The Cleveland Clinic Way by Toby Cosgrove

Author:Toby Cosgrove
Language: eng
Format: epub
Publisher: McGraw-Hill Education
Published: 2014-04-06T16:00:00+00:00

Looking Ahead

A willingness to innovate will determine the clinical, social, and economic future of medicine in this country. The challenge is to create an institutional architecture that supports innovation; individuals will take it from there. Innovations will succeed on their own merits. The only failure will be the stifling of innovation—the first task is to get out of the way.

Unleashing the full power of innovation will surely produce exceptional new treatments, drugs, devices, and processes for patients in the next 10 to 20 years. The most exciting advances may well be in two areas: neurological diseases and genomics. With increasing understanding of the brain, doctors are getting a better grip on diseases such as epilepsy, Parkinson’s, drug addiction, and depression. And while the medicine of the past didn’t take all the quirks and specificities of the human body into account, developments in genomics will allow the medicine of the future to offer vastly more effective treatments and preventive measures that are specifically tailored to each person’s DNA.

The best news is that remarkable advances with respect to the diseases that afflict and frighten patients the most won’t take years to accomplish. These advances are on the near horizon, and they’re originating at academic medical centers such as Cleveland Clinic. One such advance pertains to breast cancer, the most frequent cause of death in women. Globally, nearly 1.5 million cases are diagnosed annually, with almost half a million deaths. Dr. Vincent Tuohy, a professor at Lerner College of Medicine and an immunology staff member at Lerner Research Institute, has been researching a breast cancer vaccine that would prevent tumors from forming. “Our research definitely represents a paradigm shift,” he said. “We believe we can vaccinate people against breast cancer and other cancers the way we vaccinated them against polio.”

Vaccines work by training the body’s immune system to attack and destroy specific viruses or other pathogens. The problem with cancer cells is that the body produces them itself. There is no virus or other pathogen to immunize against—no single target to attack. But Dr. Tuohy is taking a different approach. He has chosen to attack what he refers to as “retired” proteins. In breast cancer, these proteins are those that enable women to lactate, an ability that ceases after a woman reaches a certain age, usually roughly 40 and certainly by menopause. He designed his vaccine to prevent these proteins from causing tumors once a woman no longer lactates.

The vaccine could also be used in younger women, especially those who they have a high risk for breast cancer. Should they become pregnant, they would need an endocrinologist to impede their ability to lactate. They would then feed their baby formula.

After quietly working on this research since 2002, Dr. Tuohy caused something of a stir in 2010 when he published a paper in Nature magazine describing the breast cancer vaccine for the first time. He wasn’t expecting all the pushback he’s received, but he realized that he was promoting a new paradigm. Dr. Tuohy is working to turn his vaccine into a product that is available to the general public.

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