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Things change – by Dr Judith O’Malley-Ford

Medicine, The Health Industry

We can all be mindful that “things change.” This applies to the world at large, and not merely to the world of medicine.

In the early 20th century, we went from horse and buggy to motorised vehicles, which represented a huge shift in thinking. It also resulted in a myriad of new industries that lead to the use of cars as a means of transport. Penicillin was discovered, and from that day onwards, lives were saved with the use of antibiotics. DNA was discovered. Radium was discovered by Madam Curie over 100 years ago. It is now used widely not only for research, but daily in medicine, for the generation of energy, and as a potential weapon of mass destruction.

In the 21st century, the world is a smaller place, with the widespread availability of air travel, and use of information via telecommunications on the internet.

Research and development is now big business. Medical Research is huge. We celebrate achievements of endeavour with the Nobel Prize in various fields. We should celebrate the achievements of our local health providers in more ways as these people provide us with advice and assistance that improves our everyday lives.

It is a great step forward for the world of medicine and the community. New technologies open a whole new door to potential early diagnosis and ongoing treatment monitoring in the management of cancer diseases. Such is the case in question with the discovery that prostate cancer may be detected using a technique which most people may find akin to star-wars or exploration of outer space.

Hence the intersection of medical need and the scientific know-how of physics. A test is being developed using fibre diffraction, using skin samples as small as 3 mm in diameter. Add the physics of a symchratron and it is possible to detect the presence of prostate cancer cells. This is but the tip of the iceberg, when it comes to using innovative technology not currently in use. It is possible to detect the presence of other cancers using this technique. The research for these tests is cutting edge but the everyday access to this diagnostic technique is still some time way.

This depth of knowledge and far-sighted vision is the dream that enabled man to walk on the moon, and more recently landed a spacecraft on Mars, and on a comet zooming through space.

Not infrequently, some cancers may present at a time when the disease is already advanced. Prostate cancer is one of a number of cancer where this applies. Some families carry an inherited risk for certain cancers markers in their DNA which predispose them to these cancers them more readily than in the general population. e.g. bowel cancer, breast cancer, and prostate cancer.

Surgical treatment for a wide range of conditions has been revolutionised with the advent of keyhole technique. Early detection of bowel cancer and prevention of bowel cancer has been achieved with the use of the fibrotic screening with the colonoscope. Hospital Length of stay for bowel cancer as a result has been reduced to a few days in hospital. Gall bladder surgery has become an overnight stay. Replacement of malfunctioning heart valves and coronary artery bypass procedures have become a daily event with the knowledge and skills of highly trained professionals.

Cataract surgery has become a day procedure under local anaesthetic with or without sedation, and achieves better results with the use of intra-ocular lenses. Microprostheses for eyes as well as coronary arteries has redefined and refined over two or three decades.

Improvements in diagnostic techniques and technology and operator skills have reduced the complexity of previously complicated procedures. Improved technology goes hand in hand with highly trained skills of the professional, all of which is a learning exercise which benefits the health and wellbeing of the community.

But there’s more.

We are now into the age of robotic surgery. Prostate cancer surgery is leading the way here. Who knows where this form of technology will lead.

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