Dial Me Up a Cure Doc!

Medicine and treating sickness started with the ancient Greeks and Romans. Early trial-and-error treatments often failed, perhaps not surprisingly. Many were based on herbs or religious rites that many of us today scorn as useless.

Over time, we discovered anaesthetics and antibiotics. We also learned what helped with muscle strains and, though roughly, how to set broken bones. In the mid-1980s, morphine and quinine were extracted and made available for purchase.

The modern pharmaceutical manufacturing sector started in the second half of the 1980s. European dye and chemical companies began applying organic chemical synthesis to medicine. The humble aspirin was born. The world would never be the same. Until now, that is.

Every human is unique, and we often differ in how we develop diseases and respond to treatments. For centuries, doctors treated patients by using broad categories. They prescribed treatments based on these general models. We have lived in a ‘one size fits all’ mentality; we had no choice.

While this approach has helped many, it has limitations. Some forty per cent of the drugs that we take are ineffective. We show the same symptoms, but one drug that helps one person may not work at all for another.

Data studies show that 91% to 99% of approved drugs have several side effects. Worse yet, over 90% of oral medications have at least one inactive ingredient that can trigger allergies or intolerances in sensitive people. We would not be where we are without the use of broad-based drugs. Our history of battling disease and fixing body issues is truly remarkable.

Customising medications and treatments for individuals is now a reality. It is here. Right here, right now, and it is growing. Research into genetics, environment, and health patterns is growing. So, medical science has moved toward personalised medicine.

Under personalised medicine, treatments can be customised for each patient. This approach aims for the best results, moving away from a ‘one size fits all’ method. It is already a part of our healthcare. It considers each person's unique genetics, molecular makeup, lifestyle, and environment.

It's transforming healthcare at every stage:

• Primary prevention

• Better prediction

• Accurate diagnosis

• Personalized treatment

• Rehabilitation

Personalised medicine offers better treatment by focusing on the patient's genetics. This approach helps predict the best range of treatments for many diseases.

This field is already getting very complex, and the processes involved are sophisticated. Not all personalised medicine is like this, however. Consider someone who is lactose intolerant. Many oral medications use lactose as a filler. Someone in this situation could be hurt by taking a medication with lactose. This means a patient can take lactose-free drugs. They get the benefits of the active ingredient while avoiding the complications.

Another advantage of personalised medicine is reduced trial-and-error prescribing. Initial prescriptions may not work well because of genetic differences. This means patients often need to try several drugs to find one that suits them. Knowing a patient’s genetics and how they react to certain drugs leads to better care and saves money.

Many years ago, while I lived in the United States, I was diagnosed with a condition called NASH. Without going into detail, my liver does not process fats the same way a normal person does. Instead, it finds these cells in the liver and body and stores the fat there.

I was prescribed a statin drug called Lipitor. Many of you will be familiar with it because it is one of the most popular cholesterol drugs.

For months after, I was lacking in energy and had muscle weakness. When I moved back to Australia, my new specialist ran a series of blood screening tests. They revealed my liver and kidney functions were abnormal. This pointed to a condition known as "statin toxicity." These symptoms occur in less than 1% of patients. The damage done has had an impact on my ongoing liver function. It could have been avoided with a personalised medical screening.

Personalized medicine shows great promise in the fight against cancer. The annual global burden is expected to grow by 67%. By 2050, there will be about 34 to 35 million new cases each year.  One in five people is expected to develop cancer at some point in their lifetime.

About 71.6% of people diagnosed with cancer now survive for at least five years. This is a big improvement compared to past decades. Much of this is because of personalised medicine. 

For example, women with variations in the BRCA1/2 gene have over an 80% chance of developing breast cancer. They also have a 60% chance of getting ovarian cancer. Detecting these variants, therefore, allows preventive surgery and chemotherapy treatments.

Some patients get melanomas from a specific mutation in the BRAF gene. Typical treatments for melanoma do not work in these patients. When the mutation is found, they can be treated with a specific BRAF-targeting drug. This treatment greatly improves prognosis.

Perhaps the crème de la crème of personalised medicine is training the cells that mediate a patient's immune reactions. In a lab, these cells are harvested and modified. They are trained to recognize and target the patient’s tumor. These cells go back into the patient. With the aid of drugs, they then effectively kill the cancer tumors.

Personalised medicine represents a revolutionary approach to healthcare. High costs and data privacy concerns are challenges. But the chance to improve health outcomes is huge. Advancements are making it crucial for the future of healthcare.

The older we become, the more different we become. This could be due to diseases we’ve accrued, our environment, or our socioeconomic status. These factors influence our aging. They lead to differences in our physiological reserve and function. The balance of risk and benefit grows more fragile as reserves drop or weakness rises.

What used to be “Frankenstein” science fiction is now real life. It is already here and growing.

Submitted for the "Already Here" challenge":

Till next time,

Calvin