If you feel as if the pace of medical innovation has speeded up lately, you’re right. In the past year, important medications have been approved for treating multiple sclerosis, diabetes and obesity. What’s more, the time lag between when a discovery is made and when its application appears at a doctor’s office has gotten shorter. For instance, a link between HPV and cervical cancer was first shown in 1983; it took an additional 23 years for a vaccine against the virus to be approved. But just 10 years passed from the finding of aberrations in an enzyme that affects the DNA of breast-cancer tumors to the development of a genetic test that determines the risk that a breast cancer will recur. This faster pace means you may benefit from today’s breakthroughs more quickly now than you would have if they’d come along a decade or two ago.
What kinds of breakthroughs can you expect in the next 15 years? We asked four women on the front lines of health care to share their predictions.
Better prevention and detection of ovarian cancer
The five-year survival rate for ovarian cancer is estimated at 44 percent—much lower than that for other female cancers, such as breast (90 percent) and cervical (69 percent)—but by 2028 that prognosis is likely to improve. Genetic testing that gives women an estimate of their inherited risk of ovarian cancer should become both more comprehensive and more available.
Increased knowledge of genetic patterns will give doctors more ways to test your vulnerability to the disease. “We will be able to say, ‘Here’s your risk, and here are decisions you could make to prevent the cancer,’ ” says Barbara Goff, MD, president of the Society of Gynecologic Oncology. For example, if you’re genetically at high risk, you could choose to have your ovaries and tubes surgically removed. In addition, because of technological developments and a Supreme Court ruling that genes can’t be patented, “the cost of genetic testing is going to come down drastically in 15 years,” Goff predicts.
Substantial work is also being done on tests that can detect ovarian cancer, which is much more treatable in its early stages. Researchers are looking for biological markers—proteins, DNA and other molecules in the blood or urine—that indicate cancer long before symptoms appear. Another possibility is identifying, at an early stage of the disease, abnormal cells that may be shed from a tumor into the vagina. “An accurate screening test could save many lives,” says Goff.
Greater understanding of women’s heart disease
Within 15 years, insurers and mainstream doctors will probably acknowledge the differences in the way heart disease plays out in men and women, says Suzanne Steinbaum, DO, director of women’s heart disease at Lenox Hill Hospital in New York City and author of Dr. Suzanne Steinbaum’s Heart Book.
One difference: Women are prone to experience damage throughout the arteries that supply their heart muscle, while men are more likely to have specific trouble spots, such as clots, in these blood vessels. The frequently used nuclear stress test, which measures blood flow in the heart during exercise, works well for gauging artery blockages (the more common situation with men) but is not necessarily the best test for spotting diseased arteries in women. That practice will change over the next 15 years, Steinbaum speculates, because cardiologists will put a greater emphasis on the now--experimental endothelial--dysfunction test, which is especially useful for detecting early blood vessel trouble in women. This test detects stiffness in artery walls, which precedes the plaque buildup known as atherosclerosis. An office test can assess the health of a woman’s arteries and pinpoint a heart problem at a stage early enough that it can be reversed through lifestyle changes such as regular aerobic exercise.