Drug Information Q&A Q42. Are there any diseases that can now be treated with drugs without surgery?
Answer
Today, most gastric ulcers and duodenal ulcers can be treated with drugs instead of surgical resection.
Explanation
If patients can be cured with drugs without surgery, it will be much easier for them physically, mentally, and financially.
Some drugs have realized or have the potential to realize such patients' expectations. For example, a drug for peptic ulcers has been a breakthrough.
H2 blockers treat ulcers by suppressing histamine-induced gastric acid secretion. PPIs, on the other hand, treat ulcers by suppressing the function of the proton pump, which is responsible for stomach acid secretion. PPIs have a powerful effect in suppressing stomach acid and are considered the ultimate stomach acid suppressants.
These two drugs have drastically reduced the number of surgeries for peptic ulcers, and it is said that "a surgical disease has become a medical disease.
Another example is cyclosporine, an immunosuppressant drug.
The current best treatment for aplastic anemia caused by a disorder of the hematopoietic system of the bone marrow is bone marrow transplantation.
However, donors matching the white blood cell type (HLA) are so rare that only one in four siblings will donate bone marrow, and only one in hundreds to tens of thousands for the rest. For this reason, bone marrow banks have been established and efforts are being made to secure donors.
Under such circumstances, immunosuppressive drugs are now being used for treatment prior to transplantation.
Originally, these drugs were used to control rejection after transplant surgery. The drugs are helping to reduce autoimmune dysfunction and improve aplastic anemia.
Chart/Column
42｜Peptic Ulcer Drugs
Source: Adapted from "Medical Pharmacology to Understand Prescription" (Gakken/Yasuhiro Nakahara).
MINI Column Bone Marrow Transplantation
Blood diseases such as leukemia and aplastic anemia once had no effective treatments. Now, however, bone marrow transplantation has opened the way to a cure.
In a bone marrow transplant, abnormal bone marrow cells that cause disease are killed by anticancer drugs or radiation, and then bone marrow fluid from a donor is injected intravenously to restore hematopoietic cell function. Every year, approximately 2,000 people need a bone marrow transplant. For this reason, a bone marrow bank has been established and calls for donor registration are constantly being made.
As of September 30, 2013, there were 436,998 registered donors and 2,896 registered recipients awaiting transplantation, bringing the total number of bone marrow transplants actually performed to 16,083.
(Source: Japan Marrow Donor Program "Current Status of Bone Marrow Donor Program")
In addition to bone marrow transplantation, peripheral blood stem cell transplantation and cord blood transplantation are also performed. Peripheral blood stem cell transplants do not require general anesthesia and have the advantage of rapid hematopoietic recovery after transplantation.
In addition, frozen blood can be stored, making it possible to perform transplants in a timely manner.
(Source: Japan Cord Blood Bank Network, "Number of Cord Blood Transplants Per Month")
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