Wednesday, August 14, 2024

Cancer surgery reimagined

The ideas and innovators shaping health care
Aug 14, 2024 View in browser
 
Future Pulse

By Erin Schumaker, Toni Odejimi, Daniel Payne and Ruth Reader

INNOVATORS

A surgeon prepares to install the Cirq robotic arm of the Loop-X robotic-assisted surgery installation to secure his work on the spine of a patient affected by a metastatic breast cancer, on June 10, 2021 at the University-affiliated hospital (CHU) in Angers, western France. - The Loop-X robotic-assisted surgery installation is a premiere in Europe. (Photo by LOIC VENANCE / AFP) (Photo by LOIC VENANCE/AFP via Getty Images)

Improving cancer surgery is on ARPA-H's agenda. | AFP via Getty Images

From artificial intelligence tools to new fluorescent dyes to better identify blood vessels, researchers are putting federal money toward an ambitious goal: improving cancer surgery.

Totalling up to $150 million, the awards are meant to help surgeons remove tumors in a single operation. They went to:

— Dartmouth College, for a laparoscopic imaging tool for prostate cancer surgery, including 3D mapping and visualization.

— Johns Hopkins University, for non-invasive imaging to give surgeons a more colorful view of surgery. JHU is also using fluorescent dyes, combined with endoscopes, to help surgeons more easily see blood vessels and nerves, so they don't accidentally cut them.

— Rice University, for a microscope for imaging tumor slices and artificial intelligence algorithms to classify those cells.

— Tulane University, for a high-resolution and 3D system that allows surgeons to see tumors more clearly and for an AI algorithm to identify cancer cells and quickly classify them.

— University of California, San Francisco, for a microscope to help surgeons better see cancer cells and remove them before the end of surgical procedures, as well as a multi-cancer dying agent that's activated by enzyme activity in tumors.

University of Illinois Urbana-Champaign, for an imaging test to identify suspicious tissue structures after surgery.

— University of Washington, for a microscope system allowing surgeons to see the whole tumor surface and use AI to grayscale tumor images, so samples don't need to be physically dyed.

— Medical equipment company Cision Vision, for advanced imaging techniques to help surgeons see blood vessels, veins and the lymphatic system without using dye.

The White House announced the awards Tuesday.

"One of the most devastating words anyone can hear, and it's not hyperbole, is cancer," President Joe Biden said at a press conference in New Orleans on Tuesday. "Imagine cancer surgery that removes all the tumor the first time without harming healthy cells," Biden said.

The backstory: The awards stem from a call for proposals from the Advanced Research Projects Agency for Health last summer.

ARPA-H's Precision Surgical Interventions program is among a series of cancer-related initiatives the agency has funded in service of Biden's cancer moonshot, which aims to improve people with cancer’s lives, while slashing the cancer death rate by half over 25 years.

Why it matters: Nearly two million Americans are diagnosed with cancer each year, according to the American Cancer Society. Accidentally damaging healthy tissue can mean more operations, pain and extended hospital stays. Corrective procedures and treatments cost the U.S. more than $1 billion each year.

 

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WELCOME TO FUTURE PULSE

Holmenkollen, Norway

Holmenkollen, Norway | Shawn Zeller/POLITICO

This is where we explore the ideas and innovators shaping health care.

There’s a reason people feel older during their 40s and 60s, and according to The Washington Post it’s because the body’s molecules rapidly change during that time.

Share any thoughts, news, tips and feedback with Carmen Paun at cpaun@politico.com, Daniel Payne at dpayne@politico.com, Ruth Reader at rreader@politico.com, Erin Schumaker at eschumaker@politico.com, or Toni Odejimi at aodejimi@politico.com.

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AROUND THE NATION

More states want to follow California in securing permission from the Centers for Medicare and Medicaid Services to offer treatment to people with substance use disorders who are incarcerated.

CMS bars those services without a waiver, but Medicaid directors across the country, including North Carolina Deputy Secretary for NC Medicaid Jay Ludlam, seek exceptions.

Even though CMS lauded California’s program and urged states to follow suit, it’s been slow to approve more.

Toni spoke with Ludlam about his state’s plans and the waiting game.

This interview has been edited for length and clarity.

Why are you seeking a waiver?

We see just generally higher rates of health issues with justice-involved individuals. Seventy-five percent have substance use disorder of some kind. On top of that, based on some local studies we’ve done, we see that recently released individuals are 40 times more likely to suffer an opioid overdose.

Why can’t justice-involved individuals receive this treatment now?

There’s a prohibition. That probably goes to historical biases and a desire to potentially create cost containment, plus reluctance to have a Medicaid program spill into the prison setting generally.

What’s the timing?

We still are negotiating with CMS. Right now, we have seen a desire by the Biden administration to conclude the negotiations by the end of September.

What’s the delay?

A lot of it has just been thoughtful feedback from CMS, thoughtful pushback from North Carolina and commitment from CMS to put this on a time frame and get it done.

 

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FORWARD THINKING

A person holds a mobile phone.

Brain exercises on your phone could help with depression, their maker says. | George Frey/Getty Images

A new app could help relieve symptoms in people with major depressive disorder — but they’ll need a prescription to use it.

Rejoyn, a so-called digital therapeutic, includes six weeks of “brain exercises” in which patients try to recall sequences of faces with different emotional expressions and incorporates techniques from cognitive behavioral therapy — on the theory that it will better connect the part of the brain that processes emotions with the system that exerts cognitive control. The app also features personalized reminders and messages.

Rejoyn is meant to be used as an adjunct therapy for people with clinical depression who are taking antidepressant drugs.

The FDA has cleared — though not approved — the app based on a 13-week study with nearly 400 participants that found using it was associated with a reduction in depression symptoms.

Rejoyn’s makers, Otsuka Precision Health and Click Therapeutics, said they’ve received no reports of adverse events.

Why it matters: There’s significant demand among providers, patients and policymakers for new therapies for mental illnesses, especially depression and anxiety.

 

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