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Top 5 Medical Breakthroughs of 2023

New research is changing the future for older people. Here’s a sampling of the good news.

1. Pain school for chronic pain
Chronic pain affects approximately 37.8 million midlife and older Americans, and nearly a third have high-impact pain that makes daily life difficult. In 2019, the Department of Veterans Affairs called on the National Academies of Sciences, Engineering, and Medicine to study the potential of the whole healthcare model being used at the VA to address chronic pain.

The Salem Veterans Affairs Health Care System’s (VAHCS) innovative Prevail Center for Chronic Pain gives veterans basic coping strategies through an online or face-to-face “pain school,” after which they meet for an hour with a caregiving team — made up of a psychologist, a pharmacist, a dietitian, a physical therapist and a physician specializing in pain — that creates a personalized, six-month treatment plan focused on healthy eating, exercise, spirituality and reducing stress.

Prevail’s first group of 280 participants have reported that their pain is no longer controlling their life, says clinical psychologist Rena Courtney, director and creator of Prevail.

Find out more about Prevail and other breakthroughs in chronic pain, including drug-free help for diabetic nerve pain.

2. A new prostate cancer treatment for men
Ultrasound and other “focal” cancer therapies that treat part of the prostate are offering new hope to men with prostate cancer. TULSA-Pro is an outpatient procedure cleared by the Food and Drug Administration (FDA) in 2019 that destroys cancerous tissue from inside the prostate gland with ultrasound heat. Doctors use magnetic resonance imaging to guide the robotic procedure while a cooling catheter inserted in the rectum reduces heat exposure of nearby tissue. Recovery is generally faster than with surgery or radiation. It’s intended mostly for men with low- and intermediate-risk prostate cancer that hasn’t spread.

In a recent study where midlife and older men with low- to intermediate-risk prostate cancer who had their prostate gland completely treated via TULSA-Pro, 96 percent of participants saw their PSA levels fall by 75 percent or more within a year, 25 percent had new problems with erectile dysfunction (ED) and 11 percent reported some urinary leakage or incontinence.

By three years after their procedures, 13 percent needed additional prostate cancer treatment, but none had severe erectile problems, and 99 percent didn’t need pads for managing incontinence.

In contrast, 25 percent to 33 percent of men who undergo standard surgery or radiation treatment see their cancer return, according to the Prostate Cancer Foundation.

3. Better cancer screening for dense breasts
Cancer risk is up to four times higher in dense breasts, possibly because dense tissue has more cells that can become abnormal, and women with dense breasts may have higher levels of estrogen, which can increase the risk of cancer. Conventional mammograms may miss up to 40 to 60 percent of cancers in dense breasts.

A three-dimensional whole-breast ultrasound screening called SoftVue was recently granted premarket approval by the FDA as an add-on cancer check for dense breasts.

With this 3D whole-breast ultrasound tomography system, the new technology sends sound waves to create a 360-degree image of the breast that offers a more comprehensive look at the tissue — without compression or radiation — showing tissue changes in detail.

Clinical data has shown that scans with SoftVue, plus a conventional mammogram, found 20 percent more cancers than mammograms alone, and were better at weeding out false positives, says Rachel Brem, M.D., director of breast imaging and intervention at George Washington University in Washington.

4. Advances in continuous glucose monitors for people with diabetes
This year, Medicare expanded its coverage for continuous glucose monitors (CGM), making it significantly easier for millions of adults to manage their blood sugar levels. Once used mostly for insulin-dependent type 1 diabetes, CGMs are rising fastest among people with type 2 who typically take oral medications and may use injectable drugs, sometimes along with insulin, to control blood sugar.

Compared to finger-stick blood sugar checks, CGM devices help midlife and older adults lower their blood sugar further and keep it in a healthy range longer.

5. A new way to bust blood clots
Pulmonary embolisms (PEs) are the third-leading cause of cardiovascular death in the United States behind heart attack and stroke, hospitalizing 350,000 people per year and causing more than 100,000 deaths. The clots usually form in deep veins in the legs and travel upward to the lungs. PEs need aggressive care to prevent heart and lung damage.

The Bashir Endovascular Catheter is a device that’s threaded through the blood vessels to the lungs, then opens into an expandable infusion basket in the clot, creating multiple channels to allow for blood flow, while the catheter’s arms spray a clot-dissolving drug directly into the blood clot.

The Bashir and Bashir S-B Endovascular catheters, cleared by the FDA in 2023 for pulmonary embolisms, are part of a growing number of treatments for medium-risk PEs, which affect up to 65 percent of people with the condition.