Top Trends in Preventative Health Care – Personalized Medicine

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2016-Science and Technology Increasingly Converge
Part 2

In my previous blog, I have been discussing some of the technological and scientific opportunities in preventative health care. So what does personalized medicine mean?

PERSONALIZED MEDICINE AND GENETIC PROFILING ON THE RISE

Personalized medicine is an emerging practice that uses an individual’s genetic profile to guide decisions about the prevention, diagnosis, and treatment of disease. Knowing a patient’s genetic profile can help doctors select and administer the proper medication or therapy in the correct dose or regimen.
A report by PricewaterhouseCoopers (PwC) highlights that medical science and technological advancements have converged with the growing emphasis on health, wellness and prevention to push personalized medicine to a tipping point. We are now seeing a blurring of the lines between traditional healthcare offerings and consumer-oriented wellness products and services.
I think we need only be open-minded about innovations but also vigilant about expectations and about medical evidence in evaluating these products.

INCREASING USE OF GENOMICS AND OTHER DIAGNOSTICSbigstock-Test-Tubes-in-Science-Research-5143772

What this means is that with the help of genomics and other diagnostics we will increasingly be able to target medical care and identify an individual’s susceptibility to disease to predict how a given patient will respond to a particular drug.

Genetic testing, helping us understand personal risk, may be a wonderful starting point.

Genetic testing will also help eliminate unnecessary treatments, reduce reactions to drugs and increase the efficacy of treatments and, ultimately, improve health outcomes.
In the field of oncology, we do tests on tumors for receptors, as a means of understanding the likelihood of a response to a certain drug. This has become standard for example in breast cancer, learning whether a tumor is hormone sensitive or not, to then decide to treat with a hormone- blocking agent. This is not new. What is new is the arena of testing for prevention, not only for treatment options.

We are also now also seeing the growth of in-home testing of genetic products that are giving consumers information to will enable them to predict better medical risks, detect health issues sooner to manage their health. This early trend will no doubt continue in 2016 and beyond. So let’s welcome new options, but be careful as to medical evidence and expectations.

Disclaimer
The material contained in this blog is for informational and educational purposes. Great efforts have been made to maintain the quality of the content.  However, it is strongly recommended that the treatment/management of any medical conditions mentioned here, should not be used by an individual/visitor of this blog, on their own, without consulting competent persons such as your doctor, or health care provider.   As always we encourage your comments on this blog or any others and hope you will join discussions.

 

 

 

 

 

 

Pharmacogenomics: Determining the most effective drug for your genetic makeup.

shutterstock_437357662.jpgGenetic Testing & Drugs
Each person is unique and so is his or her response to certain medications.  Since the mapping of the Human Genome Project was completed in 2003, a new area of study and research has opened up called, Pharmacogenomics, the technology that analyses how genetic makeup affects an individual’s response to drugs—will a drug be helpful for a specific treatment or will it be toxic? Will it help or hinder? Will you be at increased risk for certain side affects or will genetic testing help to avoid a serious adverse drug reaction.

 

Such approaches promise the advent of personalized medicine in which drugs and drug combinations are optimized for each individual’s unique genetic makeup. There are two areas  pharmacogenomics is being applied.  One is in the area of cancer treatment and the other is using genetic testing to determine response to certain medications. In the area of cancer treatment, oncologists may order certain tests that will look at the genetic features of a tumor to assess how the cancer will respond to certain types of treatment and what form of therapy would be best for a particular patient.  This is the only area today that may be covered by health insurance in Ontario.

 

The other use for genetic testing is in the area determining the effectiveness of certain drugs for treatments related to heart disease such Plavix or Warfarin. We have learned that the uniqueness of our genetic makeup means that not all drugs work in the same way for all individuals or it may be hard to get the dose right.   It is not yet common practice in Canada or covered under OHIP, but genetic testing in this area can be carried out privately if your doctor determines it is warranted.  Ideally, Medisys genetic counselor, Katherine Hodson, suggests the test be carried out before a drug such as Warfarin or Plavix is prescribed to avoid adverse reactions and ensure the right dosage.

 

Genetic testing may also be used to determine whether certain pain relievers such as codeine will work well for a given patient.  An individual suffering from chronic pain may not respond to codeine as genetically, that person may metabolize the drug too quickly.  In this case, the patient would need a different medication and of course, given concerns about narcotics and drug seeking, how reassuring it is to have a clear medical answer about different or higher dosing requirements.

 

We are on the cusp of understanding more about genetics, medications, reactions, both good and bad, and that will make prescribing drugs much more personalized, with predictable and better outcomes.

 

#medicine #healthcare #healthy

Disclaimer
The material contained in this blog is for informational and educational purposes. Great efforts have been made to maintain the quality of the content.  However, it is strongly recommended that the treatment/management of any medical conditions mentioned here, should not be used by an individual/visitor of this blog, on their own, without consulting competent persons such as your doctor, or health care provider.   As always we encourage your comments on this blog or any others and hope you will join discussions.

Personalized Medicine –When should you consider genetic testing?

cropped-dr-brown.jpgSince the Human Genome project made it possible to map the entire DNA of a human in the 1990’s, it has become a powerful information tool. Learning an individual’s personal genetic make up can lead to improved diagnosis of certain illnesses. We also can advise you, if you are at higher risk because of a disease or condition that runs in your family.  It can help physicians like me make more informed decisions when prescribing medicines.  It is truly miraculous and a continually emerging and exciting field.


Breast cancer, heart disease, type II diabetes, prostate cancer are just a few of the diseases and conditions that can be tested. However, before you begin the process, I would suggest you discuss your concerns with a qualified genetic counselor.  And that counselor should be certified by the Canadian Association of Genetic Counselors. (
www.cagc-accg.ca)


Sometimes, the first and only step you may need to take, is knowing your family history for a medical condition to be flagged with your counselor.
 For instance, the vast majority of breast cancer cases occur by chance and are not as the result of genetic factors.  Genetic counseling can be incredibly reassuring. Although rare, inherited changes in the BRCA1 and BRCA2 genes, which was the case for actress Angelina Jolie, are linked to a high lifetime risk of breast, ovarian and other specific cancers.  In that case, preventative measures were taken.  And that too is reassuring.


Once you and your counselor decide genetic testing is right for you, all that is needed is a saliva sample to begin the process. In a future blog, I will discuss genetic testing and medication responses. We are learning how genetic testing can help in prescribing the best medication to treat a condition or disease. And we can tailor medication to specifically treat an individual…. for we all know, it is NOT one size fits all.