January 28, 2010
Personalized medicine is health care treatment or therapy tailored to our own personal genes.
Since the mapping of the human genome was completed, great strides have been made in medical research to link various gene variants to common health conditions. These include heart disease, diabetes, and cancer.
In the past on this blog, I have talked about the importance of knowing our family health history. In part, knowing my family health history and telling my doctor about it may guide a doctor’s decisions to recommend testing for some of these genetic contributors to health and disease.
There are several realities associated with personalized medicine.
First, we have more research linking specific gene variants to specific health conditions than we have medical tests to identity the presence of these gene variants.
Second, sometimes the media reports the results of ongoing or newly published research to link gene variants to health conditions long before the results have been translated to health care, including genetic tests and treatment.
Third, when a tests exists for a gene variant linked to a health condition, there still may be no treatment that is any different for someone who has the gene compared to someone who does not have the gene. If my doctor recommends a genetic test to guide diagnosis of my condition, I ask if having the test results can make a difference in my treatment. For me, if the answer is, ‘no,’ then I generally would be unlikely to be tested. For now, having my medical record indicate that I have a gene variant linked to a health condition might make me appear to be someone at higher risk for poor health related to that condition. In an era linked to efforts to reform health care, until matters are more settled, I do not personally plan to give anyone a reason to limit my health insurance coverage.
Fourth, if I asked my doctor whether having a genetic test result would lead to the possibility of different treatment, and the answer was ‘yes,’ I would then ask: ‘what are the possible options?’ I would ask this before agreeing to be tested because some options for treatment would be ones I would not choose. So, if all that is ‘gained’ by having the genetic test results were options that I found to be unacceptable–prophylactic surgery or abortion, for example, in my case–then having the information would not be a benefit for me.
Fifth, but if I asked my doctor whether having a genetic test result would lead to the possibility of different treatment, and the answer was ‘yes,’ and I asked about the treatment options and found them to be acceptable, I would be likely to agree to a genetic test. I would then talk with my doctor about these options and make a choice that might well be based on my genetic make-up–a result of personalized medicine.
