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Written by Dr Tom Nolan for Doctify

Gene editing, face transplants and the rise of antibiotic resistance have grabbed the headlines in 2015. We asked our experts what the most important developments have been in their fields over the last year.

Mr Hashim Ahmed, Urology Consultant, Nuada Group

The single most important breakthrough in urology over the last year is that we can finally ‘locate’ prostate cancer. Being in the 2010’s general readers might be surprised at this fact. However, for decades we have been diagnosing and treating prostate cancer without knowing precisely where in the prostate the tumour is. Biopsies were inaccurate and harmful. With multi-parametric MRI and image-fusion biopsies we are able to diagnose cancer more accurately whilst causing less harm. The same MRI information is used to deliver precision-based treatments that improve cancer control with fewer side-effects.

 

Tom Nolan, GP and Doctify Journal Editor

The update to the NICE Cancer referral guidelines, was an important change for GPs this year.

I once read that everyone goes to the doctor thinking they have cancer. That’s certainly a worry I hear from my patients every day. However, in our practice of 7000 patients only a handful of people are diagnosed with cancer each year. So I have a problem: I want to diagnose cancer as early as possible yet I also know that doing too many tests can be harmful. The new NICE guidelines are a big help as they give clear instructions, based on evidence and expert opinion, on which symptoms need further investigation urgently. They should also give GPs better access to specialist tests, such as CT scans.

 

Dr Simona Cicero, Consultant Obstetrician & Subspecialist in Fetal Medicine

The ASPRE Project is an important study that began this year. It aims to improve how we predict and prevent Pre-Eclampsia (a disorder of pregnancy characterized by high blood pressure and protein in the urine). Unfortunately, with current practice there is very little chance of detecting Pre-Eclampsia in time to mediate its effects, but with the ASPRE study we could be able to detect up to 90% of high risk women, for a false positive rate of 5%.

ASPRE aims to identify women at high risk of developing pre-eclampsia by screening women early in their pregnancy. This involves a blood test for levels of two hormones, measuring the blood flow to the womb, and a blood pressure check.

This points to a future in which, rather than waiting for disorders to develop then deploying the bulk of our resources to treat them, we can deploy more resources during early pregnancy to achieve better outcomes whilst saving significant sums of money.

 

Dr Adam Friedmann, Dermatologist

The advent of new anti-melanoma drugs has been pretty enormous in the last year. Some of these drugs are super targeted molecules that can switch on the immune system or attack the melanoma cells. For the first time in 40 years the treatment of advanced melanoma has shown a survival benefit. These are exciting times.

 

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