CHILDREN born in Australia today can expect to survive long into their 80s, but will they want to? What will their quality of life be like at advanced age?
Will they be active and energetic? Will they be healthy?
If the medical research underway locally is any guide, their future looks bright.
To celebrate QUT turning 25 this year, this week we are showcasing 25 amazing innovations, devices and fields of research being developed in Queensland.
Each idea has the potential to change the world, in small ways and big, and always for the better.
This series, 25 ideas to change the world, presents five ideas each day, grouped in themes like technology, genetics and sustainability. Today we look at health – five areas of medical study that will help everyday people live better, longer.
3D printing of body parts
“Gentlemen, we can rebuild him. We have the technology’’.
That famous line was used to introduce The Six Million Dollar Man – the hit 1970s TV series about a US astronaut reconstructed by scientists after a terrible crash.
But the fictional Colonel Steve Austin’s body was re-built with super-powerful metal, plastic and wiring.
In reality, too, medics have had to rely on synthetic materials to repair or replace limbs and other body parts lost or damaged through injury or illness.
But biomedical engineers at QUT have gone beyond the science fiction – using 3D printing to enable patients to repair and re-grow their own body parts.
Professor Dietmar Hutmacher, Chair in Regenerative Medicine at the university’s Institute of Health and Biomedical Innovation describes the breakthrough as a “medical revolution”.
To demonstrate the possible applications and benefits, Prof Hutmacher cites the example of former Formula One motor-racing champion Michael Schumacher who was left in a coma with severe head injuries after a skiing accident last December.
“Part of his skull-bone had to be removed to relieve the pressure from the brain, so he will end up with a little hole in his skull,” Prof Hutmacher said.
“The normal procedure (previously) after a patient has recovered and the brain swelling has gone was to put titanium mesh on top of the skull and fix it with 10 to 12 screws.
"But we can now use bio-fabrication to make biodegradable implants which are designed custom-made and patient-specific and add the patient's own cells and / or growth factors, so after two to three years the patient will get his own bone back instead of having a titanium implant for life."Another key use will be to enable women to grow new breasts following mastectomy due to cancer.
In fact, the technology can be used to repair most types of human tissue – including bone, muscles, nerves, cartilage and skin.
Scans are used to create a computer simulation of the area to be repaired or rebuilt. Using biomaterial polymers, a 3D printer constructs a tailor-made scaffold of the body part.
This is implanted in the body and injected with the patient’s own cells and a growth enhancer. The cells can either be taken from fat removed by liposuction or stem-cells drawn from bone marrow.
The human tissue grows around the scaffold which then gradually dissolves over time.
Prof Hutmacher said bone will take three to four years to rebuild while a breast would grow in nine to 18 months.
“This technology will be very important for children,” he said. “At present, the surgeon has to do multiple operations as they grow.”
About $30 million has been invested in the work over the past 10 years at QUT, where Prof Hutmacher leads a team of 30 directly involved and a broader group of up to 70 across the university.
QUT is collaborating with the University of Wollongong and two European centres – the Netherlands’ University Medical Centre Utrecht and the University of Wurzburg in Germany – on various aspects of the research.
Prof Hutmacher said one of the major challenges is cost.
“We had to develop 3D printers which can be used with bio-materials. Also, as our materials are going to be in the body so they need to have very specific properties and purity and need to be tested to ensure there are no reactions.”
While some polymers are now commercially available, they are very expensive – costing between $6000 and $10,000 per kilo, compared to as little as $1 per kilo for usual 3D printer materials.
But Prof Hutmacher said the cost will reduce as use grows and the major medical supply companies get involved.“And the scaffold will certainly be more expensive than titanium mesh and screws, for example. But it is up to us to show the advantages and long-term benefits and savings from one operation rather than three or four.”
The technique can already be used to repair broken or missing bone and the team believe they will be able to regrow breasts within five years.
Other centres are already well-advanced in research into producing custom-made prosthetics using the same approach and Prof Hutmacher says that restoring eyesight is definitely a longer-term possibility.
And they predict that within a few decades, entire organs will be bio-fabricated.
In addition to the benefits for individuals, Prof Hutmacher says: “One thing really at the bottom of my heart is that this is a great opportunity for Australia to become a leader – to develop a specialised sector which would be highly competitive in the Asia-Pacific region and globally.”
Learn more at www.ihbi.qut.edu.au
Artificial heart that skips the beat
ABOUT 300,000 Australians suffer from heart disease. Worldwide, the figure is 11 million.
Few families have not been touched by it.
For those at the most advanced stages, a heart transplant is often their best – or only – chance of survival.
But many will die before an organ becomes available. Only 100 heart transplants are performed in this country each year and 4000 globally.
Since the first human heart swap in 1967, scientists have been seeking to create an efficient, durable artificial version of this vital organ – and largely failing.
“Hundreds of millions (of dollars) have been spent on developing an artificial heart but most were modelled on the way the heart works, and were too large and didn’t last for long,’’ said Dr Daniel Timms.
But he has come up with a device which is being hailed as the “holy grail” of artificial hearts by international experts.
Motivated by the death of his father Gary from heart disease, Dr Timms has spent more than a decade researching the issue, gaining a Bachelor of Engineering (mechanical) and a PhD in biomedical engineering at Queensland University of Technology.
The breakthrough was a shift in thinking. Dr Timms realised it was not necessary to replicate the pumping action of a natural heart in order to maintain a continuous blood flow around the body.
Rather than pumping, his BiVACOR device propels blood using blades which rotate about 2000 times per minute.
These impeller vanes are located each side of a single rotating disc, driven by magnets to create centrifugal force to ensure blood-flow to both sides of the heart, unlike earlier designs which supplied only the left or the right. The technology allows the device to respond to the patient’s changing needs.
Dr Timms compares the different approach to man’s first attempts at flight.
“We thought we had to replicate bird flight and so early flying machines had flapping wings.”
The device is encased in a titanium shell the size of a fist. The impeller disc is the only moving part. The absence of friction means it is expected to last more than 10 years after being fitted.It is small enough to be implanted in an eight-year-old child but powerful enough for an adult. The BiVACOR can be used to support – or replace – a patient’s heart.
Staff at the world-leading Texas Heart Institute were so impressed that they secured $2 million from a philanthropic supporter to relocate Dr Timms and his team to the United States last year to continue their work.
He will divide his time between Houston and QUT’s research facility at Prince Charles Hospital. Intensive care specialist Professor John Fraser, head of the hospital’s critical care research group, is one of Dr Timms' partners in BiVACOR Pty Ltd, a private company.
The business is seeking investors to take the device to clinical trials, hopefully within five years.
With more than one million new cases of heart disease each year – expected to rise by 25 percent by 2030 – the potential commercial market for a successful artificial heart is enormous.
Learn more at www.bivacor.com
Cancer detector in palm of every hand
NEW technology could soon change the way Queenslanders monitor their skin for signs of cancer.
Brisbane scientists are exploring whether a small, but powerful magnifying device equipped with a polarising light, known as the Handyscope, could hold the key to diagnosing skin cancers sooner and without the need for in-person consultations.
"We're trying to detect melanoma early, because if it's cut out when it's very thin and hasn't penetrated the Basel layer of the skin, then it can be healed," said senior QUT research fellow Dr Monika Janda.
The German-developed Handyscope, now being applied to practical situations by QUT researchers, allows users to photograph skin lesions with the aid of their smartphone camera and then forward the images to their health professional for analysis.
If found effective in assisting diagnoses, this 'Pocket Doctor' concept will put the power, quite literally, into the hands of patients.
For those living with a history of skin cancer or in regional areas, the benefits of having a remote treatment option are likely to be particularly great.
“If they (patients) find something that is new, or that has changed, they could take a picture and communicate that picture to the doctor,” Dr Janda said.
“That doctor could give them advice (and) triage them quickly into care if necessary, or otherwise reassure them.”With most melanomas detected by the patient themselves, Dr Janda said she and her team hoped the technology might help people stay vigilant about their skin health.
“We’re also looking at the health economics,” Dr Janda explained.
“Let’s say some of the examinations were to be replaced with telemedicine … Could we save some health budget using such technologies?”
Early trials comparing the reliability of images produced by the Handyscope to traditional in-person consultations have produced promising results already.
"We've done one small study where some patients from the PA Hospital helped us. We found that almost all of the pictures those people sent using the device were clear enough for the dermatologist to actually give a diagnosis."
But Dr Janda said large-scale testing of the technology would need to be conducted before the treatment was likely to be offered to the general public.
Learn more at www.handyscope.net
Prostate cancer drugs made more effective
More than 20,000 Australian men are diagnosed with prostate cancer each year – and the disease kills 3,300 annually.
“The death rate of men from prostate cancer is higher than the death rate in women from breast cancer,” said QUT professor Colleen Nelson, who heads the country’s largest centre researching the disease.
More than a quarter of patients develop the most aggressive form of the disease, where it spreads outside the prostate – often into bones, resulting in great pain and increased risk of bone stress and fractures.
While treatments – known as androgen targeted therapies – are available for patients with the more aggressive form, Prof Nelson says the cancer can become resistant to them.
And the treatments themselves create a Pandora’s Box of new problems.
“These drugs are extending life but because they are targeting the production or action of testosterone, they induce a number of side-effects."
“They can include type 2 diabetes and cardiovascular challenges, decreased bone density and muscle mass," Prof Nelson said.
In a cruel irony, the therapies can even create new hormone pathways for the tumours to grow and spread.
“As soon as you abruptly remove all the testosterone from a man, he gets completely rebooted from a hormonal point of view,” Prof Nelson said.
This metamorphosis factor is one of the reasons researchers call prostate cancer the “master of disguise” among diseases.Prof Nelson and her 70-strong team at the Australian Prostate Cancer Research Centre – Queensland, based in the Translational Research Institute at Brisbane’s Princess Alexandra Hospital, are developing new drugs which will slow down the disease without the adverse results.
The new drugs are at proof-of-concept stage, a huge effort being funded through a Movember Revolutionary Team Award of $4.5 million. (Yes, being sponsored to grow a moustache each year really does help.)
"I would hope in three years we have enough pre-clinical proof of the principles that we can look to evaluate in human trials," she said.
“We have a hopeful sense that while we are still seeking a cure, we might be able to manage the disease with the technologies we have and new drugs so that we can turn it into a chronic disease – so men can live out their lives managing it as they would with any chronic disease.
“It really changes our mindset. With most other types of cancer, it’s always about a cure.
“This is about how to approach the disease management and give people the best quality of life.”
Learn more at www.australianprostatecentre.org
Keeping a closer eye on cancer survivors
THEY say fighting cancer is like going to war.
Normal life is suspended, replaced with countless hours spent in cold hospital corridors, often undergoing painful treatments.
But what happens then when the fighting stops? When victory is declared? When the ‘all clear’ is given?
For many women, a cancer diagnosis is not a death sentence. Breast and cervical cancer survival rates now sit at 89 and 79 percent respectively, five years after diagnosis.
But with improved treatments has come a greater need to address the long term side effects of cancer treatment.
“These women are at high risk of further chronic disease, like heart disease as a result of their chemotherapy,” Professor Debra Anderson, from QUT’s Institute of Health and Biomedical Innovation, explained.
The researcher is part of a team developing a world-first treatment program designed to guard women’s health after their cancer treatment ends.
“What we’ve developed is a really new (intervention). It’s a new part of the health system that we’ve never targeted before” Professor Anderson said.
The Women’s Wellness after Cancer Program is a 12-week course that aims to assist women improve not only their physical, but emotional wellbeing.
A pilot study targeting breast cancer survivors delivered in face-to-face environment has already shown participants’ level of exercise and diet measurably improved as a result of their participation. Menopausal symptoms among the women were also reduced, Prof Anderson said.
“(It’s) a huge issue for women after cancer, because chemo knocks them into menopause whether they’re 25 or 45."
But it wasn’t all sunshine and roses. Feedback from early adopters revealed a need to improve the program’s flexibility and accessibility.
“What these women said to us is they’re busy. They go back into their lives and they’re still running children to football and working.
“So they really asked if we could put it on e-health, so it’s an e-health platform.”
It’s a natural evolution that will open the program to women in rural and remote areas often excluded because of geographic and financial barriers.
The e-health tool will be accessible on iPads and also online and will enable to be delivered through Skype and Facetime. It includes an interactive iBook that presents the 12-week program and walks women through it on a day-by-day basis. Health areas like exercise and diet and stress are all addressed.“They can record all their feelings, it’s very private. So it’s an interactive journal and a health education resource as well,” Prof Anderson said.
Unpinning the program is an approach that encourages the participating women to step out gradually.
“We start with small goals and then that success builds on being able to incorporate further and further. So we don’t just blast them with all the things that we want them to do.”
Professor Anderson believes the program will also have economic benefits for the wider community.
“What we predict is that these women don’t revisit (and) recur again in the health system. We prevent the chronic disease occurring,” she said.
“I know that the information that we’re giving them is the latest and the best and gives them the best chance of preventing chronic disease, preventing cancer recurrence, but also feeling really good about themselves.”
Learn more at www.womenswellness.com.au
Animated images are illustrative only and do not represent real designs or projects.
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