Imagine it's the year 2040 and you're due for your regular health checkup. Time to schedule your next colonoscopy, Pap smear if you're a woman, and prostate screen if you're a man.
"The evolution of the biological ion transistor technology is a game changer."
But wait, you no longer need any of those, since you recently got one of the new biomed implants – a device that integrates seamlessly with body tissues, because of a watershed breakthrough that happened in the early 2020s. It's an improved biological transistor driven by electrically charged particles that move in and out of your own cells. Like insulin pumps and cardiac pacemakers, the medical implants of the future will go where they are needed, on or inside the body.
But unlike current implants, biological transistors will have a remarkable range of applications. Currently small enough to fit between a patient's hair follicles, the devices could one day enable correction of problems ranging from damaged heart muscle to failing retinas to deficiencies of hormones and enzymes.
Their usefulness raises the prospect of overcorrection to the point of human enhancement, as in the bionic parts that were imagined on the ABC television series The Six Million Dollar Man, which aired in the 1970s.
"The evolution of the biological ion transistor technology is a game changer," says Zoltan Istvan, who ran as a U.S. Presidential candidate in 2016 for the Transhumanist Party and later ran for California governor. Istvan envisions humans becoming faster, stronger, and increasingly more capable by way of technological innovations, especially in the biotechnology realm. "It's a big step forward on how we can improve and upgrade the human body."
How It Works
The new transistors are more like the soft, organic machines that biology has evolved than like traditional transistors built of semiconductors and metal, according to electric engineering expert Dion Khodagholy, one of the leaders of the team at Columbia University that developed the technology.
The key to the advance, notes Khodagholy, is that the transistors will interface seamlessly with tissue, because the electricity will be of the biological type -- transmitted via the flow of ions through liquid, rather than electrons through metal. This will boost the sensitivity of detection and decoding of biological change.
Naturally, such a paradigm change in the world of medical devices raises potential societal and ethical dilemmas.
Known as an ion-gated transistor (IGT), the new class of technology effectively melds electronics with molecules of human skin. That's the current prototype, but ultimately, biological devices will be able to go anywhere in the body. "IGT-based devices hold great promise for development of fully implantable bioelectronic devices that can address key clinical issues for patients with neuropsychiatric disease," says Khodagholy, based on the expectation that future devices could fuse with, measure, and modulate cells of the human nervous system.
Naturally, such a paradigm change in the world of medical devices raises potential societal and ethical dilemmas, starting with who receives the new technology and who pays for it. But, according clinical ethicist and health care attorney David Hoffman, we can gain insight from past experience, such as how society reacted to the invention of kidney dialysis in the mid 20th century.
"Kidney dialysis has been federally funded for all these decades, largely because the who-gets-the-technology question was an issue when the technology entered clinical medicine," says Hoffman, who teaches bioethics at Columbia's College of Physicians and Surgeons as well as at the law school and medical school of Yeshiva University. Just as dialysis became a necessity for many patients, he suggests that the emerging bio-transistors may also become critical life-sustaining devices, prompting discussions about federal coverage.
But unlike dialysis, biological transistors could allow some users to become "better than well," making it more similar to medication for ADHD (attention deficit hyperactivity disorder): People who don't require it can still use it to improve their baseline normal functioning. This raises the classic question: Should society draw a line between treatment and enhancement? And who gets to decide the answer?
If it's strictly a medical use of the technology, should everyone who needs it get to use it, regardless of ability to pay, relying on federal or private insurance coverage? On the other hand, if it's used voluntarily for enhancement, should that option also be available to everyone -- but at an upfront cost?
From a transhumanist viewpoint, getting wrapped up with concerns about the evolution of devices from therapy to enhancement is not worth the trouble.
It seems safe to say that some lively debates and growing pains are on the horizon.
"Even if [the biological ion transistor] is developed only for medical devices that compensate for losses and deficiencies similar to that of a cardiac pacemaker, it will be hard to stop its eventual evolution from compensation to enhancement," says Istvan. "If you use it in a bionic eye to restore vision to the blind, how do you draw the line between replacement of normal function and provision of enhanced function? Do you pass a law placing limits on visual capabilities of a synthetic eye? Transhumanists would oppose such laws, and any restrictions in one country or another would allow another country to gain an advantage by creating their own real-life super human cyborg citizens."
In the same breath though, Istvan admits that biotechnology on a bionic scale is bound to complicate a range of international phenomena, from economic growth and military confrontations to sporting events like the Olympic Games.
The technology is already here, and it's just a matter of time before we see clinically viable, implantable devices. As for how society will react, it seems safe to say that some lively debates and growing pains are on the horizon.
Imagine a man with colorectal cancer that has spread throughout his body. His tumor is not responding to traditional chemotherapy. He needs a radically effective treatment as soon as possible and there's no time to wait for a new drug or a new clinical trial.
A plethora of novel combinations of treatments can be screened quickly on as many as 400,000 flies at once.
This was the very real, and terrifying, situation of a recent patient at Mount Sinai Medical Center in New York City. So his doctors turned to a new tactic to speed up the search for a treatment that would save him: Fruit flies.
Yes, fruit flies. Those annoying little buggers that descend on opened food containers are actually leading scientists to fully personalized cancer treatments. Oncology advances often are more about about utilizing old drugs in new combinations than about adding new drugs. But classically, the development of each new chemotherapy drug combination has required studies involving numerous patients spread over many years or decades.
With the fruit fly method, however, a novel treatment -- in the sense that a particular combination of drugs and the timing of their administration has never been used before -- is developed for each patient, almost like on Star Trek, when, faced suddenly with an unknown disease, a futuristic physician researches it and develops a cure quickly enough to save the patient's life.
How It Works
Using genetic engineering techniques, researchers produce a population of fruit fly embryos, each of which is programmed to develop a replica of the patient's cancer.
Since a lot of genetically identical fly embryos can be created, and since they hatch from eggs within 30 hours and then mature within days, a plethora of novel combinations of treatments can be screened quickly on as many as 400,000 flies at once. Then, only the regimens that are effective are administered to the patient.
Biotech entrepreneur Laura Towart, CEO of the UK- and Ireland-based company, My Personal Therapeutics, is partnering with Mount Sinai to develop and test the fruit fly tactic. The researchers recently published a paper demonstrating that the tumor of the man with metastatic colorectal cancer had shrunk considerably following the treatment, and remained stable for 11 months, although he eventually succumbed to his illness.
Cancer is in fact many different diseases, even if it strikes two people in the same place, and both cancers look the same under a microscope. At the level of DNA, RNA, proteins, and other molecular factors, each cancer is unique – and may require a unique treatment approach.
Determining the true impact on cancer mortality will require clinical trials involving many more patients.
"Anatomy of a cancer still plays a major role, if you're a surgeon or radiation oncologist, but the medical approach to cancer therapy is moving toward treatments that are personalized based on other factors," notes Dr. Howard McLeod, an internationally recognized expert on cancer genetics at the Moffitt Cancer Center, in Tampa, Florida. "We are also headed into an era when even the methods for monitoring patients are individualized."
One big unresolved question about the fruit fly screening approach is how effective it will be in terms of actually extending life. Determining the true impact on cancer mortality will require clinical trials involving many more patients.
Using machine learning and artificial intelligence, Towart is now working to build a service called TuMatch that will offer rapid and affordable personalized treatment recommendations for all genetically driven cancers. "We hope to have TuMatch available to patients with colorectal/GI cancers by January 2020," she says. "We are also offering [the fruit fly approach] for patients with rare genetic diseases and for patients who are diabetic."
Are Towart's fruit flies the answer to why the man's tumor shrunk? To be sure, the definitive answer will come from further research that is expected soon, but it's also clear that, prior to the treatment, there was nothing left to do for that particular patient. Thus, although it's early in the game, there's a pretty good rationale for optimism.
"That's one small step for man; one giant leap for mankind."
This July 20th marks fifty years since Neil Armstrong, mission commander of NASA's Apollo 11, uttered those famous words. Much less discussed is how Project Apollo shifted lunar science into high gear, ultimately teaching scientists just how valuable the Moon could become.
A lunar-based solar power system would actually be cheaper than Earth-based solar power implemented on a global scale.
During the six missions that landed humans on the lunar surface from 1969 to 1972, Apollo astronauts collected some 842 pounds of lunar rocks and dirt. Analysis of these materials has provided us with major clues about the origin of Earth's celestial companion 4.51 billion years ago, but also has revealed the Moon is a treasure trove. Lunar rock contains a plethora of minerals with high industrial value. So let's take a look at some prime examples of how humanity's expected return to the lunar surface in the years to come could help life here on Earth.
24/7 solar energy for Earth
During the 1970s, scientists began examining the Apollo lunar samples to study how the lunar surface could be used as a resource. One such scientist was physicist David Criswell, who has since shown that a lunar-based solar power system would actually be cheaper than Earth-based solar power implemented on a global scale. Whoa! How is that possible, given the high cost of launching people and machines into space?
The key is that it would be enormously expensive to scale up enough Earth-based solar power to supply all of humanity's electrical needs, since solar power on such a scale would require a lot of metal, glass, and cement.
But the Moon's lack of atmosphere and weather means that photovoltaic cells built by robots from lunar materials can be paper thin, in contrast with the heavy structures needed in Earth-based solar arrays. Ringing the Moon, such a system would be in perpetual sunlight, making it cheaper to collect solar power there and beam it down to Earth in the form of microwaves.
A source of helium-3 for clean, safe nuclear fusion power and other uses
The gas helium-3 is extremely rare on Earth, but plentiful on the Moon, and could be used in advanced nuclear fusion reactors. Helium-3 also has anti-terrorism and medical uses, especially in the diagnosis of various pulmonary diseases.
A place to offload industrial pollution
Since there are minerals and oxygen in lunar rocks and dust, and frozen water in certain locations, the Moon is an ideal home for factories. Thus, billionaire Jeff Bezos has proposed relocating large segments of heavy industry there, reducing the amount of pollution that is produced on Earth.
The Moon could be a place for colonists to get their space legs before humans put down roots on more distant locations like Mars.
Radio Astronomy without interference from Earth
Constructed on the Moon's far side (the side of the Moon that always faces away from Earth), radio telescopes advancing human knowledge of the Cosmos, and searching for signals from extraterrestrial civilizations, could operate with increased sensitivity and efficiency.
Using the Moon as a destination for tourists may not sound helpful initially, given that only the very wealthy would be able to afford such journeys in the foreseeable future. However, the economic payoff could be substantial in terms of jobs that lunar tourism could provide on Earth. Furthermore, short of actual tourism, companies are gearing up to provide lunar entertainment to fun-seekers here on Earth in the form of mini lunar rovers that people could control from their living rooms, just for fun.
Similar to lunar tourism, lunar colonization sounds initially like a development that would help only those people who go. But, located just three-days' travel from Earth, the Moon would be an excellent place for humanity to become a multi-planet species. The Moon could be a place for colonists to get their space legs before humans put down roots on more distant locations like Mars. With hundreds or thousands of humans thriving on the Moon, Earthlings might find some level of peace of mind knowing that humanity is in a position to outlive a planetary catastrophe.