Personalised medicine is one of the current buzz phrases knocking around the healthcare community. It is high tech, innovative and smart. People speak about it in an excited way as the next big step for medicine in the 21st century.
Personalised medicine is jargon for the development and use of medicines targeted to the individuals DNA profile. A person’s genetic code (i.e. DNA) is unique to them. It is the programming that determines a lot about who we are, the risk of some diseases such as certain cancers, and whether or not we can tolerate particular drugs, how effective they will be and who is likely to get side effects. I am a fan and I don’t hear any arguments against. Such an approach is one of the benefits of the billions invested into the understanding of the molecular basis of disease over the last 2 decades. I applaud it and am delighted to see the research findings and understanding being applied to transform all our lives. It may make a massive difference in some disease areas, whether it will rival the giant leap forward that the introduction of anaesthesia or antibiotics achieved remains to be seen.
It does however make me smile, (the alternative would be to cry!), at those with a medical-model view of the world, who see the potential in knowing the individual’s detailed gene sequence as the sole key to unlocking improvements in outcomes. People are more than the sum of their DNA. We are shaped by our environment and experiences in early life. These factors, referred to as social determinants, also have a major effect on our risk of vascular disease, mental health problems and many cancers.
Our aspirations for the future, values and what we hold dear are also as personal and unique. They make us all different in where you may wish to go on holidays, what music you like or what you would do if you won the lottery.
If personalised medicine is to be the step change we hope it will be, we have to recognise these personal differences as well as the different genetic make-up each of us has.
So yes – let’s embrace personalised medicine – but let’s broaden the term to mean personalised care as well as designer drugs. Let’s ensure that people are involved in the planning of their care, have the options and trade-offs explained to them and are encouraged to be involved as much as they wish to be in all decisions that will affect their future. We don’t need to wait for all the molecular biology answers to make that change.
Consultant in Kidney Medicine
Salford Royal Foundation Trust