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Proponents say high-intensity focused ultrasound HIFU has comparable short-term results and may have fewer side effects than surgery or radiation, while giving some patients another option between actively monitoring their cancer for signs of spread best iq binary option long term 2018 usg those more aggressive steps. But studies show that for patients undergoing treatment of the whole prostate, rates of erectile dysfunction are similar to those for more aggressive treatments, although incontinence rates are lower.

When only part of the gland is treated, which proponents liken to a lumpectomy for women with breast cancer, side effects are reducedbut not eliminated, according to some studies.

HIFU is the latest treatment to prompt concerns over whether there should be limits — such as requiring tracking of results — placed on expensive new technology while additional data is gathered.

The treatment of prostate cancer has been a particularly controversial — and lucrative — niche, because the disease for some men can be slow-growing.

Using HIFU, a device directs ultrasound waves to heat prostate tissue to about degrees, destroying all or portions of the gland. Focusing on what is considered the main tumor and only removing that is a newer trend in prostate cancer treatment. HIFU machines have been used in Europe longer than in the United States, although national health programs in the United Kingdom and elsewhere limit coverage to patients enrolled in clinical trials or other research programs.

While the devices are approved in Canada, the national health program does not pay for it. Until recently, best iq binary option long term 2018 usg men in this country traveled to have the procedure done by US doctors who set up shop in Mexico, the Bahamas, or Bermuda.

Data submitted by the company included an analysis of men who had their entire prostate treated and were followed for 12 months. There is also debate over the type of best iq binary option long term 2018 usg best suited for the treatment: Ongoing and previous studies from abroad are available, but have limitations, including fairly short follow-up periods.

Indeed, some technologies have been granted approval by the FDA or coverage by Medicare with a condition that patients must be enrolled in clinical trials or registries. Meetings between registry proponents, the FDA, and the device makers are ongoing, but challenges remain, Hu said, particularly around who would pay for such a registry. His firm will also contribute some funding to a broader US registry that Hu and his coauthors support, which would incorporate results from other HIFU devices, as well.

The evidence gathered could convince Medicare and other insurers that a treatment is valuable — and worth covering. Currently, men usually pay for it themselves, with some successfully appealing to their insurers to cover part of the cost, said Carol. But in the meantime, surgeons using the device with cash-paying patients may not be in a rush for that to change. But they can show how treatments, drugs, or devices perform in common use. Surgery and radiation can pose problems such as incontinence or impotence; while hormonal treatments also cause impotence and can also result in hot flashes, muscle weakness, and other problems.

When the cancer is aggressivethe benefit of these approaches outweigh such side effects. But for men with lower-risk profiles, based on factors such as age, and results of tests and biopsies, the choice is more difficult. With prostate cancer, there may be a dominant best iq binary option long term 2018 usg but small cancer cells elsewhere in the gland, said Justin Beckelman, associate professor of radiation oncology at the University of Pennsylvania.

Still others note that patients who choose HIFU need to select physicians with lots of experience and training because the procedure is complex. He said patients should do their research and choose only very experienced physicians who are willing to show their outcome data.

I came out of HIFU with no pain or incontinence or impotence. HIFU can target just the tumor and leave the rest of the gland alone. Leaving as much of the gland untouched as possible greatly reduces incontinence and greatly improves erectile function rates over other more radical therapies.

To the author- Here are a few easy reads for you: Uchida, Toyoaki et al. A Prospective Development Study. Van der Meulen, and M. Our FDA is aligned more with industry companies interests than with the public and patients harmed.

That is an best iq binary option long term 2018 usg violation of their mission as a federal public health agency! The entire culture at the FDA needs to change. The days of letting the FDA treating industry as a client rather than a regulated entity must come to an end. FDA approval is thought to represent a full endorsement for safety and efficacy. Crawford — pleaded guilty to lying and conflict-of-interest charges in connection with stock he and his wife owned in companies he regulated as chief of the FDA!

The scandal has been going on for decades. Back ina Vermont Congressman asserted that the FDA collaborated with the manufacturer of a genetically engineered dairy hormone in best iq binary option long term 2018 usg the new drug for approval and sale!

Yet, the masses keep swallowing the hype! Sadly, the outcome of weak FDA standards has become all too clear. According to USA Today, more than half of the experts hired by the FDA to advise the government on the safety and effectiveness of medicines have direct financial relationships with the Industry Companies who will either be helped or hurt by the decision of FDA approval.

These conflicts include helping a pharmaceutical company invent a medicine, then serving on the FDA advisory committee which then decides whether the drug will be approved for human consumption. Most conflicts best iq binary option long term 2018 usg in the form of stock ownership and obtaining consulting fees or research grants from the drug industry.

Historically the FDA revealed when best iq binary option long term 2018 usg financial conflicts were present, but these conflicts have been kept secret lately. This sets a new precedent in drug approval. This ensures that the FDA remains a lap dog to the pharmaceutical industry does it not? If the law is too loose, we need to change it. Can the FDA really believe that scientists and doctors are more immune to self-interest than other people? The people who approve a devise when they see that there is a safety problem with it are very reluctant to do anything about it because it will reflect badly on them.

They continue to let the damage occur! The conflict of interest amongst the FDA has become so apparent that it has caught the attention of major university researchers. A team of Harvard University professors has publicly advised physicians NOT to prescribe new drugs to their patients because their safety has not been established, despite FDA approval. Call it human nature, greed, or just plain old corruption; the protective mechanism that was once the driving force of the FDA is gone.

As the Industry business has grown, the FDA has changed from an institution that was trying to protect public health from bad food to a rubber stamp government organization that only takes public health into account when it is forced to by some form of gross publicly made error. As currently configured the FDA is not able to adequately protect the American people. The next trial is scheduled for October 31, Well done article and terrific example of thoughtful info gathering and good writing to inform interested readers.

By Robert Weisman — Boston Globe. Newsletters Sign up for our Cancer Briefing newsletter. Please enter a valid best iq binary option long term 2018 usg address.

Newsletters Sign up for The Readout: A guide to what's new in biotech. Leave a Comment Cancel reply Name Please enter your name. Email Address Please enter a valid best iq binary option long term 2018 usg address. Comment Please enter a comment. Notify me of followup comments via e-mail. Looks like Duke University is trying it. New on the streets: Gabapentin, a drug for nerve…. Gabapentin, a drug for nerve pain, and a new target of misuse.

Flawed herpes testing leads to many false positives —…. Flawed herpes testing leads to many false positives — and needless suffering. How is cancer science advancing patient care? Chinese patients get these cancers at an alarming rate. Now drug makers see an opportunity. Calls intensify to get Medicare to pay for genetic sequencing of tumors By Dylan Scott.

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Fellow UN agencies, experts in artificial intelligence, representatives of industry, ladies and gentlemen,. I welcome this opportunity to learn from the vast amount of technical expertise assembled in this room. Market analysts predict that intelligent machines, programmed to think and reason like the human mind, will revolutionize health care in the very near future. In fact, proponents of the transformative power of artificial intelligence usually give two examples: Artificial intelligence is a new frontier for the health sector.

As so often happens, the speed of technological advances has outpaced our ability to reflect these advances in sound public policies and address a number of ethical dilemmas. Many questions do not yet have answers and we are not yet sure we know all the questions that need to be asked. Much of the enthusiasm for the use of smart machines to improve health care reflects the perspectives of wealthy countries and well-resourced private companies.

We need a broader perspective. I find it wise to look at potential benefits, risks, and ethical dilemmas in the context of several worldwide trends that shape priority health needs. Over the past decade, I have visited many countries where the majority of health facilities lack such basics as electricity and running water.

I would be hard-pressed to sell these countries on the advantages of artificial intelligence when even standard machines for analysing patient samples or sterilizing equipment cannot run for want of electrical supplies. Any discussion of the potential of smart machines to revolutionize the delivery of health care must be alert to these huge gaps in basic capacities.

At the same time, I have also observed the ubiquitous presence of smartphone even in the most resource-constrained settings. Schools may not have toilets or latrines. Children may not have shoes. But smart phones are ready to hand. The traditional dichotomy between health conditions in rich and poor countries no longer holds. Health everywhere is being shaped by the same dominant forces, namely population ageing, rapid unplanned urbanization, and the globalized marketing of unhealthy products.

Under the pressure of these forces, chronic noncommunicable diseases have overtaken infectious diseases as the leading killers worldwide. Diseases like heart disease, cancer, diabetes, and chronic respiratory diseases are profoundly shaped by human behaviours and the environments in which people make their lifestyle choices. These are among the most democratic of all diseases, affecting all income groups in all places.

They are also the most costly. Could artificial intelligence help improve lifestyle choices? Could smart machines help consumers understand the meaning of food labels or interpret restaurant menu options? Could a smartphone app help people with diabetes maintain good metabolic control between visits to a doctor? Moreover, the demands of long-term if not life-long treatment for chronic conditions have placed unsustainable pressure on an overloaded health workforce.

The high-level Commission on health employment and economic growth estimates that the management of NCDs and conditions like dementia will require 40 million new health workers by in wealthy countries. In contrast, the developing world is expected to experience a shortfall of 18 million health workers. The waves of populism and anti-globalization sentiment that are sweeping through some parts of the world are driven, in part, by technological advances that have eliminated many jobs, especially for the middle class.

Given the significant shortage of health workers, the application of artificial intelligence to health care could potentially reduce some of the burden on overloaded health staff. This is one advantage: Given the power of super computers and superchips to mine and organize huge amounts of data, it is easy to envision a number of applications in the health sector.

As we all know, health information is often messy and poorly structured. In many cases, it is systematically collected but not systematically analysed and used. Artificial intelligence can give that data a structure, and by detecting patterns, guide some medical decisions. Supercomputers can accelerate the screening of novel molecules in the search for new drugs. They can speed up the reading and interpretation of results from radiographs, electrocardiograms, ultrasound and CT scans, and even the analysis of blood samples.

By reducing the likelihood of human errors, they can contribute to more precise diagnoses and predictions of patient prognoses, and to enhanced patient safety. Other applications currently under development include personal use of smartphones to communicate symptoms and obtain a diagnosis from the cloud. Enthusiastic developers see this as a way to cut down health care costs by keeping the worried well from flooding clinics and emergency rooms. For patients recovering from a stroke or an accident, developers have already introduced a system, involving sensor technology and the latest advances in cloud computing, that provides tailor-made physiotherapy that can be performed in homes.

Immediate feedback scores the number of right and wrong movements. The cost of the system is estimated at one tenth of that for facility-based physiotherapy. In the midst of all this exciting potential, I see several reasons for caution. First, medical decisions are complex. They depend on context and values such as care and compassion. I doubt that a machine will ever be able to imitate genuine human compassion. Second, machines can aid the work of doctors, organize, rationalize, and streamline the processes leading to a diagnosis or other medical decision, but artificial intelligence cannot replace doctors and nurses in their interactions with patients.

Third, we must consider the context and what it means for the lives of people. What good does it do to get an early diagnosis of skin or breast cancer if a country offers no opportunity for treatment, has no specialists or specialized facilities and equipment, or if the price of medicines is unaffordable for both patients and the health system? What happens if a diagnosis by smartphone app misses a symptom that signals a severe underlying disease?

Can you sue a machine for medical malpractice? Medicines and medical devices are heavily regulated, and with good reason. Medical schools are accredited. Doctors and nurses are licensed to practice and are often required to undergo continuing education. How do you regulate a machine programmed to think like a human? Regulatory issues must be solved before a new AI technology reaches the market. The reliability of wearable devices for monitoring cardiovascular performance is already being questioned.

Medical history is replete with examples of technologies that were eventually rejected because they created a false sense of safety and security. The mining of huge amounts of data raises serious issues of patient privacy and the sacrosanct confidentiality of medical records. This is another set of issues that must be addressed in advance. Finally, we need to keep in mind that many developing countries do not have a great deal of health data to mine.

These are countries that still do not have functioning information systems for civil registration and vital cause-of-death statistics. In short, the potential of AI in health care is huge, but so is the need to take some precautions. Sign up for WHO updates. Skip to main content. Search Search the WHO.