Medicine is the New Frontier

By John Prufeta, Founder & Managing Partner, Medical Excellence Capital, LLC.

Can we prolong life well into our 100s, and if so, how far? Can we do so in a state of vigorous health? Can we eliminate or control all disease?

In the 1960s the entire world was enthralled by the Space Race, culminating with astronauts from the United States landing on the moon. President Kennedy laid down the gauntlet with his electric speech promising to take a human to the moon and back safely by the end of the decade. With billions of dollars spent (when billions was real money!) on ever more fascinating engineering R&D, innovations small and large combined to make the seemingly impossible, well, actually possible. Aside from the sheer technical feat, it was a stunning example of the scientific community focusing to solve a series of obstacles on the way to a very big goal. It was also a colossally successful public/private partnership endeavor.

After spending large amounts of time sifting through mountains of published papers detailing recent innovations and results of clinical trials emanating from the true wizards of health care, one big revelation came to me:

Medicine in the 2020s is analogous to the Space Race of the 1960s. The new goal: achieving and maintaining a high state of health while significantly pushing the boundaries of longevity.

Missing perhaps is the competitive drama of the Soviet Union and the United States each flexing their technological muscles in geopolitical struggle. This has been replaced with a more quiet, gentle, and indeed collaborative process between thousands of dedicated scientists. But have no doubt that the competition for success in the lab and commercial marketplace is fierce, and I predict the cumulative outcome to be no less significant than our incredible achievement in space on July 20, 1969. By the time this decade has run its course, our lives will be significantly changed by medical innovation. Moreover, while the average human certainly enjoyed the fruits of the technological advances of the space race, if we are wise and fair, achieving this new goal in medicine will positively and directly affect nearly every person on earth.

In understanding the nature and pace of medical research and innovation today, it becomes important and necessary to assimilate the meanings of essentially a whole new vocabulary. Genome and Genetic Medicine, Molecular Diagnostics, Synthetic Genome Life Form, Mitochondrion Cell Biology, Catabolic Photoreceptor Metabolism, Gene Therapy/Surgery, Placenta-based Stem Cell Therapy, Precision Medicine – the list goes on and on, as does the complexity. So then, what are the practical takeaways for the rest of us mere mortals in a language we can understand:

• What science is being developed to impact our lives?
• When will these miracles be available to me and how can I implement them?
• How much will it cost?
• Lastly, the question of “just because we can, should we?” becomes so much more urgent.

Perhaps it makes sense to boil down the avalanche of data to the basic newer lines of scientific pursuit and explore the outcomes they are seeking to achieve. With this done, then we can get to the most interesting question on anyone’s mind, that is, what does this all mean for me in particular?

Let’s examine the scientific pursuits in medicine along two distinct, albeit often intersecting, lines:

Preventative medicine and longevity – organized around using scientific methods to prevent disease and increase lifespan.

Disease treatment and management – defined by using scientific methods to cure disease or to control disease to such an extent that the individual can function normally and indefinitely.

Preventative Medicine and Longevity

This arena is characterized by using traditional techniques ranging from physical exam, personal physician observation, and diagnostic tools such as imaging and blood tests combined with emerging technologies, such as genetic testing and predictive analysis. For example, using genetic testing, we can now fairly well predict the likelihood of a host of cancers. Unfortunately, we can actually prevent only a few. However, genetic testing does give physicians an opportunity to organize greater surveillance of potential problem areas. For example, discovering and treating breast cancer at its earliest stage has a greater than 95% cure rate. Just a few years ago, this test cost tens of thousands of dollars, the analytics was very early stage and understood by only a handful of physicians. Today, the cost is about US$350, and the test results can be reliably explained by many thousands of quality physicians.

Further down the line, but fairly close to fruition, are accurate predictive tests for neuro-degenerative diseases, such as Alzheimer’s, ALS, multiple sclerosis as well as a host of other debilitating diseases. At a practical level, many individuals are also expanding the conventional “one doctor and a blood test” annual physical regimen to include a cross-section of specialists and diagnostic tests to receive a more three-dimensional annual health assessment.

Next, scientists are closely examining disease at the genetic level with an eye toward eliminating the conditions that lead to the disease through genetic manipulation. For visualization purposes only, think of genes as “on-off switches” in terms of allowing or not allowing certain processes. Scientists are exploring novel pathways to manipulate those genes that are individually or collectively responsible for enabling disease.

For longevity, practical technologies using diagnostics to spot disease early (and thus greatly increase the success rate of treatment) are resulting in greater life expectancy. As are technologies to combat obesity, which aside from materially increasing the chances of incurring heart disease, fatty liver, and hypertension, also significantly increases the likelihood of certain cancers. Scientists at Stanford recently discovered a gene that signals the body to collect cholesterol in the blood vessels, even in individuals who are otherwise superbly fit. This discovery has unleashed new research dedicated to learning how we might “turn-off” the cholesterol switch and how we might discover and “turn-off” the obesity switch.

Extensive research is also being done at the cellular level to examine precisely what causes cells to age. Scientists now postulate that human aging can actually be “controlled.” Studies with mice recently showed that by manipulating mitochondria, cell aging can slow down. Our understanding of how cells, organs, and entire beings age is increasing phenomenally and is the key to using cell biology and cell structure to delay or prevent aging.

Disease Treatment as Cure or Management

First, some definitions. Contemporary tools for treatment of disease broadly break into several categories: medicines, surgery, devices, data, and radiation. These tools can be used individually to treat a particular disease, or more often is employed in creative combination. Data has become the number one weapon in fighting and curing disease, and in the last decade or so has introduced a new phrase into our lexicon – precision medicine. This term can be defined differently according to use and requires context when used for a specific disease. But, generally speaking, precision medicine is a methodology that customizes health care to select an optimal treatment pathway using advanced molecular diagnostics (genetic sequencing), imaging, and analytics that is SPECIFIC to the patient.

In a play of words, we are now in the early stages of optimizing optimal care through precision medicine. Clearly, precision medicine has enjoyed some successes, particularly in the field of cancer treatment. Physicians now routinely can identify certain genes and customize medicines to attack or support, depending on the objective. Hormone therapy, a therapy designed to slow or stop cancers that use certain hormones to grow, is another very advanced, targeted use of precision medicine. With all the excellent foundational work that has been done, the next decade will see an explosion of disease-causing targets and the understanding of those targets that portends prolonging life in individuals with cancer and a number of other diseases.

In the field of surgery, most innovations are the result of a continuous process of refinements to achieve better outcomes in efficacy and safety. However, a new field of “cellular surgeons,” using biology and chemistry as their tools rather than a scalpel, are researching methodologies that manipulate cells, genes, mitochondria in creative combination to potentially cure our most devastating diseases. New technologies such as CRiSPR, mitochondria manipulation, and stem cell therapy will revolutionize medical treatment.

New medicines for disease treatment are being introduced every day. There are currently hundreds of clinical trials going on at major universities just in the field of cancer and many hundreds in other fields of medical pursuit. In addition to the impending introduction of new medicines, concurrent research in terms of understanding the where, when, and how of attacking disease is evolving as well. As these theories are field-tested, individually and combined, we will see major improvements in cure rates, longevity, and quality of life.

Using the substantial building blocks developed from 1953 with the explanation of DNA by Watson and Crick, to more recently the world’s first decoding of the human genome, scientists are now positioned to build practical patient-ready solutions to combat disease and greatly increase longevity.

Lastly, if we are both wise and fair, the 2020s will end with readily-available tools for disease treatment or eradication and high quality life extension that could only be dreamed of just a short time ago. This will fundamentally change humanity with respect to our individuality and almost all of our traditional social constructs.

Therefore, a new major challenge emerges ‒ as we enjoy ever-greater achievements on the scientific front that both push the boundaries of medicine and our traditional understanding of life ‒ we will be required to put in an equal effort in understanding the inevitable balance sheet issue of the credits and debits of unprecedented scientific success.

About the Author

The Medical Excellence Group (MEC) was founded by the author, Robert Prufeta, and his wife, Olga. MEC is dedicated to curating the world’s finest medical talent to assemble a set of peerless preventative, diagnostic, and treatment services for patients across four continents. They are constantly scouting for promising medical technologies and trials for their patients throughout the world. Late in 2020, they teamed up with an MEC client who has a multi-billion dollar family office to found Medical Excellence Capital, LLC, an early stage venture capital company. Along with partners Kim Kamdar, Eric Heil, Brian Halak, and Joni Mancini, MEC provides funding to incubate and nurture carefully selected scientists working on meaningful potential breakthroughs.

Copyright 2021 John R. Prufeta, reproduced by permission only.