Biomedical Engineering Reference
In-Depth Information
the molecular events that are markers for early malignant change. This dynamic
imaging will lead to more sensitive screening and treatments. Imaging agents will
accumulate in cells exhibiting tell-tale signs of pre-cancer activity, and will be used
to introduce treatment agents directly (Brumley, 2002).
Imaging and diagnosis will be minimally invasive and enable the selection of the
best and most effective targeted treatment (Table 4). Better imaging will be able to
pick up pre-disease phases and deal with them before they are currently detectable.
These techniques will be crucial in successful follow-up. A patient with a predis-
position to a certain cancer process will be monitored regularly, and treatment will
be offered when necessary. Not all cancers will be diagnosed in these early stages.
Inevitably, some patients will fall through the screening net. Nevertheless, there
will be more opportunities than there are at present to offer less invasive treatment.
Surgery and radiotherapy will continue but in greatly modified form as a result of
developments in imaging. Most significantly, surgery will become a part of inte-
grated care. Removal of tumours, or even of whole organs, will still occasionally
be necessary. The difference is that the surgeon will be supported by 3-D imag-
ing, by radio-labelling techniques to guide incisions, and by robotic instruments.
Although many of the new treatments made possible by improved imaging will be
biologically driven, radiotherapy will still play a role. It will always be the most
potent DNA damaging agent for treating cancer with the most geographical accu-
racy. Radiotherapy targeting will be greatly enhanced, and treatment will be more
precise.
In addition to the reconfiguration and merging of the clinicians' skills, the deliv-
ery of care will also change. Minimally invasive treatments will reduce the need for
long hospital stays. It will not only be possible for patients to receive care close to
their homes, as this report will show later on, it will be expected. The prospect of
highly sophisticated scanning equipment and mobile surgical units that can be trans-
ported to where they are needed, is not unrealistic. Technicians, surgical assistants
and nurses would provide the hands-on care, and technical support will be provided
by a new breed of clinician — a disease-specific imaging specialist who works from
a remote site. Cost control will be an essential component of the diagnostic phase.
Table 4.
Innovation in diagnostics.
Radiology and pathology will merge into cancer imaging
Dynamic imaging will create a changing image of biochemical abnormalities
Cancer changes will be detected prior to disease spread from the primary site
Greater precision in surgery and radiotherapy will be used for pre-cancer
Molecular signatures will determine treatment choice
Cost control will be essential for healthcare payers to avoid inefficient diagnostics
Search WWH ::
Custom Search