Human health is mostly influenced by three main factors:
- Genes
- Lifestyle
- Environment
And that makes every individual exclusive in acquiring, presenting the disease, and responding to the treatment. Until now, standardized treatment options were being followed for most diseases without any individual variation. Technological advancement in healthcare has made possible customization of healthcare. Today, we will look into the customization of healthcare as used for cancer management.
Personalized Medicine is the use of specific medicines or drugs as per patient’s molecular analysis to manage a health condition. Genomics defines the molecular foundation of any disease in a particular individual. Some synonymously used terms are Precision, Predictive, Preventive, Participatory, and Personalized.
Benefits of Genome Sequencing:
- Discover the existence of mutation (single or multiple)
- Find out if its effect can be reduced,
- If the inception of the disease can be delayed and how(environment or lifestyle dependence)
- Permit suitable drug and dosages to allow maximum efficacy
Precision medicine offers disease treatment and preventive measures based on a person’s environment, lifestyle, and genetic makeup.
This therapy is based on the fact that ‘each patient is different so is their cancer’. A small sample of their tumor tissue is taken and grown for similar bigger growth for testing. The chemo drugs are then tested over the tissue for the best results. The same drug is then administered to the individual. The best part about the therapy is:
- Saves the patient from all the hit and trails
- Saves money on the large number of drugs incurred in hit and trails
- Saves suffering involved in administering that hit and trails
- Specific desired Results
- Saves time of both patient and doctors
Current Cancer Management methods used based on:
- Type of cancer
- Size of tumor
- Its metastasis
Various modalities used for cancer treatment include:
- Surgical Oncology
- Radiation Therapy – Can be used before, during, and after surgery. With X-rays or protons, if cancer has spread beyond the organ. During the procedure to shrink the tumor for easy removal. Given post-surgically to prevent a recurrence:
- Radiation from an outside machine through a linear accelerator
- Radiation placed inside your body – Brachytherapy through implanted seeds
- Chemotherapy in conjugation with Radiation Therapy – To reduce the size and number of tumors
- Targeted Drug Therapy
- Immunotherapy to help immune system fight cancer
- Hormone Therapy with hormones to slow cancer growth while treatment
Precision medicine adds the specifics to each like targeted therapy with which specific drugs will work finest and so on.
Drugs are being tested for precision medicines are still in the trial phase. Such clinical trials are accepting patients with a genetic mutation over which a drug treatment can be tested.
The scope of Precision Medicine:
- The tumor is tested for type, stage, and genetic mutation through a biopsy
- The DNA of the sample is taken and tested on a sequencer (tumor profiling)
- Availability of targeted drug is then matched
- In case the match is found the patient qualifies for a clinical trial
- The patient needs to sign a lot of consent forms mentioning about treatment trial, its side effects and the like
Limitations of Precision Medicine:
- Mutation understudy may or may not be relevant to the cancer
- Lack of drugs for Targeted Therapy
- Sampling error is the actual tumor may respond contrarily to the same drug
- Modification of tumor with time
- Difficult to interpret tumors like stomach, lung, breast, etc.
- Quality of sample collected
- Number of patients qualifying for clinical trails
- Number of clinical trials
- Limitations with analyzing data
As the cancer is growing and changing forms, so is medical technology. We now have measures to differentiate between slow-growing localized tumors from fast-growing metastasizing ones. The tumor sampling can now be done from a swab of your saliva. A new paradigm has been added to all aspects of cancer management, the diagnostic procedures based on PET that can show in a single image all the cancerous cells illuminated within the entire body to use of a pen-shaped device being used to differentiate between cancerous or normal tissue just by placing it over. Of course, it might take a little while before personalized medicine actually reaches you. But the fact of this matter is that cancer is treatable, exclusively treatable and if personalized medicine taking a while to reach you, you can reach it instead…
Dr. HS Darling (Sqn Ldr), Consultant – Haemato Oncology, Medical Oncology, Oncology, Narayana Superspeciality Hospital, Gurugram