
Cyfrowy bliźniak, który uratuje Ci życie | Mikołaj Frankiewicz | TEDxGdansk
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The speaker, a urologist, begins by recounting a dangerous encounter with a viper paddletail, symbolizing his initial lack of knowledge about significant threats. This leads to a discussion about the evolution of medicine from symptom-responsive to disease-predictive, driven by advancements in technology and the creation of "digital twins" for patients.
A decade ago, hospitals began implementing digital documentation, and today, gigabytes of patient data are generated daily, forming these digital profiles. Collaborating with Professor Benjamin Breer's team at the University of California, a leader in prostate cancer research with extensive databases, highlighted both the wealth of information and significant data gaps. Analyzing data from over 150,000 prostate cancer patients over 30 years revealed that crucial life events impacting disease recognition often occur outside of clinical settings. Technology is now being employed to fill these gaps.
The speaker notes that surgical specialties, including urology, are still struggling to keep pace with diseases. He humorously describes how men often delay urological consultations until prompted by women, emphasizing that urology also addresses diseases affecting women, such as kidney, ureter, and bladder cancers. He points out that inhaled toxins, like those from tobacco smoke, are filtered by the kidneys and can damage the urinary tract, with bladder cancer being a major beneficiary of nicotine. The rise of e-cigarettes is compared to the historical introduction of asbestos-laced cigarette filters, suggesting potential future health concerns.
Focusing on prostate cancer, the speaker acknowledges the fear men have of the digital rectal exam but reassures them that non-invasive PSA tests are increasingly used for diagnosis. Prostate cancer, a slow-developing disease affecting millions annually, offers time and a large patient pool for developing and implementing digital patient models.
Two patient examples illustrate this progress. In 1980, a man with undiagnosed prostate cancer died due to late detection. Today, his son, presenting with an elevated PSA, undergoes an MRI for a detailed anatomical map, followed by a fusion biopsy of a precisely located tumor. Further testing with PET PSMA confirms the disease is localized, leading to robot-assisted surgery. Pre-operative practice on the patient's anatomy and digital recording of surgical movements enhance precision and training.
Despite these advancements, the speaker highlights that even with precise detection of a 10mm tumor (a billion cells), the disease has progressed significantly. The concept of liquid biopsy, detecting as few as 50 cells circulating in the blood, is the next frontier. A research team at the Medical University of Gdańsk has developed the first publicly available atlas of circulating cells in prostate cancer, a critical step in identifying metastatic disease.
The speaker also touches upon managing complications like stress urinary incontinence after surgery, where reconstructive techniques using cheek mucosa grafts are employed. Future urology treatments include electronic artificial urethral sphincters and microscopic bladder sensors, providing continuous monitoring. The challenge now is integrating this vast data into a secure digital twin.
Returning to the snake analogy, the speaker stresses that in health, luck is not a strategy. Unlike the saying "what doesn't kill you makes you stronger," illness often weakens individuals silently. He encourages proactive health management by promoting a free, online prevention program in Poland. The future of medicine is personalized and technologically advanced, but the initial step towards better health is individual responsibility.