It’s back to school, and we know a well-nourished child/teen will be able to pay attention to the instruction and perform better. Some experts say universal free meals are as important as books and school supplies for our children — the future of our nation.
Q I’ve been around the medical center lately, trying to support a family member undergoing treatment for cancer. I have heard the term “precision medicine.” Can you help me understand what that is? — JK, Greenville
A As you know, I write mostly about food and nutrition. And I think it is important to talk about precision nutrition. So, Aaron Phillips, a fourth-year Brody medical student, will describe precision medicine to you this week and then precision nutrition next week. Both are about personalizing treatments to each person. Here is what Aaron wants you to know.
Imagine if, at the end of your doctor’s appointment, you left with a treatment designed only for you. The number of side effects is reduced and the benefits from your medications or procedures are maximized. This is the future of precision medicine.
Precision medicine is an exciting new field that includes the details of an individual’s life to treat them, such as genetics, environment and lifestyle habits — including diet. Currently, physicians offer the same treatment to many people with the same disease but do not have the tools to factor in all the personal factors that may make them sicker or not respond to a treatment that works well for others. Precision medicine aims to get over these hurdles of trial and error in finding the appropriate treatment and providing personalized care.
How does precision medicine work? Precision medicine takes into consideration the role our genes play in our health. Genes are made up of DNA that determine our traits, like how we look to what diseases we may be susceptible to in our lives, and are passed down from parent to child. Genetic testing can determine a person’s risk for certain diseases and their response to different medications, and suggest lifestyle improvements such as exercise and diet to better their health. Doctors can gather detailed information about a patient’s health and create customized treatment plans using these data and electronic health records.
Some of the benefits of precision medicine is that it gives the doctor the ability to make correct diagnoses and treatments. Knowing a patient’s genetic makeup allows doctors to find treatments that are more likely to work for an individual. An example would be the current way cancer is treated; by treating patients with known genetic mutations, doctors can use drugs that target specific characteristics of that cancer and find the drug that is most likely to cure it. Similarly, other diseases can be treated with precision medicine by tailoring lifestyle recommendations (precision nutrition) and medication dosages to the individual, leading to better control, such as determining what cancers one may be susceptible to and giving them information on what exposures they should avoid.
Precision medicine is not limited to chronic disease but also plays a role in preventative medicine or stopping a disease from happening. For example, if genetic testing reveals a person has a higher risk of developing heart disease, their doctor may recommend specific lifestyle changes like diet and exercise plans to reduce the risk. Biomarkers, or chemicals present in the body that can be measured, may also help in identifying the risk that a person has of getting a disease before the symptoms even start.
While there are many benefits to precision medicine, it is also important to consider the disadvantages. The cost of genetic testing is high and often not covered by medical insurance. While companies like 23andMe offer more affordable genetic testing options, they do not provide interpretation of the results that a geneticist or physician can provide that is required for medical management, which can range from hundreds to thousands of dollars. Recently, the cost of genetic testing for cancer has reduced considerably and insurance companies have loosened their coverage restrictions. As the field of genetics advances, there may be a way to reduce the cost of testing and interpretation of the results.
The future of precision medicine is promising and ongoing research is paving the way for new treatments and therapeutic approaches. As the field of genetics grows, the practice of precision medicine will expand and can lead to more personalized and effective healthcare options. With this, the way we think about medicine will change the way we think about health management and outcomes for patients and lead to a more efficient healthcare system.
Precision medicine represents a shift in healthcare and abandons the one-size-fits-all approach that is often used. While there are challenges to consider, the potential benefits outweigh the disadvantages. Many specialties within precision medicine are blossoming as well, including pharmacogenomics, the study of how certain drugs can affect an individual, and precision nutrition, to name a few. As this field continues to grow, it could transform healthcare, offering new hope for better diagnosis, treatment and prevention of diseases. In our small southeastern city, embracing precision medicine could lead to healthier lives and a stronger community.
I would like to extend my sincere thanks to Dr. Johanna Hannan, administrator of the Research Distinction Track at the Brody School of Medicine, for invaluable support and guidance. More on precision nutrition next week.
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