Etc.: Last Word

Making medicine personalized – again

By Giuseppe Colasurdo, M.D.

Personalized medicine. Thee concept of the “right medicine, for the right person, and the right time” has come into our parlance since the Human Genome Project began to reveal our genetic makeup. For the right price, you can purchase a copy of your own genomic profile, and even here in Houston, physician groups hawk the magical promises of genomic medicine.

The going rate for a full sequence of one’s genetic code is $350,000 – a price affordable to only a few who have signed up. There is a heated industry race with companies trying to create an instrument that can sequence a person’s genome for $1,000, thereby bringing the service into arm’s reach for those who want to peer into their health’s future.

But what is personalized medicine, and what would you see for your money?

More than 1,000 genetic tests exist today, with the promise of more to come. Newborns are screened at birth for a variety of diseases – and women may have prenatal tests to determine the genetic hallmarks of diseases known to present at birth. The scan of specific genes or chromosomes that can cause problems such as prostate cancer, autism, and Alzheimer’s, among others, are presently being studied.

Now that the human genome has been decoded, scientists are turning their attention to mapping the genes of diseases. With a complete genetic profile of a disease, future treatments and diagnoses could be specifically matched to a patient.

Thanks to the vigorous studies of investigators worldwide, the day in which we are able to tailor treatments to a specific genetic expression of a disease will come. However, that day is still in the future.

We presently are in the embryonic stages of creating this ideal of “personalized medicine.” Even so, there is personalized medicine that occurs daily. My definition of personalized medicine is a well-qualified, caring physician providing expert treatment for a patient.

This humanistic view of medicine, which although more easily understood, is not always easy to find. We teach our students the importance of the human factors of medicine – to be involved, to care. As our world becomes more high-tech, it becomes less personal and more distancing. Technology and innovation are keys to outstanding medical care, and we must embrace the future with the welcoming arms of caring physicians.

Changing the way we think about, diagnose, and treat diseases is the result of scientists making discoveries at the gene and protein level. While these findings will ultimately improve patients’ health, we must deal with the realities of what personalized medicine means today – creating a personalized experience as we care for our patients. ]

Giuseppe Colasurdo, M.D., is dean of The University of Texas Medical School at Houston and holder of the H. Wayne Hightower Distinguished Professor in the Medical Sciences.