Many of us are familiar with the most common strategies for treating cancer: surgery, chemotherapy and radiation therapy. But in the past two decades, more targeted treatments have been developed. One such innovation, called theranostics, uses specially engineered radioactive tracers in combination with advanced imaging techniques, to not only find and map cancer cells throughout the body, but also serve as a beacon, lighting a path that cancer-destroying drugs can follow.

The platelets in our blood are best known as clotting agents, but they are great healing agents, too. Platelets don’t just clot. They also help structures to regrow and remodel. Washington University orthopedics specialists at Barnes-Jewish Hospital make the most of platelets’ healing qualities through platelet-rich plasma therapy. The best candidates for this procedure are people who have arthritis, especially mild arthritis.

Men with prostate cancer that has metastasized, spreading to other parts of the body, now have a new treatment option available to them that, though not lifesaving, can offer a better quality of life. Approved by the Food and Drug Administration (FDA) in 2022, a drug, called lutetium Lu 177 vipivotide, or Pluvicto, may be used in patients for whom other available treatments did not work or became ineffective.

Imagine surgeons performing surgery with the assistance of augmented reality glasses. Or doing complex, minimally invasive procedures through an incision smaller than your fingernail. These aren’t some-day scenarios; they represent the latest advancements in spine surgeries, making these procedures more precise while causing less damage to surrounding healthy muscle and tissue.

Citing current statistics from the Centers for Disease Control and Prevention, the American Academy of Family Physicians recently reported that the opioid epidemic is far from over. As long as the incidence of substance use disorder in pregnant women continues to rise, a growing number of babies will be born at risk for opioid withdrawal syndrome.

Until recently, the standard treatment for newborns with kidney disease, whether caused by congenital anomaly or acute injury after birth, has been kidney dialysis, a complex intervention that too often has not prolonged life.

A first-of-its kind device, called IpsiHand, will soon be available to people working to recover hand and arm movement after a stroke. And it works by using a technology called BCI, short for brain-computer interface. In fact, it is the first stroke-rehabilitation device that relies on BCI. The device is not yet available to patients, but its developer, a Washington University startup called Neurolutions Inc., is preparing to bring the device to market.

The new drug sotorasib reduces tumor size and shows promise in improving survival among people with lung tumors caused by a specific DNA mutation, according to results of a global phase 2 clinical trial. The drug is designed to shut down the effects of the mutation, which is found in about 13% of people with lung adenocarcinoma, a common type of non-small-cell lung cancer. Non-small-cell lung cancer makes up over 80% of all lung cancers. And more than 200,000 new cases of non-small-cell lung cancer are diagnosed annually in the United States.

People diagnosed with obstructive sleep apnea, or OSA, experience frequent disruptions of breathing while asleep. Those disruptions can range in frequency from five times in an hour for mild sleep apnea to 30 times or more for severe sleep apnea. In other words, a person with severe OSA stops and starts breathing at least every two minutes within an hour.

All that holds true for the use of robotics in partial knee replacement surgery, also called unicompartmental knee arthroplasty or UKA. In fact, a team of Washington University orthopedic researchers found that using robotics during UKA yielded results that were up to 10 times more accurate than doing the procedure without robotic assistance. The study was published in The Bone & Joint Journal, March 2021.

Functional neurosurgery—surgical interaction with the brain to improve function—was pioneered to treat people in need of pain relief, often those suffering with terminal cancer. Simple early procedures included surgically creating tiny lesions, also called ablations, in specific areas of the nervous system linked to pain.

The field has come a long way since those early days, says Jon Willie, MD, PhD, Washington University neurosurgeon at Barnes-Jewish Hospital.

When used to perform living-donor nephrectomy—the removal of a kidney from a living donor for transplantation into a recipient—a robotic surgery system offers a number of benefits. For example, the donor’s stay in the hospital may be shortened and recovery may happen more quickly.

Though many such donation surgeries already are being done using a minimally invasive procedure that offers living donors similar benefits, the robotic procedure allows for additional improvements.

While radiation is a key part of therapy for 70% of people treated for cancer, its side effects can be significant. That doesn’t mean radiation shouldn’t be used; it is an effective treatment. But making radiation more targeted can mitigate side effects. That’s where pencil beam proton therapy comes in.

BY PAM MCGRATH

In the past two decades or so, minimally invasive surgery has become widely used for many operations: gallbladder removal, appendix removal and hernia repair, just to name a few. The benefits of several small incisions versus a large, single one are well documented: reduced pain, faster recovery, fewer complications. Some heart surgeries, too, have gone the way of minimally invasive surgery, making standard open-heart surgery one option among several instead of the only option available.

A triple-drug cocktail, called Trikafta, was approved by the Food and Drug Administration in late 2019 and is the first therapy shown to dramatically improve lung function in most people with cystic fibrosis, a condition that often can be fatal.

In the recent past, people needing spine surgery underwent traditional open procedures, meaning neurosurgeons or orthopedic surgeons made a five-to-six-inch-long incision in the back that allowed access to the relevant area. Although this method allowed the surgeon to easily view the spine, it also involved retracting muscle and surrounding soft tissue. The invasive nature of such procedures meant patients often remained in the hospital for a week after surgery, and total recovery sometimes took months.

An aneurysm is an enlargement of arteries caused by a weakening of the artery wall. It can be especially dangerous if located in the brain, where a rupture can cause bleeding that is neurologically devastating. To date, standard treatment for a brain aneurysm includes, among other strategies, medication to control blood pressure, as well as various surgical interventions that essentially seal off the aneurysm as a way to help prevent rupture.

Severe heart failure affects more than 2 million people in the United States, making even simple tasks—climbing stairs, taking a walk—extremely difficult. Medications can help ease symptoms but they don’t alter the course of this fatal disease.

Difficulty walking. Memory problems. Urinary incontinence. Alone or in combination, these symptoms can indicate a variety of diseases and conditions. That’s why making a definitive diagnosis for a collection of symptoms such as these isn’t always easy.

Despite today’s advanced state of medical diagnosis and treatment, there are people with challenging medical mysteries who, even after referrals to multiple specialists and seemingly endless testing, have no answers for the cause of their sometimes-debilitating symptoms.