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Several Skidmore professors are doing fascinating work with

potentially profound medical implications, so Scope asked six of them to share a prediction about America’s health care future.

Think a cancer walk means fundraising? Think again. Chris Repka says walking, lifting weights, cycling, and other exercise should and will be a standard treatment in can- cer care and re habilitation. Certainly physical therapy helps patients regain strength and flexibility after surgery. But his re- search shows that aerobic, cardiovascular exercise after and even during chemo therapy and radiation is especially valuable as well. “Radiation and chemo kill cancer cells by causing them se-

vere oxidative stress,” Repka says, “and exercise helps healthy cells recover from just that kind of damage.” Post-treatment ane- mia is a common problem, but exercise speeds the body’s gener- ation of red blood cells. Cancer survivors often talk of “chemo brain—forgetfulness or fuzzy thinking that can linger for years afterward. We know that exercise stimulates not just blood flow to the brain but actual neuronal development.” One common and effective chemo drug is known to be so cardiotoxic that it can permanently weaken patients’ hearts. Repka’s lab rats show significantly reduced heart damage when they do even a little bit of exercise before, during, or after being dosed with this drug. His conclusion: “Ex- ercise is a way of treating the treatment.” Just as patients used to be told to take it

easy after a heart attack but are now given exercise programs, cancer patients may soon find exercise among their prescrip- tions. “Cancer exercise is growing but is still years behind cardiac rehab, in that it’s not part of the oncologist’s or surgeon’s or pri- mary-care doctor’s standard protocol and it’s not covered by in- surance. But it should be,” Repka says. The American College of Sports Medicine just created an official “cancer exercise special- ist” certification. As cancer treatments keep improving, more and more people

are living long-term with the aftereffects. “That’s a huge popula- tion that can benefit from cancer exercise rehab.”

our “prozac naTion” is a failed sTaTe, according to “extensive research showing that psychotropic drugs like antide- pressants are often no more effective than placebos,” says Andy Molteni. Studies are reviving the reputation of “talk therapy” as more efficacious than mood-altering pills. Molteni also points to “alarming research about the dangers of such drugs for chil- dren.” (He cites the too-frequent practice, when attention-deficit meds don’t work, of “rediagnosing the kids and switching them onto antipsychotic drugs, which have serious long-term risks.”) Reacting to the research, pharmaceutical companies aren’t

investing as much in new depression and anxiety drugs lately, Molteni says. He adds that as more states pass mental-health parity laws, more insurance companies will be required to cover psychological treatment costs as thoroughly as physical ones. He predicts, “We’ll be returning to more behavioral and cognitive

therapies, in offices and clinics as well as through exercises that patients can do on their own on smartphones and computers.” He sees this trend as crucial in addressing pediatric obesity.

“Being told to follow a new diet regimen isn’t enough. There are strong underlying reasons why people don’t stop certain behav- iors. People negotiate and embrace change differently and need different psychological supports during the process. There’s in- teresting research trying to identify interventions that best match the stages of thinking that kids and their families go through in changing their eating habits.” He adds that insur- ance plans are seeing the value of covering psychological sup- port in pediatric obesity, because the cost of covering lifelong adult obesity is far higher.

“Time and Time again,

medical innovaTion has reseT The sTandard for

whaT we can expecT from The healTh care sysTem and from human life.”

Big BroTher could save your life. From blood-pressure cuffs to EKGs, more and more equipment can send health data directly to a doctor’s computer or cell phone. This mobile e- medicine may be “the most exciting development in health care,” Denise Smith says. Consider chronic congestive heart disease. Blood pressure is crucial to manage, but it fluctuates frequently, so occasional readings in a doctor’s office (where it com- monly rises anyway) aren’t as informative as daily monitoring at home, to watch for trends and responses to medications. With a wireless link, a home blood-pressure gauge can transmit readings directly to a doctor’s office.

In her research on cardiovascular stress in firefighters, Smith

says, “we’ve helped develop a T-shirt with a sensor that monitors heart rate, breathing, and temperature.” As the little gizmo transmits over Bluetooth wireless, “we integrate the data to get a good overview of how the firefighter is recovering after work- ing.” Future firehouses could have baseline stats for each crew member on file, and then during or after a fire the shirt-sensor data could be collated and compared to track each firefighter’s cool-down and return to normal heart rate. The more telehealth can keep people out of hospitals, the

more health costs can drop. So Smith says, “Companies are in- vesting heavily in these technologies, and health care reform will drive this even more.” She predicts it’ll happen fast: “Once you figure out and devise a system, it’s relatively easy to expand it. For e-medicine, it’s just different sensors or diagnostics.” She sees this as a “monumental change, because it’s not just

for one condition or injury. It can change our whole approach to doctor’s visits, hospitalizations, home care—it’s a new para- digm for health care across the board.”

whaT color is your Body faT? That question may be “an important watershed for developing really novel therapies for obesity,” predicts T. H. Reynolds. Using PET scans and then biopsying the hot areas, Dana Farber Institute researchers have found that adults retain some adipose tissue that resembles the “brown fat” that babies have. Brown fat’s role is not to store en- ergy, as regular white fat does; instead, it burns energy to gener-

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