With the potential to completely revolutionize healthcare, personalized medicine is a custom-made approach that involves your genetic profile to make informed decisions about your disease prevention, diagnosis, and treatment.
Also called genomic/precision medicine, it is a multifaceted yet outstanding breakthrough in healthcare that highlights ways in which your disease risks are exclusive and dissimilar, just like your other, more apparent features, based on predilections imprinted into your genome – your set of genes – at birth, combined with your environment and lifestyle. Your genome is you in code; it is what makes you, inside and out.
Why do we need this? So far, whenever you’re diagnosed with a problem and prescribed a treatment, nobody asks ‘Is this therapy going to work for me?’. Because, what we healthcare providers go by nowadays are standard modes of therapy, which are sensible and safe, but don’t we all agree with the fact that the ‘one size fits all’ principle isn’t always perfectly sufficient? What actually goes on is a process of trial and error, with what on the line? Your life.
Cancers – the second leading causes of death – occur by mutations in your genetic profile. Even the slightest change can lead to very lethal forms of cancer – costing both life and money. But what mutation precisely – this was impossible to locate exactly until 2003, when the first successful complete human genome sequencing was accomplished.
Say, you’re diagnosed with melanoma – a form of skin cancer – but due to a less common mutation in B-RAF, a growth-promoting gene in your body regulating normal growth – making your disease different from the common forms, which harbor mutations in CDKN2A (cyclin-dependent kinase inhibitor 2A, a vital regulator of your cell division). What do you do then? Wouldn’t knowing the molecular basis of your disease be vital evidence for doctors looking for the most promising treatment plan for you? It can even change your future, just as it’s done some people’s, the most notable example being Angelina Jolie’s, the very famous actress made headlines about having undergone proactive double mastectomy soon after she discovered that her family harbored a BRCA1 (breast cancer-susceptibility gene 1) mutation in their genome, to depose her risks of acquiring breast cancer, which had 65% occurrence rate with the mutation.
Today, we’re all proud to proclaim that HIV/AIDS is now seen not as a death sentence but merely a chronic condition, all thanks to personalized medicine. Heart disease, infectious diseases, multiple sclerosis, and rheumatoid arthritis are also gradually making their way into our list of achievements!
Undoubtedly, our greatest treads are in cancer – especially melanoma – not only for risk valuation in healthy people, but also screening, diagnosis, prognosis, and even choosing remedies based on this information! We know of Stephanie Haney, who was diagnosed with stage 4 lung cancer and given Tarveca (erlotinib), which kept her tumors at bay for only three years. Only then did she learn that her tumor was ALK (anaplastic lymphoma kinase – another growth-promoting gene) positive, which prompted her doctor to shift her to Xalkori (crizotinib), a specifically developed ALK +ve tumor-targeting drug. The result? Her tumors were barely visible within three years!
Overwhelming, right? However, we all agree that we’re all different. You are NOT an average patient. You are to be understood before you are prescribed a treatment.
Unquestionably, there are yet a horde of barriers to be overtaken. Apart from cost, we have practical and ethical challenges regarding privacy, ownership, access, etc. Conclusively, once we have flexible payment systems, controlling strategies, inclusion of personalized medicine into medical school curricula, and patient awareness and demand, then and only then will personalized/genomic medicine become medicine.