Amazing Breakthroughs

"It's phenomenal," Carron says. "It's the most gratifying procedure, because you get immediate feedback from patients."

Targeting Tumors

For decades, doctors have used radiation therapy to kill cancer cells. While often successful, radiation can cause lingering or painful side effects because it passes through normal organs and tissues in order to reach the cancer site. A common side effect is fatigue. Other side effects are specific to the cancer being treated. Patients with throat cancer may develop a dry mouth due to salivary gland damage. Breast cancer patients might develop burning of the skin or breast thickening from radiation.

Dr. Debra Freeman, a radiation oncologist at Raymond L. Lutgert Cancer Center in Naples, says an improved technology called intensity modulated radiation therapy, or IMRT, is reducing some of these side effects and may increase the cure rate of various cancers. Instead of radiation being delivered from a single "field" or beam, IMRT treatment targets the tumor more precisely by treating with multiple tiny beams. The radiation can also be "modulated" or adjusted so that the tumor receives a higher dose than surrounding tissue. Previously, doctors were limited by the damaging effects of radiation to healthy tissue; now, by increasing the radiation to the tumor, they may cure more patients.

IMRT can't be used in all cases, cautions Freeman, and patients can still experience side effects. "But it's an improvement over what we did previously," she says. "It's pretty cool technology."

More Miracles

Last year, the FDA approved another alternative for the just-turned-40 set who find that reading the newspaper requires a longer arm. Dr. James Croley of Naples says the latest procedure, called conductive keratoplasty (CK), corrects mild-to-moderate farsightedness-and, when performed only on one eye-can restore reading vision, too. (The treated eye will be the reading eye and the other eye will be used for distance.) Many doctors are finding it's a less risky procedure than the older LASIK surgery, which involves cutting a flap in the cornea before reshaping the cornea with a laser. CK uses radiofrequency waves, delivered through a fine probe in a pattern around the cornea, to reshape the cornea. "I did it myself a couple of months ago," says Croley. "I don't wear glasses or contacts." Does CK mean you'll never have to wear reading glasses? Unfortunately not. Our eyes continue to change as we get older. But, take heart. "You can have it repeated," says Croley.

Every day in Collier County, three to four people suffer strokes, says neurointerventional radiologist Dr. Gerald Grubbs. Until tPA was introduced in 1996, they had few options besides supportive care. The powerful drug dissolves obstructions in blood vessels, minimizing damage to brain cells. For best results, however, patients must be treated within 90 minutes of the stroke and not later than within three hours. Grubbs says a new, more effective form of delivering tPA called intra-arterial revascularization (IAR) gives doctors and patients six to 24 hours in which to be treated, depending on the type of stroke. Now, when doctors detect a brain clot through scans in the emergency room, they can pinpoint its exact location and place a catheter within the clot to administer the "clot-busting" drug right at the source.

Only two percent of all stroke patients ever receive tPA, however, because most ignore the signs of stroke for too long. "It's critical to get to an emergency room right away if you suspect you are having a stroke," says Grubbs.

Sometimes people with perfectly normal cholesterol levels suffer heart attacks and strokes. Doctors used to wonder how they could identify these people and others at risk. Now they have another indicator. Called C-reactive protein (CRP), it detects inflammation within the body-when the plaque in our vessels becomes inflamed, it can erupt, causing a clot-and can help predict not just which patients, but when patients are about to have a stroke or heart attack. Dr. James Talano, director of cardiology of Cleveland Clinic Florida in Naples, says doctors can tell patients the likelihood of having an event within the next 30 days to 10 years based on CRP results and can prescribe various drugs to reduce the risk. Right now, because of cost, CRP is only used on patients who have already suffered a stroke, heart attack or other vascular event or have other red flags that make them look like candidates. But CRP, he says, is potentially useful for all of us.

By now, everyone has heard of Botox. Plastic surgeons inject it into the muscles of the face to get rid of frown lines. But urologists think Botox may also work to treat the overactive bladder, a spastic muscle condition where patients are urinating more than eight times a day and more than twice at night with an urgency that they can't control. Because Botox temporarily paralyzes or weakens muscles, it shows great promise, says urinary incontinence specialist Dr. Jonathan Jay of Naples, who is involved in a research protocol to study its effectiveness.

About 17 million Americans are affected by this condition-think of those drugstore aisles stocked with adult diapers. It's caused by aging, neurological conditions or for no reason doctors can discern. In the past, most people have assumed it is a natural part of aging and have decided to live with it or have been too embarrassed to discuss it with their doctors.

Drugs used to treat incontinence can cause dry mouth and constipation. Botox, injected directly into some of the muscles of the bladder, causes muscles to relax without either of these annoying side effects, Jay says. The improvement in the condition lasts anywhere from four to nine months. Urologists are also beginning to use it for urinary retention.

Psoriasis, a condition that causes thick, red scaly patches on the skin, affects seven million people in this country. About 80 percent have psoriasis on 10 percent or more of their body. Besides itchiness, the biggest complaint doctors hear is that it's embarrassing, says Dr. Charles Camisa, the senior staff dermatologist for the Cleveland Clinic Florida. Steroid creams and sunlamps were once the treatments of choice. But recently researchers have dissected ultraviolet light into its individual wavelengths, and they have discovered that one particular wavelength of the spectrum can successfully treat many cases without the risk of sunburn. Camisa also says new drugs, "designer molecules," that actually tamper with a specific part of the immune system and block the inflammation, are also proving to be more successful and less risky. They're expensive right now, he says, but for patients who may have despaired of improving their condition, "It's like a holiday."