With genetics and environmental factors that can influence how the human body reacts to certain medications, today’s medicine seems to have a lot to learn yet. The most effective and desired way for the future is personalized medicine.
As we develop more and more technologies and testing abilities, we start to realize that there is no medicine capable of curing everyone with the same effects.
These types of personalized medicine aren’t as far as you would think. Some are already in use, while others should be in 5 to 10 years. And, with enough resources, they might be even closer than that.
Scientists are starting to unlock the ability to make medicine more useful for the person that they are treating through genome analysis.
What Is Personalized Medicine?
Personalized medicine, or precision medicine, is a medical model in which interventions, drugs, and decisions are customized to the patient based on a predicted risk or response that can be interpreted from DNA sequencing.
Since the human genome project was finished, the ability to sequence genomes has increased exponentially. In 2013, there were 62.000 known variants in the human genome; in 2018, it grew to 850.000.
Applications
Cancer is a leading cause of death worldwide. The search for drugs that can block the appearance of cancer cells has been going on for decades; that is where precision medicine shows promising aspects.
One of the applications that are currently in use against advanced cancer is T-cell therapy. T cells are taken from the patient, genetically modified, and then given back to the same patient.
This could make for better choices when given antibiotics because doctors would not have to make educated guesses anymore. Just take some blood samples and get a fast result of what bacteria or virus they are fighting against.
Treatments for Alzheimer’s, Parkinson’s, and others are plentiful, but a solution to slow them down considerably has yet to be discovered. Scientists are already working to identify the specific signs of these types of diseases, rather than waiting for the symptoms.
Getting your genome sequenced can be the only way to find out for sure what disease you really have. People can live for years with the disease, with no idea what exactly is wrong in their bodies. Rare diseases can be found much easier with personalized medicine.
Precision medicine might be close to pinpointing the genes that are guilty of causing epilepsy. When this is done, treatments will become more specific and reliable.
Priorities For Precision Medicine In The US
The Center for Disease Control has, at the moment, three priorities for the use of personalized medicine: familial hypercholesterolemia (high levels of cholesterol in the blood), hereditary breast, ovarian, and colon cancer.
The desire is to use these diseases to implement precision medicine as quickly as possible.
Also, there is a need to train healthcare workers and the population with screenings and databases. With these priorities in place, it is obligatory to implement the necessary tools throughout the United States of America.
Diagnosis
Precision medicine is already used for a more exact or early diagnosis. The possibility of having breast cancer can be identified by looking for a protein called HER2.
A blood test can be used in the near future to identify every type of stage 2 through 4 cancer that is in the body. These tests are cheaper and healthier than the PET scans that are in use today.
Some drugs are only approved for some types of cancer, but by looking at the genetic makeup of the tumor, doctors could identify that the best course of action would be to use unapproved drugs. People with diabetes can get personalized treatments in the future.
Right now, everyone is treated in the same way and gets the same diagnostic testing. We might be able to subcategorize type 2 diabetes and get specific treatments for everyone.
Advantages
The most significant advantage is the fact that it can diagnose diseases based on the patient’s unique variations in the human genome and not on symptoms. This way, treatment can be found without complications and with a higher chance of success.
By studying the human genome of the patient, the perfect dosage can be found for them. We are therefore reducing harmful effects while receiving all the benefits.
As we are starting to pass over the limitations of traditional medicine, personalized medicine can prevent diseases. This action can be done by sequencing the genome and predicting an illness’s susceptibility to happen during that person’s lifetime.
With that known, preventive steps can be taken to kill the disease before it even manifests. Surgeries and chemotherapy can be done to destroy cancer cells in their early days, or even before they start showing. Preventive medication might become a thing so that people can have a long and healthy life without taking into account any inclinations toward diseases that they have.
Knowing exactly which type of medication you should take will almost kill the idea of trial-and-error prescriptions. It can also be used to let people know if they should make changes in their lifestyle, what type of nutrition is best for them, and even what food they should or shouldn’t eat.
Knowing beforehand what your future could hold can be the right motivation to stick with the prescribed drugs and adopt a healthier alternative to living. With a sound system put in place, the healthcare system can significantly benefit from this. If patients are treated before the disease even starts, with a significant effects and no trial for the needed drug, the expenses will incur a considerable decrease.
Disadvantages
The biggest concern about personalized medicine that is mentioned every time someone speaks about it is patient privacy. With a database that knows what type of diseases you are most likely to have and can estimate how long you will live, people and companies will try to profit from it.
Insurance companies might refuse your application based on your predisposition or force you to show your genome to get one. They can make a system where they can charge people an amount of money that can vastly differ depending on what a calculator says your future health looks like.
Companies could choose not to hire some people if they don’t want to pay insurance for them. Even dating can become tricky. Soul mates will be searched by their genetic variations to give the best genes to your child.
What about diseases that have no treatment? Telling a person that there is a high probability of having, in the future, something that cannot be treated will cause substantial mental stress. The ability to know when you are likely to die might take away the reason to live for some people. Although it is seen as unethical to let someone know this kind of detail, they will be available and, as such, used.
Besides that, incorrect findings will always be a possibility. Expenses and mental stress can appear because of the genome or who knows what has not been read correctly.
With some massive flaws, personalized medicine could be able to create havoc in our society. Fortunately, most of these disadvantages can be fixed with strong regulatory laws.
Challenges And Limitations
It is clear that we need better and more efficient treatment and that we have gained a lot more scientific knowledge in the last few years than ever before. Positive results, on the other hand, had not seen an increase in clinical trials in that same period.
A lot of time and money will need to be invested in order to put to fruition all the research that we have done. Another point that should be taken more into account is the disparity that these findings might create in the future between different classes of the population.
As genetics are not the primary cause of chronic diseases and cancer, scientists have pointed out that there could be important improvements in public health by teaching a healthy lifestyle.
The healthcare system has limited experience in genetics. Healthcare providers need to be educated with specialized knowledge that is unknown to most of them. New education courses should be created to teach healthcare providers and the public alike about genetics.
Genetic counselors are the people who engage the patient before and after testing. For these types of tests to become mainstream, there need to be more genetic counselors.
Connecting Health Data
A transition to personalized medicine would need databases for every patient that can be accessed by multiple hospitals and laboratories. The problem is that the system currently in use organizes laboratory tests by the provider and is no longer efficient for the purpose that it now has to serve.
There are small companies that offer everything that is needed to switch to the new database system. But, for a good transition, the same database has to be used by the vast majority. That is why the state has to make and supervise the decision.
After that, data can be organized by patients and used to give a much better picture. As more and more patients are put into common health data, the better will be the results.
Conclusion
Still in its infancy, personalized medicine is an emerging approach that seeks to fix problems before even starting, rather than waiting for the symptoms and then trying to deal with the problem.
For faster implementation, the healthcare system and workers need to develop and learn ways to integrate personalized medicine into everyday uses. The early steps have been deciphered. We now need to put regulations in place and start treating people with the help of genome sequencing on a larger scale.