"I don't think there will ever be a cure for cancer."
This was the opening line by
Alfred Knudson, Jr, MD, PhD, the 1998 Lasker Award recipient, as he lectured at our medical school.
He had just been introduced by our director of cancer research who ended with the high-flying statement "... and some day we may see a cure for cancer."
Knudson went on to say,
"Cancer is the natural consequence of cooking DNA in an aqueous solution at body temperature over a lifetime." This follows from his discovery that a
two-hit mutation causes retinoblastoma, confirming the hypothesis that cancer is the result of accumulated mutations to a cell's DNA.
Sitting in the lecture hall with my other white-coated colleagues, ready to begin clinical rotations, I was impressed by this one-upmanship, but even more so later on when I realized what an elegant and memorable explanation this was.
It's a challenge to come up metaphors as good as that one for phenomena occurring on the molecular level such as "apoptosis." Talking or writing about medical science in an easy-to-understand way forces you to go back many times to make sure your explanation gives a fair sense of the current model.You also don't want to fall into the trap of presenting an overly
cheery view of the future that is merely a platitude. Someone might come along and deliver the real goods.
Wireless Devices for Remote Patient Monitoring and Personal Health Records (PHR)Since medical school, I've also been involved with investigating the uses of information and device technology for supporting clinical practice. Part of my passion for exploring emerging technologies involves the hope of seeing the next big thing, but appraising current capabilities and what might just be coming next must be done carefully if you want to retain your credibility.
The prospect of using cell phones for multiple purposes is easily accepted by most people in this world. In fact, the US is lagging behind in using text messaging, accessing the Internet, while the vast majority of citizens in other countries use their cell phone as their primary Web access device over the PC.
Wireless monitors could also be in the form of machine-to-machine (M2M) systems that can be applied as an adhesive bandage for monitoring vital signs for a post-op patient or as a capsule that is temporarily embedded in the esophagus to check pH as a means of diagnosing gastroesophageal reflux disease.
The real challenge is finding of way of integrating these devices and technology into the already busy workflow of clincians, and ideally with their input on how these will be designed.
For most of maladies of humankind or our healthcare system, there will never be a cure. However, it will always be expected that medical research will make steady progress through careful evaluation and good strategic decision making.