine withdrawal by mimicking nicotine. Smokers feel the effects of nicotine without burning their heart and lungs.

SOURCES: Thomas Wright, internist, Wentzville; the Society for Women’s Health Research; Dr. Joseph Kahn, pediatric medical director, Mercy Medical Group; Dr. David Caplin, plastic surgeon, private practice; Dr. John Morley, chief of geriatrics, St. Louis University School of Medicine; Connie Diekman, director of university nutrition, Washington University; Post-Dispatch wire services.