10 Medical Advances That Matter to You
Every year we see breathless roundups of “medical breakthroughs,” but generally speaking, the changes that are most likely to have an effect on you and your family are the smaller ones — the new medications, study results and tweaks to guidelines that will change the way your doctor thinks and acts in the exam room. Here are 10 of the real game-changers of 2012.
- More choices for atrial fibrillation: If you need to take a blood thinner for atrial fibrillation, for years the almost automatic choice was warfarin (Coumadin), a medication that comes with lots of hassles, like frequent blood tests to monitor how quickly your blood clots. It’s now recommended that you take one of a few newer medications instead: Dabigatran (Pradaxa,) Rivaroxaban (Xarelto,) or Apixaban (Eliquis). These new blood thinners are just as effective and a whole lot easier.
- A pill for a cancer killer: A drug known as regorafenib (brand name Stivarga) was approved this year for metastatic colorectal cancer. This pill has been shown to improve survival for colon cancer patients who have already tried chemotherapy, only to have their cancer continue to grow and spread. Regorafenib got expedited approval from the FDA—something that’s reserved for drugs that offer a major advance over what’s currently available. Awesome news.
- More testing for hepatitis C: In 2012, there was a major change in recommendations regarding screening for this disease. The new recommendations: Anyone born in the United States between 1945 and 1965 should get a one-time antibody test for the hepatitis C virus. The reason for this may surprise you. Baby boomers are five times more likely than other American adults to be infected with this virus, according to the CDC. Chronic hep C can cause serious liver disease or even liver cancer if it isn’t treated. This change will help make sure people have the information they need to get potentially life-saving help.
- A pill to prevent HIV: The FDA has approved the first drug that can help prevent HIV infection: tenofovir-emtricitabine (brand name Truvada). This daily pill is meant to be used with other risk reduction methods (condom use, etc.) by HIV negative adults who are at high risk for sexually acquired HIV.
- A new approach to sinus infections: To treat or not to treat? Sinus infections can make you miserable, but because a virus is often the culprit, antibiotics often don’t help—and over-eager use of the drugs raises the risk of antibiotic resistance. The new recommendations are that you should not take antibiotics unless: you’ve had symptoms lasting 10 or more days with no improvement; you have a fever of more than 102°F (39°C ) along with nasal discharge or facial pain; or you have worsening symptoms following a viral upper respiratory infection that lasted five to six days.
- A change in cervical cancer screening: How often do you need a Pap smear? All guidelines now agree on this: Average-risk women aged 21 through 29 years who are at average risk of cervical cancer (no new sexual partners and no previous abnormal pap smears) should be screened with a Pap smear every three years. Average-risk women aged 30 to 65 years should get a Pap smear every three years, or a combination of Pap smear and HPV testing every five years. If you’ve had a hysterectomy, you don’t need to be screened for cervical cancer, unless you have a history of the disease.
- A slowdown in screening for osteoporosis: It appears we have been screening our female patients too often. If you’re 65 years or older with normal or slightly low bone mass (osteopenia), you should have a follow-up bone density scan (what’s called a DEXA scan) in 10 to 15 years. Yep, you read that right: 10 to 15 years. If you have osteoporosis or are on osteoporosis treatment, this does not apply to you—check with your doctor for the right schedule for you.
- Sorting out statins: If you’re taking one of the cholesterol drugs known as statins, you may have been getting periodic blood tests to check how well your liver is working (statins can affect liver function). In 2012, the FDA revised its labeling on these drugs: The agency now recommends you get a baseline liver test before starting the drug, and then have repeat testing only for certain problems, such as nausea, vomiting or abdominal pain.
- Coping with constipation: It may be time for people to say goodbye to the Fleet enema. There was a major change this year to the recommendations regarding treatment for constipation, especially in people over the age of 70. It is now suggested patients not receive sodium phosphate enemas (Fleet enemas); instead, the enema should consist of simple warm water. This change should ward off serious adverse events, including kidney failure.
- An easier way to treat TB: Up until now, people who have had a skin test indicating exposure to tuberculosis (TB) have had to go through a long and demanding treatment, taking meds for nine months. Now, things are much simpler: You can take isoniazid and rifapentine once a week for three months (the doctor will observe you taking the drugs). That’s a change that may make it easier to get this terrible epidemic under control.
- Dr. O
What medical advance would you most like to see? Share your wishlist in the comments section below.
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