CHENNAI: Different people react differently to the very same situations. As in the everyday chores of life, so in the hospital bed, be it the most-dreaded cancer or diabetes or any genetic disease that affects only a certain group of people.
Taking note of the way a disease works differently in groups of people, doctors and researchers have successfully introduced a new field of medicine.
Named Precision Medicine, it takes into account an individual’s environment, lifestyle and genetics to determine the kind of treatment that is best suited for that patient. Doctors also use genomics to determine the kind of risks that a patient can foresee in the future, making the disease not only treatable but also preventable.
However, experts say that precision medicine is often confused with personalised medicine. According to them, personalised medicine would mean prescribing unique medication and treatment for each individual, while precision medicine means a certain treatment or medication would be developed to tender to certain kinds of patients, who share certain medical history, genes or a similar environment.
“When Hollywood actress Angelina Jolie got a double mastectomy done a few years ago, it made big news. But this is essentially what we do. Through genomics, it was determined that she had a high risk of breast cancer, so she removed them. We can do the same thing with other cancers as well. So we study the genes and we study the environment to determine what health risks patients could potentially have,” says Dr Richard Barker, Chairman, Precision Medicine Catapult, UK.
Speaking at a conference to discuss the UK-India association for research in precision medicine, Barker says precision medicine is set to revolutionise the way diseases can be treated, giving patients the option of getting to know their bodies before the sickness strikes or by taking precautionary measures or by at least making sure they are ready to survive it.
He also explains how just by studying the environment and roots of an individual, it would be easy to diagnose the disease. “Say, in India, they discover that a certain group of people in a town tend to be prone to a certain disease and I happen to have an Indian patient in the UK who shows signs of the same disease. I can then immediately look up the database and make a connection. Then it would be easy to determine why and what is wrong with him and what would be the best way to treat the disease,” he says.
While scientists, researchers and doctors have been working on precision medicine for over a decade, it has become a topic of discussion only recently. In 2015, US President Barack Obama launched the Precision Medicine Initiative and was quoted at the event as saying, “Doctors have always recognised that every patient is unique, and have always tried to tailor their treatments as best they can to individuals. You can match a blood transfusion to a blood type - that was an important discovery. What if matching a cancer cure to our genetic code was just as easy, just as standard? What if figuring out the right dose of medicine was as simple as taking our temperature?”
Besides the US, the UK too is one of the biggest investors in Precision Medicine and is developing a database of all its citizens. “More than 5,00,000 UK citizens have voluntarily come forward to record their medical history so that we can conduct research into their genes and environment. The more people hear about it, the more willing they are to give it a try,” Barker says.
While India might not be able to boast of such advances yet, experts think the country is not far behind as a lot of research is already taking place in several labs. “It might take a good 20-30 years for precision medicine to be fully implemented. But we can confidently applaud India for taking steps in the right direction,” says Barker.
Mike Messenger from the University of Leeds says India could also be a few steps ahead of other countries in a few years with its quick medical inventions. “As the country has a shortage of doctors, precision medicine can even help patients with self care,” he adds.
One of the centres in Chennai involved in precision medicine is the Institute of Tuberculosis Research. “Over the years, we have found that vaccines cannot always prevent all kinds of tuberculosis. Neither is the treatment the same for all. Some persons are completely resistant to certain TB treatments. In such cases, precision medicine comes into play,” says Srikanth Tripathy, director of the institute.
Tripathy says they were gearing up to set up an exclusive research department for precision medicine within a few months.
When it comes to cancer, precision oncology is employed. Though expensive, it helps to make a patient’s life better by studying his/her history, genes and environment and prescribing suitable medication.
For this, a new tool called Proton Beam Therapy is used. “When a patient undergoes radiation, not just their tumour but a large part of the rest of their body is exposed to radiation. This not only weakens their body and shortens their life span, but also increases the risk of a relapse of cancer,” says Dr Steven Hahn, Anderson Cancer Research Centre, US.
Apollo Hospitals here will soon become the first hospital in South Asia to provide proton beam therapy.