I have been writing medical articles for the Seaford Star since about the time the paper began. I arrived in Seaford in December 1996. So it has been almost as long as I have been here. A lot has changed in medicine over the last 30 years.

One of the biggest changes is one that is not related to medications or medical procedures. It is related to patient records. Records have gone from completely handwritten to completely computerized in 30 years. You can now check in by computer, read physicians’ notes, and check lab results. However, no one can make fun of physicians’ handwriting anymore!

Another computer-related change is Telehealth. The COVID pandemic led to a lot of advances in the use of telemedicine. Some of that has continued. It is especially important in medically underserved areas like Sussex County.

The most interesting medical advances have come in the world of genetics. By 2003, the human genome was nearly completed. It took until August of 2023 to fully map it out. When my oldest grandchildren started attending college, I kept telling them that the future of medicine was pharmacogenomics.

Once we know what genes a person has, we can select the best medication for them. In the future, conditions that have multiple potential medication possibilities will be treated differently. For example, someone can see the physician for hypertension. The physician will be able to select the most effective medication with the fewest side effects specifically for that patient based upon their genetics.

We are already seeing that happen in cancer therapy. Genomic sequencing can be used to develop therapies that specifically target the patient’s cancers.

Moderna mRNA vaccines are based on a new technique that was first developed in the 1990’s. However, it was not stable. An advance in 2005 found how to make the technique stable. Moderna was founded in 2010. It showed its capabilities by producing the most effective COVID vaccine of the three that were developed. It will be the way of the future as long as political pressures do not get in the way.

CAR T-cell therapy is a big genetic advance. It takes the patient’s T-cells (one type of immune cell) and genetically alters them to have them seek out and destroy cancer cells. What most people do not realize is that most cancers start out as a cell mutation. The immune system is supposed to seek and destroy these abnormal cells. Sometimes that does not happen and the cancer grows. T-cells can help correct that immune mistake.

Medical imaging techniques have changed significantly in the last 30 years. PET scans look for hidden cancer. High field MRI allows earlier diagnosis. In addition, 3D Mammography can also do advanced diagnostics.

Robotic surgery has helped surgeons significantly. Surgeons can perform more complex surgery. They can have more precise small incisions. The result is a faster recovery time.

The list goes on and on. However, what is clear is that our advances have been beneficial to patients. The one real continuing issue is related to health insurance. You cannot take advantage of these things if you do not have the right health insurance. Even if you do, you need to make sure they approve what you need. This might be a problem worth solving in the next 30 years.