The Top 10 Medical Breakthroughs for 2013

A handheld optical scanner to detect skin cancer, “bladeless” cataract surgery, and an amazing new headache treatment are among the Top 10 Medical Innovations for 2013 selected by a panel of Cleveland Clinic scientists and researchers.

A surprising government program also made the list, unveiled at the clinic’s Medical Innovation Summit. To qualify, a breakthrough had to offer a major improvement in patient care, have a high probability of success, and must either be on the market now or be close to being introduced.

Here’s a look at the remarkable therapies and game-changing technologies expected to dramatically reshape healthcare—and save lives—over the next year:  

#10. Financial Rewards for Healthy Choices. About 96 percent of Medicare’s budget is spent on treating people with potentially preventable chronic diseases. The bipartisan Medicare Better Health Rewards Program Act of 2012 presented to Congress offers a new approach to improving health and cutting costs. The three-year program uses the annual wellness visit Medicare already covers to motivate patients to improve six areas of health: BMI (body mass index), blood pressure, diabetes indicators, vaccinations, and smoking. By saving Medicare money, participants who take steps to boost their health in these areas will be paid up to $400 after checkups in the program’s second and third years.

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#9. 3D Mammography. Also called breast tomosynethesis, this new diagnostic imaging technology received FDA approval in 2011. It can be performed along with a traditional mammogram for more accurate screening. The x-ray arm of the machine makes a quick arc over the breast, taking dozens of images at various angles that are then merged into a 3D image. Preliminary study results in 25,000 women report a 47 percent rise in cancer detection when tomosynethesis was used. 

#8. Modular Stents for Aneurysms. Aortic aneurysms—weak, ballooning areas in the heart’s largest artery—are often fatal if they rupture. The preferred treatment for large aneurysms (those 5.5 to 6 cm in diameter or more) is a minimally invasive procedure to insert a stent graft in the affected area, but stents currently on the market aren’t suitable for up to 40 percent of patients, due to their anatomy. A new modular stent now in multi-center trials allows surgeons to treat these complex aneurysms, thus saving the lives of high-risk patients.

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#7. Ex Vivo Lung Perfusion. Many people who need lung transplants can’t get them, due to a shortage of donor organs. Often because of complications that make lungs unsuitable for transplantation, these organs are only harvested from 15 percent of deceased donors. A new “lung washing” technology—ex vivo lung perfusion—can reverse injuries in donor organs by treating them with proprietary fluids and, if needed, medications to clear infections. Experts estimates that up to 40 percent of lungs currently rejected for transplant could be repaired with this technology, which is already approved in Europe and Canada.

#6. Femtosecond Laser Surgery for Cataracts. Operations to treat cataracts—clouding of the eye’s lens—are the most common surgical procedures in the US and improve vision in more than 95 percent of cases. A new, FDA-approved “bladeless” technology already used for LASIK eye operations uses pulses of light lasting one-quadrillionth of a second (a femtosecond) for more precise cataract surgery. Not only is the laser technique more accurate than traditional cataract surgery with a blade, but it also causes less inflammation and provides more stability when doctors implant an intraocular lens.

#5. Handheld Optimal Scan for Melanoma. More than 76,000 Americans develop melanoma—the deadliest form of skin cancer—annually and 9,600 die from it. A new FDA-approved handheld device uses imaging technology developed by the military to guide missiles for non-invasive analysis of moles and suspicious skin areas. Light of ten different wavelengths penetrates the skin, then computer software compares the findings to 10,000 archived images of melanoma and other skin cancers. In a clinical trial of 1,300 patients, the device correctly identified 98 percent of melanomas.

#4. Better Drugs for Advanced Prostate Cancer. In the past two years, however, five new drugs have been approved for advanced prostate cancer; sipuleucel-T, denosumab, abiraterone, cabazitaxel, and enzalutamide. Many experts believe that these drugs and others in the development pipeline could ultimately turn advanced prostate cancer into a manageable chronic disease

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#3. Mass Spectrometry to Identify Bacteria. When a patient has a dangerous bacterial infection, getting a rapid diagnosis and the right medication could be lifesaving. In the past, culturing bacterial could take days. Mass spectrometry lab technology has made it possible to accurately identify bacteria in a patient’s sample in minutes, at a cost of just 50 cents.

#2. Neuromodulation Therapy for Severe Headaches. For patients with excruciating  migraine or cluster headaches, a tiny, almond-sized implant can block the pain without drugs. The nerve stimulator is placed inside a small surgical incision in the upper gum, then patients activate the pain-blocking implant with a remote control whenever they feel a headache coming on. In European studies, 68 percent of patients with cluster headaches responded to neuromodulation therapy with pain relief, fewer headaches, or both. The device is now being studied for migraines as well.

#1. Bariatric Surgery to Control Diabetes. After noticing that weight-loss surgery often helped patients with type 2 diabetes reverse their disease—often before they even left the hospital--doctors began investigating this operation as a treatment for obese patients with poorly controlled type 2 diabetes. 2012 study results published in New England Journal of Medicine astounded the medical world,” says Cleveland Clinic. Compared to diabetic patients who received medications and lifestyle counseling, those treated with bariatric surgery were far more likely to be free of diabetes—and often lowered their cholesterol and blood pressure as well. Many experts believe this surgery might even be a cure for type 2 diabetes.

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