Health tech

Seven visions of the future of healthcare

Everyone knows someone living with cancer, heart disease, lung disease, diabetes or a similarly debilitating illness. The good news is, research is progressing quickly on all these fronts. Here, seven experts lay out their visions for what the future holds. There are some inspiring ideas. The best news? Much of this is just a few short years away…

Where are we now?

It’s certainly a challenging time when we look at respiratory disease. Many lung-related conditions are increasing and will continue to be a problem. But with the tremendously rapid rate of change in the medical world, there’s hope for certainly treating some, if not all, of them successfully.

What changes are coming?

It won’t be easy. There’s the very real issue that in the future, antibiotics to treat infections will no longer be effective because bugs are becoming resistant to them. This will cause huge difficulties. It means that conditions we’ve dealt with successfully, such as pneumonia, will be harder to treat.

Paradoxically, we’re going to see long-term control over diseases that we thought were totally untreatable, such as some lung cancers and mesothelioma, a cancer caused by exposure to asbestos. This will be by immunotherapy (using the patient’s own immune system to fight off a disease) rather than relying on radiotherapy, chemotherapy or surgery.

I think we are also going to have new medicines and treatments available because of the advances we make. But many people won’t be able to afford it or have access to it.

On a more positive note, I believe in 10 to 15 years, although probably even sooner, there will be an effective vaccine for asthma. Although it may be hugely expensive to develop, it will be worth it as huge numbers will benefit.

I also believe there will be amazing imaging equipment to see inside the body that we cannot even imagine at the moment. We will have very sophisticated equipment that will show the body functioning in real time. For those with lung conditions, this will be a huge advance.

But the way society is changing will mean conditions such as Chronic Obstructive Pulmonary Disease (COPD) will increase. As more of us become obese, this has a major impact on our lungs and respiratory system.

What does the future look like?

In 20 years, if not sooner, our treatment and management plans for those with chronic respiratory disease will no longer be worked out by doctors. Instead, patients will be monitored remotely and an algorithm will keep check of their health rather than a doctor. It will be a very different medical world sooner than we think. A future where nano-medicines can cure blindness and even cancer by Sonia Trigueros, nano-bio-systems group leader at Oxford University and former co-director of the OMS Institute of Nanomedicine

Where are we now?

Nanoscience is a relatively new interdisciplinary field that studies materials at the nanoscale (about 1 to 100 nanometers). To give you an idea of how small that is, a sheet of newspaper is about 100,000 nanometers thick. To create a nanomaterial, you can either break down the larger version of it, or synthesize it from individual atoms. Part of the value of nano-materials lies in the fact that they can have very different properties to the original macro-materials.

Moreover, these properties change as a function of their size and shape. That means nanotechnology in effective increases the number of materials we have to work with in all areas of life.

What changes are coming?

Once you understand how properties change at the nano level, you can start to develop a nanostructure according to what you want to achieve with it. Take gold ‒ at a nano level it is red, and when several nanoparticles of gold cluster together, they’re blue.

If you design something that capitalises on this colour-changing property, it could be used to develop high-efficiency systems to detect and signal the presence or absence of a very small amount of viral particles, or bacteria, which is currently very hard to do.

But nanostructures can be used to treat as well as diagnose. At present it is possible to tackle genetic mutations by using virus particles to carry DNA to a cell to make changes to the genetic expression. This is an effective but sometimes toxic form of gene therapy. We are working to design nano-bio-systems with high efficiency in gene delivery but no toxicity. In the future, this approach could be used to treat genetic blindness that occurs as a result of a genetic mutation, as well as several genetic diseases.

In the future, this approach could be used to treat genetic blindness that occurs as a result of a genetic mutation, as well as several genetic diseases.

What does the future look like?

Because of the complexity of the field of nanotechnology, and the need for clinical trials to prove the efficacy and safety of these new therapies, I imagine it will be between 5 to 10 years before nanomedicines become available. But there is no doubt that nanotechnology has the potential to revolutionise healthcare in the future.

Nanotechnology has the potential to transform current chemotherapy treatments, with nanostructures loaded with chemotherapy drugs able to selectively target cancer cells, giving the benefits of chemotherapy, without the side effects.

Another important application of nanotechnology is in developing nano-antibiotics. These are only a few of the current applications being researched in the field of nanomedicine and the greater understanding we have of nanoparticles, the more applications we will find. A future where diabetes has been cured By Dr Emily Burns, research communications manager at Diabetes UK

Where are we now?

It feels as if we’re at a point where much better ways to treat both Type 1 and 2 diabetes are on the tip of our tongue.

With regards to Type 1, a disease that affects 10 per cent of those with diabetes, there’s some amazing research happening now. Because it’s a condition where the person’s own immune system attacks the pancreas (meaning the body can no longer control the levels of glucose in the blood), an artificial pancreas is now being developed.

This device will be worn outside the body and will do all the calculations a patient normally does, before automatically delivering their insulin when needed into the body via a pump. It could be available within the next 10 years.

Type 2 diabetes – when the body stops responding to insulin so can no longer control glucose levels in the blood – affects the other 90 per cent who live with diabetes. It’s caused by lifestyle choices such as diet, so we’re looking at introducing a special intensive low-calorie weight management plan diet to put it into remission.

Longer term, we know that people with Type 2 who have bariatric (weight loss) surgery find the condition goes into remission. It looks as if it’s not only caused by the weight they lose. It may have something to do with gut hormones changing, so researchers are looking at a therapy to replicate what happens after bariatric surgery without actually doing the surgery. This is very much a long- term project, probably over 10 years in the future.

What does the future look like?

Researchers are also looking at a potential cure for diabetes. They’re looking at the beta cells, which are the cells in the pancreas that the immune system attacks. We can replace those cells using an islet transplant. But they rely on donated pancreases, which aren’t easily come by. Longer term we’re looking at stem-cell therapy. Here we could make beta cells from scratch in the lab, doing away with pancreas donations.

We’re also looking to see if we can coat these beta cells with a protective outside so when you transplant them, they’re safe from the immune system. If we could replace damaged cells and protect them, then we’re looking at a cure for Type 1 diabetes. It might not happen in the next 10 years, but it’s not pure blue-sky thinking. Research is progressing at speed. We’re seeing some really incredible results to benefit people in the future with diabetes. A future where three in four people with cancer will beat it By Prof Peter Johnson, Cancer Research UK’s chief clinician

Where are we now?

In the past five years in particular, researchers have been looking at ways to employ our immune system to fight cancer using immunotherapy drugs. This treatment alerts the body’s immune system to the presence of hidden tumours, so allowing the body’s defences to launch an attack on the cancer cells.

We’ve known for many years that cancer is invisible to the immune system, but we hope this will make it visible so the cancer can be detected. We already have the first results of some early clinical trials and they’re hugely exciting.

What changes are coming?

I think this will be an important area of growth for treating cancers, especially lung and skin cancers, in the next 10 years. In the past, these types of cancers have stayed under the radar, making them hard to detect early and treat using conventional methods.

Another area where there’s lots of research activity is looking for signals in the blood. We are hoping to be able to do very detailed analysis of the blood to pick up early signs of cancer much sooner, which will be an enormous frontier to explore.

We’re looking at how we can really mine the information we can get from more advanced blood tests to help more people.

I believe in the future, new technological development will make a major difference to how radiotherapy is delivered too. We will be able to shape the beam and direct it more precisely. It means we can deliver a stronger dose that will cause less damage to other parts of the body. At the moment, 40 per cent of those cured of cancer have radiotherapy at some point during their treatment. With this more hi-tech way of delivering it, we hope this might increase even further.

What does the future look like?

I can see that individualised treatment or ‘personalised medicine’ will progress. As we find out more about the particular genetic makeup of tumours, we will be able to give specific drugs to target it.

In the past 40 years, the likelihood of surviving cancer has improved from one in four to one in two. In the next 20 years we at the charity want to reduce that risk even further to three in four. I think that’s a realistic aim as we’re now at a very exciting time for research into all types of cancer.

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