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Medical student Hannah Patterson takes a look at advancements in modern medicine
The NHS describes personalised medicine as “a move away from the one size fits all” style of medicine – the idea that if you present to your doctor with a set of symptoms, you will be given the exact same treatment as everyone else, regardless of individual factors.
The medical community has been working towards a more personalised style of medicine in some form or another for the past few decades, even if the truly groundbreaking treatments are still in their infancy. For example, it is now recognised that when treating heart failure, certain medications have more potent effects on black people than any other ethnic group, and so should be the preferred mode of treatment for that group.
These treatments work better on some people than others because of our genetic makeup. The majority of people are born with 46 chromosomes which carry their genetic code. These 46 chromosomes contain billions of genes, which we inherit from both our parents to make a unique combination. If this wasn’t complicated enough, most of us will have mutations – genes we inherited from our parents that work slightly differently in our body or combine with other genes to give a different result. Some genes are also expressed more strongly in one person than another.
This incredibly complex code that makes a person who they are can also help contribute to the various diseases a person may be susceptible to. Some people will be born with a mutation in their tumour suppression genes, leaving them more likely to develop cancer in their lifetime. A common example of this is the well-known BRCA gene. People with mutations in the BRCA gene are far more likely to develop a specific type of breast cancer. While this seems like a scary thought, the knowledge of what gene is causing an illness can often to make it easier to treat.
This is where personalised medicine comes into play, especially when it comes to treating cancer. Isolating specific genes and expressions of genes, as well as pinpointing where mutations happen and when/why can allow us to create bespoke treatments that fit an individual’s genetic profile and target specific disease processes. The hope is to create a treatment that’s more effective and has less side effects, compared to more traditional treatments such as chemotherapy, which has huge systemic side effects with often very little effect on the disease.
The University of Glasgow is pioneering one aspect of personalised medicine in their treatment of pancreatic cancer, an extremely aggressive cancer which has had a depressingly low life expectancy with traditional treatment methods. Part of the reason that this cancer has such poor prognosis is that it is difficult to catch, and usually presents late. The scientists working at the University of Glasgow’s hope is that by isolating the specific genes which cause the cancerous mutations in the pancreas, they may be able to stop them in their tracks, giving a longer life expectancy for cancer sufferers.
All these treatment possibilities make personalised medicine seem like what we should all be using every day, but the reality isn’t that simple. As I said, the truly groundbreaking research is in its infancy, and it could be decades before some of these treatments are readily available. And in the meantime, the NHS is faced with the daunting task of furthering this research while also trying to keep itself afloat. NHS England has vowed to increase its budget by 20 billion pound by 2023, but it is unclear how much of this will be put into personalised medicine. Research on this level is incredibly expensive, and the NHS has many problems to deal with right now. Many would argue that more nursing staff, shorter waiting times and more mental health training could save as many lives as personalised medicine could, and could save them now, as opposed to however many years in the future.
As with much of the NHS’s future, we will have to watch and wait to see if personalised medicine will be the revolution in disease treatment it has been advertised as. If this research comes to fruition it could change the way we react to the word “cancer” forever.