What's Ahead for Health in 2006

Predictions for health care in 2006.

From the WebMD Archives

From the first-ever cancer vaccine to a new drug set to take on "diabesity," 2006 promises to be chock full of health advances.

That's why WebMD asked thoughtful leaders in many fields to get out their crystal balls and tell us what's in store for 2006.

Bird Flu Fears

"There is a better chance that we will see what we are seeing in Southeast Asia than have a pandemic here, but a pandemic is possible almost at any time," says flu vaccine expert Peter Gross, MD,
chair of internal medicine at Hackensack University Hospital in New Jersey.

The H5N1 bird flu has caused an unprecedented epidemic in poultry and wild birds across Asia.

"We have had the bird flu in the U.S. in the past, but the difference is that it hasn't killed humans to the degree that it has in Asia," he says. So far, the number of deaths from the H5N1 bird flu globally is 71, all in Asia, out of 138 people known to have been infected. Five other people have been confirmed to have contracted the virus in Indonesia but have survived.

"Off and on over the past couple of years, an occasional person dies from a bird flu, but most of them had close contact with infected bird flocks," Gross says. "For a pandemic to occur, there must be a new strain [of the virus] that is capable of human-to-human transmission but so far it has been virtually all bird to human," he says. "It doesn't have the virulence yet to transmit from human to human."

Cancer Vaccine

The new year will likely yield the first vaccine targeted at preventing cancer. The vaccine targets HPV, a common sexually transmitted infection that is the main cause of cervical cancer, says Mary Jane Minkin, MD. Minkin is a clinical professor of obstetrics/genecology at Yale University School of Medicine in New Haven, Conn.

"I wish I could say everyone practices safe sex, but people get a false sense of security now that there are such effective treatments for HIV /AIDS," she says. "An HPV vaccine will be a wonderful advent," she says.

"Cancer vaccines -- including the cervical cancer vaccine and a potential lung cancer vaccine -- have been brewing for a while. And that may be an area in the coming year in which new developments are being seen," predicts Albert Deisseroth MD, PhD, president and CEO at the Sidney Kimmel Cancer Center in San Diego.

The new year will also bring other advances in the fight against cancer, including more research into drugs that starve tumors by cutting of their blood supply, he says.

"A third area is therapy selection with genetic tests," he says. "This is a major advance that will affect the decisions that oncologists make for their patients regarding therapy." Such selection can help determine which patients will benefit from which therapies.

The 'Diabesity' Epidemic

"Diabesity" is a new buzzword that refers to "the incredible connection between diabetes and obesity," says Francine Kaufman, MD, head of the Diabetes Center at the Children's Hospital in Los Angeles.

"Of the 90% of people with type 2 diabetes, 85% to 90% are overweight, if not obese," she says.

There will also be advances in drugs to treat diabetes in 2006; namely the approval of Exubera, an inhaled form of insulin, which may help reduce the number of painful insulin shots.

And on the obesity end, a new drug called Acomplia, which cuts appetite and curbs the craving for nicotine, is also expected to gain FDA approval.

"Both agents will add to our ever expanding war chest of agents to treat diabetes and obesity," she says. Make no mistake, "we are at war with diabetes and obesity."

Putting an End to Pain

As the dust from the arthritis drug debacle of 2004-2005 settles, people in pain will find themselves increasingly drawn toward safer, more natural remedies, predicts Jacob Teitelbaum, MD. Teitelbaum is the medical director of the Annapolis Center For Effective CFS/Fibromyalgia (FMS) Therapies in Maryland.

"The reign of Cox-2 inhibitors and nonsteroidal anti-inflammatory drugs (NSAIDs), as we know them, has passed," he tells WebMD. "New medications and natural alternatives that are highly effective and safe will replace them."

Such treatments include numbing Lidocaine patches, herbal mixes, muscle relaxants, and the use of antidepressants for pain.

"Antidepressants don't just affect depression, but they also lower substance P, a pain messenger," he says.

The year 2006 may also spell relief for people with fibromyalgia, a chronic pain illness characterized by widespread musculoskeletal aches, pain and stiffness, soft tissue tenderness, general fatigue, and sleep disturbance, says Lynne Matallana, president and founder of the National Fibromyalgia Association.

"I think that 2006 will see the approval of the first pharmaceutical medication for fibromyalgia." Matallana is betting on a new antidepressant called Milnacipran, which has performed well in trials of fibromyalgia.

Matters of the Heart

Stanley Hazen, MD, PhD, section head of preventive cardiology and rehabilitation at The Cleveland Clinic Foundation in Ohio, says that 2006 will bring some much-needed changes in the number of people who take medication to lower their blood cholesterol levels.

"Statin use will see some major changes when Zocor becomes generic," he says. A generic version of the cholesterol-lowering statin drug, Zocor, is slated to become available beginning midyear.

"We are undertreating high cholesterol and underprescribing cholesterol medications and people are not persistent with staying on their medication. But increased availability with a generic will help turn that around." Statins are the most effective class of drugs for lowering cholesterol.

Computerizing Health Records

After Hurricane Katrina pounded the Gulf Coast in late August 2005, most of the 1 million people displaced by the storm were left with no medical records -- making it difficult, if not impossible, to treat them. As a result, there has been a renewed interest in electronic medical records.

"We will see an uptick in physician office adoption of electronic medical records in 2006 --particularly in large group practices," says J. Marc Overhage, MD, PhD, a professor of medicine at Indiana University School of Medicine in Indianapolis.

"There will be a rocky road in smaller practices of less than five people because there are not good models at that scale." But don't worry, those walls of paper records and files we have all grown so accustomed to will not disappear in 2006. "The files won't be gone, but we will see some diminution."

Diet and Exercise

It's back. The South Beach diet, that is, with a new dining guide to help consumers stick to their low-carb lifestyle while dining out as well as an emphasis on core training and functional fitness.

"I really think that is where fitness should be - engaging the core muscles and doing fitness that correlates more with everyday life," says father of the South Beach diet and cardiologist Arthur Agaston, MD, director of the Mount Sinai Cardiac Prevention Center in Miami Beach, Fla.

What's more, regardless of which diet you buy into, everyone will finally be on the same page about what constitutes a healthy diet and what does not in 2006, he predicts. There will be a move away from draconian, fad diets that demonize a single nutrient and canonize another. Instead, diets will emphasize whole grains, fruits and vegetables, and lean sources of protein, he says. "There will be a move toward good carbs and nutritionally dense carbs like pomegranates, blueberries, and strawberries," he says.

Shoppers will also see heart-damaging trans fats listed on labels in 2006 as per an FDA mandate. Trans fatty acids or trans fats are formed when manufacturers turn liquid oils into solid fats. Manufacturers create trans fats via a process called hydrogenation. As a result of the new labels, "it will become easier and easier to avoid trans fats and fried foods and to make healthy choices," he says.

Medicare Part D

January 2006 marks the beginning of the new Medicare Part D prescription drug plan.

"First we will see apathy because the materials sent out were complex," predicts Nan Andrews Amish, MBA, a San Francisco-based health care consultant.

"So, when seniors cannot make sense of the … brochures, they will finally be motivated to action in March or April. Then we will see a mad rush by insurers to get people enrolled," she says.

"Meanwhile, doctors will then have to work with Medicare formulary lists to get seniors alternative prescriptions when their's is not covered [and] most chronically ill seniors will hit the donut hole," (or the lack of coverage for drug spending between $2,251 and $5,100), she says.

"Seniors will come in expecting their drugs to be paid for and be told they owe an amount larger than expected," she says. "In short, we get chaos."

The Booming Baby Business

The year 2006 may enable the stork to make even more house calls, thanks to advances in assisted reproductive technology, says Lawrence Werlin, MD, the medical director of Coastal Fertility Medical Center in Irvine, Calif.

"We will see a push toward freezing eggs, lowering multiple gestations and a push toward preimplantation genetics," he predicts. Freezing eggs has gotten a lot of play in the media lately.

As technology improves and we are able to freeze and thaw eggs better, this may become an option for women who are young, but don't want to achieve pregnancy right now because they want to pursue a career, don't have a partner, or may be undergoing cancer treatment that will damage their ovaries, he predicts.

Preimplantation genetics allows doctors to look at an embryo before implantation to determine if it's healthy from a genetic and disease standpoint, thus reducing risk of abnormalities in the fetus. Preimplantation genetics will also reduce multiple-baby pregnancies because doctors can implant two or fewer viable embryos. "This will help ensure pregnancy success while reducing multifetal pregnancies."

Nip and Tucking in the New Year

"We will still continue to see an increase in surgical and nonsurgical cosmetic procedures," predicts Mark L. Jewell, MD, a plastic surgeon in Eugene, Ore., and the president of the American Society for Aesthetic Plastic Surgery.

"Wrinkle fillers and Botox will continue to be widely utilized and new players will enter the market," he says. "We will see the approval of a silicone breast implant in the first quarter of 2006," he says. Once approved, these implants, due largely to their more natural feel and appearance, will dominate the U.S. market.

We will increasingly be doing the same thing on the body as we have been on the face, predicts Neil Sadick, MD, a dermatologist in private practice in New York City.

For example, more and more people will undergo procedures to erase the signs of aging on their hands. Another big area will be anticellulite technologies that really work, he says.

At the end of 2005, the first face transplant made headlines and we may be hearing more about such transplants in the coming year, Jewell says. The Cleveland Clinic is slated to do the first face transplant in the U.S. "This is certainly a wonderful opportunity to restore a person's life when their face is so deformed by an accident or horrific circumstances," Jewell says.

The news is not so good for microdermabrasion (a treatment in which the doctor sandblasts tiny crystals across the face to remove dead skin). "Microdermabrasion will start to decline because it is not viewed as having a long-term benefit," he predicts. And don't expect a revival of plastic surgery reality television, he says. "Plastic surgery is a wonderful thing, but it's not entertainment." Stay tuned.

Show Sources

SOURCES: Mark L. Jewell, MD, plastic surgeon in Eugene, Ore.; president, American Society for Aesthetic Plastic Surgery. Jacob Teitelbaum, MD, medical director, Annapolis Center For Effective CFS/Fibromyalgia (FMS) Therapies, Maryland; author, Pain Free 1-2-3. Arthur Agaston, MD, cardiologist, director, Mount Sinai Cardiac Prevention Center, Miami Beach, Fla. J. Marc Overhage, MD, PhD, professor of medicine, Indiana University School of Medicine, Indianapolis. Peter Gross, MD, chair of internal medicine, Hackensack University Hospital, New Jersey. Neil Sadick, MD, clinical professor of dermatology, Weill Cornell Medical College, New York City. Lawrence Werlin, MD, medical director, Coastal Fertility Medical Center, Irvine, Calif. Francine Kaufman, MD, head of diabetes center, Children's Hospital in Los Angeles. Albert Deisseroth, MD, PhD, president and CEO, Sidney Kimmel Cancer Center, San Diego. Nan Andrews Amish, MBA, a San Francisco-based health care consultant; author of the forthcoming book, Healthcare and Benefit Choices. Stanley Hazen, MD, PhD section head of preventive cardiology and rehabilitation, The Cleveland Clinic Foundation, Ohio.

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