Cancer and obesity treatments on brink of major breakthroughs in 2024

As 2023 celebrated a new era of cancer care and obesity-battling super drugs, a new year in health care promises even more lightning-paced developments in preventative treatments and longevity science to extend human life.

Cancer treatment has made strides with the use of DNA traces, artificial intelligence (AI) and new medical techniques, while experts hope the way obesity is looked at by insurance companies could go a long way to addressing the problem in 2024.

Here, The National takes a look at what progress has been made – and what we can look forward to over the next 12 months.

Cancer

Liquid biopsies have been shown to catch returning breast cancer in recovering patients by identifying DNA trace elements in the blood, with more cells indicating advanced cancer.

Research under way at Weill Cornell Medicine in New York is exploring whether the same techniques could accurately locate breast cancer cells to potentially transform early screening.

Dr Humaid al Shamsi, head of Emirates Oncology Society, said breakthroughs in the way cancer is spotted and treated are accelerating, leading to better patient outcomes.

“Pancreatic cancer is one of the most lethal forms of cancer,” he said.

“Often, it eludes detection until it has already begun spreading, resulting in a survival rate of less than 5 per cent over five years.

Dr Humaid Al Shamsi, consultant medical oncologist and president of the Emirates Oncology Society. Photo: Burjeel Medical City

“However, at the University of California San Diego School of Medicine, researchers have made a significant breakthrough. They have developed a test that in a recent study successfully identified 95 per cent of early-stage pancreatic cancers.

“This research elucidates how biomarkers within extracellular vesicles, tiny particles that facilitate communication between cells, were utilised to detect pancreatic, ovarian, and bladder cancers at stages I and II.”

Scientific breakthrough

In the first three months of 2023 there were new approvals for targeted therapies for B-cell malignancies, colorectal cancer, paediatric brain cancer and hormone receptor-positive breast cancers.

From April to June, new modified stem cell therapies based on umbilical cord blood were approved for use, while in the second half of 2023 there were further breakthroughs in treatments for more targeted therapies, including for prostate cancer, some lung cancers and paediatric cancers.

The advancements allowed doctors to give more precise and effective cancer therapies.

One of the most significant developments in medicine for the region in 2023 was the FDA granting approval for the world’s first medicine based on Crispr gene editing technology – Casgevy.

The treatment for sickle-cell disease and transfusion dependent beta-thalassaemia, both of which cause blood cells to carry less oxygen and are common in the Middle East, was a breakthrough in genetic medicines.

“There is a wave of novel advances in therapeutics in the field aiming to either completely cure this genetic disorder or modify the disease in such way to improve the anaemia and significantly reduce the requirement for transfusion therapy,” said Prof Khaled Musallam, who designed the trial for Casgevy.

“Curative therapies include gene-manipulation techniques by either inserting a new correct version of the gene into the human DNA to produce the missing haemoglobin, or gene editing to correct or support the faulty gene unable to produce haemoglobin.”

Obesity cure

One of the biggest health issues in the UAE, obesity, is also in line for a major step forward in the approach to treatment.

Defined as someone with a body mass index above 30kg per metre squared, 17.8 per cent of the UAE population is reported as obese.

Dr Brian Mtemererwa in his clinic at the NMS Royal Hospital in Sharjah. Pawan Singh / The National

At the National Obesity Conference in Abu Dhabi in November, a two-day meeting attended by ministry officials, doctors said there was a groundswell of support for insurers to recognise obesity as a disease.

“Looking to 2024, I am hoping our insurance providers will begin to accept obesity as a disease,” said Dr Brian Mtemererwa, consultant endocrinologist at NMC Royal Hospital Sharjah.

“It's recognised worldwide as a disease, but insurance is not covering these drugs unless someone has diabetes.

“Not only that, insurers will only want to pay if the diabetes is sub-optimally controlled, or if it is poorly controlled.”

Metabolic drugs used to control diabetes, such as Ozempic and Mounjaro, soared in popularity in 2023, as more people turned to the medication to lose weight.

The medications work by mimicking naturally occurring hormones, slowing digestion and supressing appetite.

Dr Mtemererwa said the drugs could give the UAE a golden ticket out of a future health crisis.

“Insurers and patients need to become aware that obesity requires the same attention as any other medical condition that takes them to a hospital,” Dr Mtemererwa said.

“There are plans under way where the government is trying to lobby healthcare funders to ensure they accept obesity as a disease that requires equal attention and funding to prevent extensive complications.”

As technology improves, more patients are being treated remotely, with doctors now able to monitor patient signs and symptom from afar. This has certain benefits, such as keeping the infirm away from other vulnerable groups receiving hospital care, and improving access.

“These technologies have the potential to offer remote consultations, improve patient monitoring, and facilitate medical education,” said Dr Shanila Laiju, group chief executive for Medcare Hospitals and Medical Centres.

“Even though we have resumed face-to-face patient healthcare services since the pandemic, we continue to notice many patients prefer virtual healthcare services.”

Longevity science

Hospitals also reported growth in conventional anti-aging and longevity markets in the GCC, which now accounts for 67 per cent of the total healthcare sector.

Meanwhile, the UAE continues to grow its medical tourism sector, which was forecast to reach Dh19.5 billion in 2023, an annual growth of 10.7 per cent.

Dr Pouya Farhadi, medical director and aesthetic specialist at Skin111 Medical Centre, said health care has seen a dramatic shift to preventative measures in 2023.

“This transformation is reflected in the rise of regenerative medicine, functional medicine, and wellness initiatives, marking a departure from traditional models centred solely around symptom management,” Dr Farhadi said.

“Regenerative medicine holds promise in treating orthopaedic and cardiovascular diseases, neurological disorders, and even autoimmune conditions.

“While research in these areas is ongoing, the potential for regenerative medicine to revolutionise health care is evident, offering personalised and regenerative solutions that target the root causes of illnesses.”

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Position: legal consultant with Al Rowaad Advocates and Legal Consultants.

Mercer, the investment consulting arm of US services company Marsh & McLennan, expects its wealth division to at least double its assets under management (AUM) in the Middle East as wealth in the region continues to grow despite economic headwinds, a company official said.

Mercer Wealth, which globally has $160 billion in AUM, plans to boost its AUM in the region to $2-$3bn in the next 2-3 years from the present $1bn, said Yasir AbuShaban, a Dubai-based principal with Mercer Wealth.

“Within the next two to three years, we are looking at reaching $2 to $3 billion as a conservative estimate and we do see an opportunity to do so,” said Mr AbuShaban.

Mercer does not directly make investments, but allocates clients’ money they have discretion to, to professional asset managers. They also provide advice to clients.

“We have buying power. We can negotiate on their (client’s) behalf with asset managers to provide them lower fees than they otherwise would have to get on their own,” he added.

Mercer Wealth’s clients include sovereign wealth funds, family offices, and insurance companies among others.

From its office in Dubai, Mercer also looks after Africa, India and Turkey, where they also see opportunity for growth.

Wealth creation in Middle East and Africa (MEA) grew 8.5 per cent to $8.1 trillion last year from $7.5tn in 2015, higher than last year’s global average of 6 per cent and the second-highest growth in a region after Asia-Pacific which grew 9.9 per cent, according to consultancy Boston Consulting Group (BCG). In the region, where wealth grew just 1.9 per cent in 2015 compared with 2014, a pickup in oil prices has helped in wealth generation.

BCG is forecasting MEA wealth will rise to $12tn by 2021, growing at an annual average of 8 per cent.

Drivers of wealth generation in the region will be split evenly between new wealth creation and growth of performance of existing assets, according to BCG.

Another general trend in the region is clients’ looking for a comprehensive approach to investing, according to Mr AbuShaban.

“Institutional investors or some of the families are seeing a slowdown in the available capital they have to invest and in that sense they are looking at optimizing the way they manage their portfolios and making sure they are not investing haphazardly and different parts of their investment are working together,” said Mr AbuShaban.

Some clients also have a higher appetite for risk, given the low interest-rate environment that does not provide enough yield for some institutional investors. These clients are keen to invest in illiquid assets, such as private equity and infrastructure.

“What we have seen is a desire for higher returns in what has been a low-return environment specifically in various fixed income or bonds,” he said.

“In this environment, we have seen a de facto increase in the risk that clients are taking in things like illiquid investments, private equity investments, infrastructure and private debt, those kind of investments were higher illiquidity results in incrementally higher returns.”

The Abu Dhabi Investment Authority, one of the largest sovereign wealth funds, said in its 2016 report that has gradually increased its exposure in direct private equity and private credit transactions, mainly in Asian markets and especially in China and India. The authority’s private equity department focused on structured equities owing to “their defensive characteristics.”