Is Personalized Medicine Only for Sick People?
Precision medical treatments are not just for people suffering from cancer and other chronic diseases.
Personalized medicine might be the future of medical treatment. Also known as precision medicine, this form of medical care focuses on developing treatments tailored to small groups of people based on their genetic makeup, health history, and lifestyle factors.
These types of personalized treatments are often developed as a way to treat specific forms of cancer or chronic conditions like cystic fibrosis. They often make the news when pharmaceutical companies release a new drug that treats these difficult mutations.
But does that mean personalized medicine is only for sick people?
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The WHOLE initiative in personalized medicine
You may be surprised to learn that the answer is no — there’s an entire branch of personalized medicine being explored for patients who haven’t developed any sort of chronic or life-threatening disease.
Known as the wellness and health omics linked to the environment, or WHOLE, this kind of precision medicine is focused on helping patients and doctors make healthy choices that prevent diseases from developing in the first place.
The ideas behind WHOLE is similar to other wellness initiatives that the medical community already uses: that preventing diseases is better than treating them, and that making healthy choices throughout your life can lower your risk for developing certain chronic conditions.
Wellness and precision medicine
What makes WHOLE different from traditional wellness initiatives or traditional medical practice is the genetic component.
With access to a person’s genetic profile, doctors can tell whether their patients are at a high risk for developing certain types of diseases. These include types of cancers, cardiovascular disease, obesity, diabetes, neurological disease, or even mental disorders like depression. With this information at hand, as well as knowledge of a patient’s family medical history and current lifestyle, doctors can recommend lifestyle changes, monitor for risk factors, or even preemptively prescribe medication if they feel that is the best way to prevent diseases from developing.
The purpose of this type of genetic sequencing isn’t to overwhelm patients with all the potential diseases they could possibly get in a lifetime. After all, genetic factors aren’t the only ones that put patients at risk for developing certain conditions.
Rather, WHOLE focuses on identifying the conditions for which a patient is most at risk and which they can most easily prevent. This is known as the PART principle: that doctors should focus on risks which are palatable, actionable, reproducible, and teachable.
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A doctor acting on the PART principle may look at a patient’s genetic sequence and decide to focus only on one potential risk, such as heart disease, that appears both most likely to develop and easiest to prevent. The doctor would then recommend lifestyle changes, or medication, that lower a patient’s chances of developing heart disease, rather than trying to prevent every single disorder possible.
Should you find out your genetic profile?
Whether or not to use your genetic profile as part of your wellness plan is a choice you and your doctor should make together. Personalized medicine is still new in the medical field, so start by speaking with your physician to find out if genetic testing would make a positive contribution to your precision wellness plan, then check with your insurance to see if they’re available under your current health plan.
If you are interested in pursuing genetic testing as part of your wellness plan, many companies can perform it. Ask your doctor to help you find a reputable testing company, as the field of personal genetic sequencing is still new and regulations may vary from state to state.
The Genetic Information Nondiscrimination Act of 2008 prevents insurance companies and employers from discriminating against a person based on their genetic profile, so you can find out this information without the risk of losing your insurance coverage or job.
Once you have your genetic profile, ask your doctor or another health professional trained in genetic sequencing to help you interpret the results. Once you understand your results, and have adequately discussed your health history and lifestyle, you and your doctor can work together to come up with a wellness plan tailored to your individual risk profile.
March 31, 2020
Christopher Nystuen, MD, MBA