Whole Health
March/April 2007

Bright Ideas

Eight innovations are changing the field of women’s health today—and laying the foundation for the medical breakthroughs of tomorrow.
By Eliza Thomas

In health care the only constant is change. With an estimated 40,000 health-related research projects under way internationally at any given moment, new findings are emerging at a near dizzying rate to affirm, hone, or entirely redirect previously held conclusions. While this may make medical forecasting an increasingly inexact science, it’s good news for us. With more great minds than ever before dedicated to understanding and improving human health, the future of medicine has never looked so bright.

To predict the big women’s health success stories of tomorrow, we consulted our crystal ball (all right, all right, medical experts and health organizations) to devise this list of the key recent advancements affecting women’s health today.

Vaccinating Against Cervical Cancer
According to leading academic medical center the Cleveland Clinic, cancer vaccines are the number one innovation shaping health care in 2007. And the very first of these treatments—the HPV vaccine, designed to prevent human papillomavirus (HPV), a sexually transmitted disease that leads to cervical cancer—was a quantum leap for women’s health.

Alarmingly common, HPV is estimated to infect 80 percent of women as they age, and cervical cancer kills roughly 280,000 women each year, most in the developing world, where regular pap tests are less available. While not all strains of HPV can lead to cancer, the HPV vaccine guards against those strains that cause 70 percent of cervical cancer cases and 90 percent of genital warts cases.

“In the past, short of ‘eat your broccoli,’ there wasn’t much we could do in terms of preventive cancer care,” says Sherry Marts, PhD, vice president of scientific affairs for the Society for Women’s Health Research (SWHR). “The HPV vaccine is the first opportunity we’ve had to truly prevent cancer. Because the vaccine guards against only the most common variants of HPV, it’s not going to eliminate the need for pap tests, but it’s going to have a significant impact on the number of cervical cancer cases worldwide.”

Building a Better Breast Cancer Test
Of the more than 1 million breast biopsies performed on U.S. women every year, eight out of 10 come back normal. “That may be good news for a lot of women, but it may also mean we are performing too many biopsies,” wrote neurosurgeon Sanjay Gupta for Time magazine. That is why Gupta and others were delighted by reports of a new technology unveiled at a November 2006 gathering of the Radiological Society of North America. “It is called elasticity imaging and, unlike a biopsy, involves no needles or scalpels. Yet it appears—on the basis of an initial study—to be remarkably good at distinguishing benign lumps from cancerous growths.”

“This could be fantastic,” says Elizabeth Battaglino Cahill, RN, founding partner and executive vice president of the National Women’s Health Resource Center. “Especially for women who suffer from a genetic predisposition to breast cancer—more than a couple of immediate family members who have had the disease—this will be a much easier option.”

Although annual mammograms, with biopsies for irregularities, remain the gold standard in cancer screening for now, doctors are eagerly awaiting the results of a large elasticity imaging trial to be completed in 2008.

Sex and Genetics
A CNN poll of doctors, scientists, and medical experts called the mapping of the human genome, largely completed in 2003, the number one greatest medical accomplishment of the past quarter century. On its list of the most important women’s health stories of the year, the SWHR lauded a 2005 study that further expanded scientists’ understanding of human genetics. Published in the journal Nature, the study found that female mammals, who have two copies of the X chromosome, are more genetically variable than men. The SWHR posted on its website that this “confirm[ed] the importance of looking for and understanding sex differences in health. As those genes are better understood, scientists may be able to prevent the onset of certain diseases tied to the X chromosome,” such as, speculatively, autoimmune disorders like multiple sclerosis and rheumatoid arthritis, which are dramatically more common in women than in men.

“We’re just starting to scratch the surface in this area,” says Dr. Marts. “Since the human genome was mapped, everyone has been waiting for the day you’ll walk into a doctor’s office, swab some DNA, and they’ll say, ‘Here’s precisely the medication you need, at the precise dose that you need it, to treat your exact problem.’ We’re not quite there yet, but this is clearly a first step toward individualized medicine.”

It’s Good to Have a Plan B
Resolving one of the highest-profile and longest-drawn-out medical debates of the past several years, the federal Food and Drug Administration (FDA) finally approved the emergency contraceptive Plan B for over-the-counter (OTC) sale last summer. Plan B, aka the morning-after pill, had previously been available only by prescription due to a controversial 2002 decision whereby the FDA rejected the recommendation of its own advisers to deny Plan B OTC status, triggering criticism that the organization was bending to conservative activist pressure and putting politics before national health.

As experts estimate that easier access to emergency contraceptives could prevent up to 1.5 million unintended pregnancies and 800,000 abortions each year, OTC Plan B, which went into effect in 2007, was widely celebrated by the women’s health community as a major milestone. “About time!” says Dr. Marts. “While this was ultimately more of a political accomplishment than a medical accomplishment—tragically, really—it’s still a major step for women’s health.”

Next up: making Plan B available over the counter to minors, a move that the SWHR calls “a commonsense strategy to reduce the approximately 850,000 teen pregnancies each year.”

Four More Developing Advancements

• Heart-strong Women. Heart disease is the number one cause of death among U.S. women, but until recently women were woefully underrepresented in studies. Increased awareness about the way women experience heart disease—such as the precursor symptoms for heart attack, which are totally different for women than men—is saving women’s lives. Stay updated at HeartHealthyWomen.org.

• Blind Ambition. The FDA recently approved Lucentis (ranibizumab injection), a promising new drug treatment for macular degeneration, a leading cause of blindness. Before Lucentis, which has been shown to improve vision, the best treatments could only halt further deterioration.

• New Hope for Mental Health. Deep brain stimulation, a treatment (already approved for Parkinson’s) by which implantable devices send electrical impulses to targeted parts of the brain, may bring relief to the millions of Americans suffering from treatment-resistant depression and treatment-resistant obsessive compulsive disorder.

• Nursing Kids to Health. A slew of recent studies, such as the University of South Carolina’s findings that nursed children are at a lower risk for obesity, are increasing public awareness about the health benefits of breastfeeding, making way for a healthier next generation.