If you saw a doctor in the mid-1800s for an illness that you just couldn't kick, they probably would have taken a quick look at you and then they might have prescribed leeches or prayer, or maybe both if you were in really bad shape. In the mid-1900s with the same condition, your doctor could draw your blood, take X-rays, and get a more complete picture of what was going on in your body. Well, now researchers could be on the cusp of a breakthrough in how you manage your health. It called precision medicine and it just might improve the way we age.
What Is Precision Medicine?
For a long time, health professionals have been taught to treat "the disease." That is, they treat the symptoms of whatever condition ails you and they try to prevent the condition from getting worse. But the focus is on the disease or the condition, not necessarily on the patient.
But some researchers think they may have found a better way. "Precision medicine is an approach to patient care that involves looking at genetics, lifestyle factors, and a patient's environmental factors to develop a highly personalized plan for them," says Dr. Kerri Masutto, VP of Clinical Operations at Lifeforce, a company that focuses on precision health care.
"This differs from the more algorithmic approach in standard western medicine which focuses on generalized care plans that are developed for a specific disease process, rather than for a specific patient." With precision health, you're commissioning a tailor-made dress instead of buying off the rack, or ordering a custom car instead of going to a dealer.
Precision Medicine vs. Personalized Medicine
The general scope of precision medicine doesn't differ much from personalized medicine, except that it can be more specific. "All precision medicine is personalized medicine. Sometimes 'personalized medicine' may not be able to go as in-depth into all areas as precision medicine dictates," Dr. Masutto says. But she adds that if your healthcare provider is paying attention to your individual body and how it might affect your plan of care, then they're likely already putting some precision medicine concepts into practice.
The History of Precision Medicine
Healthcare providers have been using some form of precision medicine for years. For example, if your mom had breast cancer, then your provider may have tested you for the BRCA gene. This gene is known to increase your risk of breast cancer and helps guide your provider's recommendations. By testing for the gene in advance of a diagnosis of the disease, you are getting a personalized, precision-oriented approach to your healthcare.
In his 2015 State of the Union speech, President Obama announced a push for precision medicine research. He called it the Precision Medicine Initiative. His administration saw the potential of precision medicine and funded research to see how well it worked and how our healthcare system could implement it for more people.
What Precision Medicine Is Used For
Precision medicine can be very helpful if you struggle with symptoms or have been diagnosed with a disease that hasn't responded to traditional treatment. "Since we look into a lot more factors, a precision medicine doctor can often identify areas for intervention that have previously been missed," says Dr. Masutto. "This works for common issues such as high blood pressure or cholesterol and more vague concerns like fatigue and brain fog."
You can feel empowered to ask your healthcare provider to dig a little deeper if your plan isn't working. You are unique and your individual attributes can affect your health and your body's response to medical intervention.
Prevention and Treatment of Alzheimer's
A complex process, Alzheimer's disease emerges over many years and can be associated with different lifestyle and environmental factors. Researchers are studying new ways to identify people who are more likely to develop Alzheimer's. The hope is, once they better understand the "why" behind this process, they can more effectively prevent and treat it with precision medicine.
Cancer Management and Prevention
Like with the BRCA gene, your body's genetic code can give healthcare providers valuable clues about where your body is vulnerable. Through precision medicine techniques, these tests can not only warn you about your high risk for certain cancers, they can help your provider come up with a plan to prevent and more effectively treat cancer.
Slowing the Aging Process
Since the dawn of time, people have been searching for a way to slow or even stop aging. Could this new way of looking at health be the answer? "If precision medicine is used to identify and develop interventions specifically for issues that may cause premature or rapid aging, then absolutely," Dr. Masutto asserts.
"How fast we age is strongly impacted by all the same factors that are evaluated in precision medicine, so it's a wonderful tool to use for anyone that's concerned about their aging." There are no promises, of course, but further research could shed some light on this exciting possibility.
How Precision Medicine Works: The Nitty Gritty
The term "precision medicine" is the umbrella over a complex network of tests, concepts, and treatments. It's not a magic pill, but rather a way of thinking about medicine and patient treatment. The key to precision medicine is your genome. Your genome describes the unique collection of genes that make you you.
Genes are made up of DNA - teeny tiny pieces of information that tell your body to have red hair or brown hair, or be tall instead of short. They can also influence which diseases you're more susceptible to. Healthcare providers utilizing precision medicine look closely at your genome, as well as environmental factors like your home and work conditions to tailor-make a treatment plan for you.
Gene sequencing allows your provider to target small sections of DNA - so that they specifically test a few pages instead of the whole book. This can be useful if your provider knows more or less what they're looking for.
Next Generation Sequencing (NGS) Tests
Next generations sequencing (NGS) takes gene sequencing one step further. NGS tests don't just check for certain genes, they catalog your entire genome. Instead of looking for one specific gene, they look at all of them, like viewing a full-body MRI instead of just an X-ray of one hand. Researchers are still deciding if this test can offer benefits to everyone across the board.
CRISPR stands for clustered regularly inter-spaced, short palindromic repeats (yep, it's a mouthful). CRISPR describes a method of gene editing. Not only can we see someone's entire genome laid out, but recently researchers have found a way to edit your genes. So if you don't like that cancer gene, they can just take it out. This technology is still new and not widely used, but that is changing rapidly.
The compounds in medications are not one-size-fits-all. Caffeine wakes some people up but makes others sleepy. Some use Benadryl as a sleep aid, but others find it makes them energetic and anxious. Precision health can pinpoint which medications will work best for your specific genetic makeup.
Health providers have long looked at biomarkers to help determine their patients' health status. The term biomarker describes any measurable characteristic of your body. Some common biomarkers are:
- Blood pressure
- Blood tests
- Genetic tests
- Heart Rate
- Imaging (X-rays, CT scan, MRI)
- Urinalysis (testing urine)
These long-used measurements of health still hold an important place in health care and now also in precision medicine.
Is Precision Medicine Right For You?
As an emerging field, some people look at precision medicine as an exciting new frontier. But others eye it with suspicion. Dr. Masutto wants to assuage any concerns. "I would love for people to understand that precision medicine is not some new test," she says. "It's an approach to care that, frankly, all doctors should be using if they were given the time and support staff that's often needed to practice in this way." If you want to know more, you can ask your healthcare provider about precision medicine and explore what it can possibly do for you.