Anyone who has found themselves caught up in what sometimes feels like a very “impersonal” healthcare system or who has tried to help a friend or loved one navigate the complexities of accessing care, can attest to the level of frustration it can induce.
For years one of the greatest criticisms of modern medicine has been a growing lack of hands-on, face-to-face interaction between patient and caregiver. For medical professionals all too often the demands of time and attention from increasing numbers of patients can rob precious time for direct communication on a personal level.
Before you throw up your hands in surrender to a seemingly inevitable future of “impersonal” medicine, there is new reason for optimism that we now have technology which has the potential to, and in fact already is helping physicians deliver healthcare, so “personal” that it is customized to a individual’s own unique genetic make up. What this means, is that by studying the map of a person’s genome, which reveals specific genetic markers, a physician can diagnose, prescribe, and manage their healthcare based on the patient’s individual genetic makeup and translate the data so it can be used to enhance care.
What is personalized medicine?
In essence, personalized medicine uses molecular testing and genetic profiling to target a person’s innate predisposition for disease and predict which medical treatments will be safe and effective for the patient. In other words, by mapping an individual’s genome, we can help take much of the trial and error out of medicine. This is tremendously significant when we consider that 5% of all hospital ER visits are due to adverse drug reactions, at a cost to the healthcare industry of as much as $400 billion a year.
Patrick Ridgeway, Area Sales Director/Distribution, with Natural Molecular Testing Corp., a leading provider of molecular diagnostic testing for women’s health, cardiovascular disease, oncology, infectious disease, and more, spoke to Well-Being about how identifying and evaluating a patient’s genetic markers can provide reliable data for physicians to use in diagnosing and treating disease.
“Genetic testing is an incredible tool to improve the quality of patient care,” explains Ridgeway. “It has the potential to revolutionize how medicine is practiced, because physicians can know in advance, for example, how a patient will react to certain medications based on the way the individual metabolizes a particular drug. Genetic mapping also gives the patient and physician the key to understanding predispositions the individual may have for certain diseases, so they can be prevented or effectively managed. We provide physicians with access to information on their individual patients at the cellular level, transforming the concept of ‘personalized medicine’ into a present day reality.”
So how does “personalized medicine” fit into the reality of the present healthcare system, or more specifically, how has it been received by physicians and insurance providers?
“Currently, we estimate that less than 5% of all physicians are implementing genetic testing as part of the medical management of their patients, but we expect that number to change as physician’s realize the effect it can have on patient care,” adds Ridgeway. “Our services are increasingly covered by Medicare and private insurance, and we are working hard to educate the industry about the significant benefits it provides for reducing costs and improving outcomes.”
L. Kevin Vance, M.D., Pain Management Physician at Comprehensive Pain Center of Mississippi, has partnered with Natural Molecular Testing Corp. to offer his patients molecular testing because knowing how they will respond to certain drugs, improves not only his ability to help reduce an individual’s pain, but also improves their overall quality of life.
“It’s so important to know how a person’s system will react to the medications we prescribe – it all depends on the way their bodies metabolize a drug,” notes Dr. Vance. “Specific enzyme types tell us whether the patient is a normal, rapid or poor metabolizer of a specific drug. Knowing how the patient’s system will react means the difference between a medication that is not effective in relieving pain, one that is successful or one that metabolizes so slowly in the liver that it can result in a toxic reaction.”
“Our patients understand the value of genetic testing to their care and are enthusiastic about it,” Vance continues. “After a simple mouth swab is submitted for DNA analysis, the results are recorded electronically and patients are given a data card so they have access to the information and can make it available to other physicians and caregivers.”
The importance of electronic records to the future of personalized medicine.
“The electronic medical record of an individual’s DNA is key to how this technology will revolutionize medicine,” adds Ridgeway. “The mapping of a person’s genome never changes. Once we have access to that information it can be used to individualize their health and wellness care throughout their lives. Ideally, if each infant were tested at birth, their parents could take home with them a much more useful “footprint” of their newborn – one that could positively affect their health from infanthood to old age.”
How Personalized Medicine Is Impacting Patient Care
The following are just two examples of how personalized medicine is already saving lives.
…in Breast Cancer: One of the earliest and most common examples of personalized medicine came in Herceptin® (trastuzumab). About 30% of patients with breast cancer have a form that over-expresses a protein called HER2, which is not responsive to standard therapy. Herceptin was approved for patients with HER2 positive tumors in 1998 and further research in 2005 showed that it reduced recurrence by 52% in combination with chemotherapy.
…in Cardiovascular Disease: Dosing of the drug Coumadin® (warfarin), used to prevent blood clots, is typically adjusted through multiple rounds of trial and error, during which the patient may be at risk of excessive bleeding or further blood clots. However, genetic tests detecting variation in the way individuals metabolize the drug can help predetermine the right dose for a patient the first time. In 2007, the FDA updated the label for Coumadin to recommend that a patient’s genetic makeup be considered when deciding what dose to administer.