If you ask older adults what personalized medicine means to them, they are likely to describe the family doctor who made house calls when their children were ill. They might also describe the doctor who personally cared for all members of the family, regardless of age, knowing all the personal history that contributed to the medical history.
Today’s personalized medicine combines genomics, informatics, and high-tech imaging to diagnose problems more quickly and accurately or prevent them before they can occur. Drugs are selected that match each patient’s unique genetic information, or molecular pathways are modified so that treatments are more effective and have fewer side effects.
One of my job responsibilities is to work in the minority community to advance cancer clinical trial awareness and participation. Last fall, I met with the program manager of a local public radio station to discuss the most promising developments in health care that the radio audience would benefit from hearing about. The goal was to identify topics and potential speakers for a health-related radio program.
I was enthusiastically explaining about our personalized medicine initiatives in cardiac and cancer care when the program manager asked how personalized medicine worked. I said, “By reading your genetic code, the doctor would know which drugs were most likely to work for you, and which you should avoid, even before you tried them. For patients with cancer, analyzing a piece taken from the tumor could pinpoint the treatment most likely to kill the tumor, and with the fewest side effects.”
The program manager did not exhibit the kind of response I was hoping for, and I asked her what she was thinking. Her reply surprised me. She said, “I am a little disappointed to think that my care hasn’t always been personal. I thought my doctor always knew what the best treatments for me were.”
I paused for a moment and then continued. I told her she was right, that her doctor did know the best treatments for her based on the information he had at the time. The modern definition of personalized medicine now adds easily available genetic information to the treatment decision process.
The implication for me was to reconsider how I think and talk about personalized medicine. Healthcare providers are excited by the implications for genetic information being readily available for treatment decisions. Lay people have only the perspective of their healthcare needs and experiences without the benefit or burden of understanding scientific developments.
ONS Connect Editor Debra M. Wujcik, RN, PhD, AOCN®, FAAN, is the director of clinical trials at Meharry for Vanderbilt-Ingram Cancer Center and an associate professor in the School of Nursing at Vanderbilt University in Nashville, TN.