sunflower hospital nagpur : Personalized medicine also called individualised or precision medicine aims to customise health care with decisions and treatment tailored to each individual patient in every possible way. Sir William Osler rightly said in 1892 that if it were not for the great variability among individuals, medicine might as well be a science and not an art.
- Why is personal Medicare important ? Modern medications save millions of lives every year. Yet one medicine that may work for you may not work for another. It may cause severe side effects for you but not for another. Your age, lifestyle, and health all influence your response to medicines. But so your genes. Pharmacogenomics or personalised medicine is the study of how a person’s unique genetic set up influences her or his response to medical treatment.
- What would personalised medicine do ? The ability to offer the right drug to the right patient for the right disease at the right time with the right dosage is what personalized medicine would do. Genetic and metabolic data will allow drugs to be tailored to patient subgroups.
- What would be the benefits of personalised medicine ? It would lead to better matching of drugs instead of trial and error method. Customized pharmaceuticals may eliminate life-threatening adverse reactions. It would also improve efficacy of drugs.
- What is the need for personalised medicine ? There are people with similar symptoms but different illness. Medical treatment may work in some people but not in others. 40 % of the drugs taken may not be effective. Advances in genomics help to treat a patient precisely and effectively. It also helps to avoid allergic and adverse effects.
- What is the story of Herceptin ? HER 2 is a gene that is involved in multiple cancer pathways. Changes in HER 2 gene caused breast cancer cells to produce the normal HER 2 protein but in higher amounts. HER2 Protein overexpression is used as a marker of aggressive disease as well as the target for treatment. Herceptin was the first molecularly targeted cancer therapy designed to shut off the HER 2 gene, making the cancerous cells grow more slowly and without damaging normal tissue.
- Does personalised medicine saves lives ? About 60 years ago blood cancers were known as only leukemias or lymphoma. The survival after diagnosis was zero percent at the end of five years. Today there are more than 38 types of leukemias and 51 types of lymphomas and the five-year survival rate has increased to 70%. This has been possible due to advances in molecular biology.
- What are some important genetic tests available ? CYP 450 genotype enzyme is responsible for metabolizing more than 30 types of medicines. Importantly it can be used to determine the dosing and effects of specific antidepressant medications, anticoagulants such as warfarin, PPI, and others. The TPMT, UGT1A1 TA repeat genotype test are some important tests available and have played a major role in cancer therapy.
- Currently can personalised medicine be practiced in all routine cases ? As of today, it is not possible. However why somebody gets repeated malarial fever or why some have a very good memory or why in some families individuals are octogenarians, well the secret would be their DNA located in their genes. In some families heart ailments or cancers are common. In some, sudden premature deaths are common too. The reason could very well be their genetic makeup. Genetic mapping perhaps may help to identify such high risk group individuals and appropriate care could be taken well in advance .
- What is the future of personalised medicine ? The future could be good in selected areas like cancer therapy or certain blood disorders. However, in a developing country like India basic health facilities and patient education may be more important than gene-based therapy at present.
sunflower hospital nagpur : Personalised medicine looks very exciting as the advantages are enormous. Though a few more decades would be required to utilize it for basic medical care on day to day basis. However, the day is not too far that every individual will carry a health card with him giving his full genetic profile making it easier for medical professionals to treat him more effectively. This health care could be ready even before birth.
Author: Dr Jay Deshmukh
M.B.B.S., M.C.P.S., F.C.P.S., M.N.A.M.S., MD
(Internal Medicine – Bombay and New Delhi)
Chief Physician and Director, Sunflower Hospital, Nagpur