Genomics Blog

March 22, 2013 9:45 AM
The Great “We vs Me” Personalized Medicine Debate
Filed Under: Pam Baker

Personalized medicine, like every medical advancement that came before it, is met with some confusion. People tend to believe that their medical care is “personalized” already in that they see their “own” doctors and get treatment according to their personal health conditions. But that perception is not exactly aligned with the reality.

Modern medicine as we know it today amounts to a physician selecting a treatment from a menu of traditional, one-size-fits-all, mass-produced medicines. By contrast, personalized medicine is the practice of making the patient the deciding element in the fashioning of medical care and includes the use of pharmacogenomics, which amounts to developing and administering medicines that are tailored to a person’s specific genetic makeup. Such drugs reduce side effects and toxicity while improving effectiveness in that person.  

In other words, traditional medicine treats people with the same disease in the same way with a pre-set number of options in drugs which entails accepting the risks of individualized adverse reactions, including death, in some cases. Personalized medicine, on the other hand, adjusts the treatment to the individual person’s genetic makeup, thereby reducing the risks and improving the outcome although it does not eliminate risks entirely. In personalized medicine, no two patients receive the same treatment even though they may have the same disease and overall health conditions.                   

To simplify the issue in general discussions, I like to think of this as the great We vs Me Medicine Debate.

Admittedly it isn’t really much of a debate. The evolution of diseases, more so than the desire for general improvement of medical care, is forcing our collective hand on the issue.

Antibiotics are fast approaching total ineffectiveness as diseases continue to evolve beyond the reach of traditional medicines. Without advances in medicine, that is to say a complete and total change in how we medicate, huge numbers of people will die as soon as the last antibiotic fails.

It is important to understand that bacteria and viruses are able to evolve to resist antibiotics in part because the same antibiotics are used in massive numbers in both human and animal care. With little to no variation in antibiotic exposure, germs can cope and successfully build defenses.  The result is commonly referred to as “super germs” that are highly resistant if not downright immune to antibiotics and disinfectants. By varying medicines to ideally suit the patient and to disrupt broad and unvarying treatment patterns that germs can use to develop resistance, mankind once again gets the upper hand. And we must retain the upper hand in the battle against disease or face calamity.

Indeed, Britain’s Chief Medical Officer Dame Sally Davies said just last week that “Resistance to antibiotics risks a health 'catastrophe' to rank with terrorism and climate change.” She also warned that “Britain's health system could slip back by 200 years unless the "catastrophic threat" of antibiotic resistance is successfully tackled.”

That same doom awaits every country that relies on traditional medicine, which is to say all countries.

A large-scale public education effort is needed to explain the ‘we vs me’ approaches to medicine so that the public understands why this change must happen in order for scientists to get on with the business of curing mankind from what ails him. Dissenters must come to understand that human lives are at stake on a global scale. The Black Plague has nothing on what’s coming next. 

Comments

Jo Good -

Pam, I am so thankful you wrote this article. I have been wondering what the heck personalized medicine was all aboabout in fact it scared of it.

love and hugs

Pam Baker -

Most people wonder about what personalized medicine really is and what it means, Jo. And, yes, many people fear it when they don't understand it. That's totally understandable and exactly why I felt I needed to write this post and shed a light on the subject. I'm very happy you found it useful!

Teresa - www.TeresaMeek.com

Very interesting and thought-provoking article. Personalized medicine would indeed be a way of avoiding the risk of individual bad reactions to today's universal treatments, which are becoming less universally viable anyhow as antibiotic resistance develops. But we have a long way to go before replacing today's mass treatments with personalized ones. Maybe in a quarter century it will work.