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Personalized Medicine

June 16, 2016

As medical science marches forward, the prospect of personalized medicine becomes more exciting than ever. The basis is simple – treat patients according to their specific disease, drug sensitivities, and genetic makeup. Different diagnostic tools are used to determine the unique needs of each patient, allowing doctors to select appropriate treatment regimens with less guesswork.

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“lol pick one” – Morpheus

It sounds like kind of a “duh” thing, right? Well, that’s because it is. In fact, the concept of personalized medicine dates all the way back to Hippocrates, who assessed the four “humors” of blood, phlegm, yellow bile, and black bile to determine the best course of action for his patients. The idea was revolutionary, but medical technology just wasn’t ready to execute it effectively. (Obviously).

Now, because we live in the FUTURE, we use something called genome sequencing to analyze the unique genetic makeup of a patient. This provides us with information about their DNA – which can be immensely helpful in detecting and treating disease. Perhaps more importantly, it can actually help prevent disease by identifying risk factors in each patient. And since your genome is more or less static, most people would only need to have it done once. Their sequence could be referenced later if they develop a new disease, become resistant to a drug, or are being considered for new drug treatments.

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Cheers to that

Cancer is the perfect poster child for personalized medicine. One of the most prominent examples is a hereditary form of breast cancer caused by mutations in the BRCA1 and BRCA2 genes that predispose women to high risk of breast and ovarian cancer. Genome sequencing allows for early detection, proactive disease prevention, and diligent screening regimens. In addition, about 20-30% of breast cancer patients have mutations causing over-expression of the protein HER2. This *specific* type of cancer can be effectively treated with a drug called Trastuzumab. Therefore, genome sequencing helps doctors know whether Trastuzumab treatment is worthwhile, or if they need to proceed directly to other options.

Cancer is a huge example, but by no means the only kind of disease that would benefit from personalized medicine. Identifying risk factors associated with cardiovascular disease and hypertension can help people make smarter lifestyle choices. Antidepressant dosages can be honed based on an individual’s response, metabolism, and adverse reactions to specific drug combinations. Aging diseases like Alzheimer’s and Parkinson’s could be detected earlier, and early intervention could postpone onset, improve quality of life, and perhaps even extend lifespan. I should mention that it’s not a silver bullet, though. Just knowing the sequence of your genes doesn’t mean we know how to cure everything – but more on that in my next post. Which I know you’re all dying for because you are amazing humanoids who loves swear words and knowledge, just like me. 😉

But I digress. Anyway – overall, personalized medicine sounds like a slam dunk. Right? Well… kinda.

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Not only would widespread application of personalized medicine be crazy expensive, it would also be controversial. First of all, although sequencing technology becomes faster and cheaper every day, it’s still hella pricey. I don’t know about you, but my itemized medical bills are more ridiculous than a Ticketmaster checkout these days. I swear there are fees for other fees – and a service charge for the person who compiled the fees. Something like genome sequencing, which actually DOES cost of a lot of money, would generate thousands of dollars in bills that neither the patient nor the insurance company want to pick up.

Which leads me to the next, sorta conspiracy-theory problem – fear of insurance discrimination. If a person has certain genetic predispositions or risk factors, could insurance companies choose not to cover them? Would their premiums be higher because they’re “riskier” clients? Theoretically this is illegal, but there will be a big grey area until regulations and legislation can be nailed down. Also, how can we ensure confidentiality and privacy for a person’s genetic code? The data files will be so large, they’ll have to be stored in this “cloud” thing everyone keeps talking about – aka the internet – aka the safest place ever.

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Heh.

Of course I would love to say that all of this is phooey nonsense, but we have to face the realities if we want personalized medicine to work. Like almost all revolutionary technology, genome sequencing is a double edged sword. Glorious access to our unique genetic information can be used for good (medicine) or for evil (discrimination). Just like splitting atoms creates access to cheap, clean energy, it also makes bombs. If Spiderman has taught me ANYTHING, it’s that with great power comes great responsibility. But I think the benefits of personalized medicine are going to far outweigh the risks, which is why scientists are striving so hard to make this happen.

But yes – routine genome sequencing will be a reality someday, which is amazing because scientists will be able to use that wealth of information to discover new cures, develop new drugs, and learn more about how diseases happen. Knowledge is power! It’s a really freaking cool time to be alive, guys.

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From → Biology

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  1. What is Genome Sequencing? | FABstracts

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