WHAT’S NEW IN HEALTH FOR 2020

Dr Sarah Jarvis looks at the latest high-tech trends and game-changing treatments coming to a surgery near you

The latest treatments coming to your surgery this year

2020 looks set to be the year of health tech

Technology and I are not natural friends. At school, I studied shorthand instead of computers because I thought they would never catch on. But even I have to concede that tech initiatives have brought most of the major health advances in recent years and 2020 is likely to be the year of health tech.

Safer health advice online

There are apps for everything these days, and health is no exception. There’s robust evidence that, handled in the right way, health and wellbeing advice can be presented digitally to guide, encourage and produce real benefits in physical and mental wellbeing. But how do we know what the ‘right way’ is?

To help us find the best apps, NHS Digital has launched the NHS Apps Library with information on each approved app and how to access it. All the apps must meet strict data security and clinical safety standards. Covering everything from My House Of Memories, which helps people with dementia and their carers to explore past experiences, to brain training, coping with self-harm or anxiety, clinically proven programmes to improve insomnia and overcoming cancer-related tiredness, there is an app in the library for you (digital.nhs.uk/ services/nhs-apps-library).

Pharmacy on prescription

If you haven’t had personal experience of the problems caused by GP shortages, you’re in a lucky minority. The NHS Long Term Plan focuses on encouraging use of community pharmacists rather than GPS for minor health conditions to try to relieve the pressure and preserve GP appointments for patients who need them most. NHS 111 and receptionists are being given the tools to determine who can safely be referred for a pharmacist appointment, and the service is rolling out across England in 2020.

Patient Access, the online service used by 8m patients in the UK for health

advice and to access their surgeries, has a new pharmacy option, so you can book a pharmacist appointment direct for minor ailments and travel services.

Mobile emotional wellness

Internet use continues to grow across all ages, and 99% of 16- to 34-year-olds use a mobile phone. I worry about the pressure that this puts on young people – the self-esteem of so many of my teenage patients is bound up in their online profiles. So I was gratified to see a company aiming to harness the power of the internet for good.

Targeting students, the app Fika: Emotional Fitness draws on scientific evidence from cognitive behavioural therapy (CBT), mindfulness and positive psychology to build emotional fitness. Its aim is to help users understand that this as important as physical fitness and to persuade students to incorporate a five-minute ‘emotional workout’ into their days.

Partners include the London Business School and Manchester Metropolitan, Coventry, Bath Spa, Lincoln, Exeter and Middlesex universities. Fika is only available to students whose university is a partner, so why not ask your older teens to suggest their universities sign up, too?

Aortic advances

The aorta is your biggest blood vessel, and a weakness in the wall can lead to a bulge called an aortic aneurysm. If this bursts, the results are catastrophic, accounting for 5,000 deaths a year in the UK. Older men are at higher risk so they are invited at age 65 for NHS screening. If an aneurysm is found, they’re offered regular screening to monitor it or surgery to repair it, depending on its size.

But factors other than size determine risk of rupture, and rate of expansion isn’t predictable. We’ve long known we need a more reliable test to reduce uncertainty for people with aneurysms, and now researchers in Scotland have identified an amino acid produced by diseased aortas that gives a more accurate indication of the risk of rupture. It could save lives, and reduce unnecessary surgery and concern.

Delaying menopause

We’ve all seen the media stories about HRT supply shortages. Could removing and cryogenically freezing your own ovarian tissue, then transplanting it back when you reach menopause to delay it for up to 20 years be the solution? Sound like a work of science fiction? British company Profam has, in fact, launched this technique as a private service.

Research on using the technique in women wanting to preserve their fertility after cancer treatment suggests that within a few months of transplanting ovarian tissue, it’s business as usual for hormone production. While many women suffer very debilitating symptoms at the menopause, HRT medication doesn’t suit all of them. This technique would give women their ‘own’ hormones back.

There are still questions to be answered, including whether and how much this may increase the risk of breast cancer in women in their 50s and 60s. But the concept is certainly interesting.

Ovarian cancer progress… and more?

For every drug that reaches the market, scientists discover dozens that fall by the wayside because of unacceptable side-effects, safety concerns, or lack of effectiveness compared with current gold-standard treatments.

Developing a whole new drug class, which has a completely different method of action from existing ones, is even more challenging. For cancer, the Holy Grail is to overcome resistance to treatment, which develops in around 20% of cancer cells. One of the main issues in chemotherapy is toxicity, as many drugs work by accelerating ‘apoptosis’, or programmed cell death, which can affect normal cells as well as cancerous ones.

A STEP FORWARD

In 2019, researchers at the University of Sheffield’s departments of Biomedical Science and Chemistry identified a new compound, which kills cancer cells without the need for apoptosis. Not only does this reduce the potential for serious side-effects (in early studies the compound had low toxicity to non-malignant cells), but it was also highly active against cancer cells, even those resistant to standard chemotherapy options. The key appears to be its dual mode of action, which makes it much harder for cells to develop treatment resistance.

While it’s still early days, this is a huge potential breakthrough for patients whose cancer stops responding to their current treatment. Excitingly, the researchers believe this compound could be particularly effective against ovarian cancer, where improvements in survival continue to lag behind those seen in other cancers. Watch this space.