In the past five decades, the progression of medicine has been rapid and progressive. Medical research has set down into exploration and finding cures for many diseases through surgical techniques, drugs and vaccines hence in the long run improving the health standards and life span of humans in general. All this is en route to a personalised medicine, "the tailoring of medical treatment to the individual characteristics of each patient. It does not literally mean the creation of drugs or medical devices that are unique to a patient, but rather the ability to classify individuals into subpopulations that differ in their susceptibility to a particular disease or their response to a specific treatment" Priorities for Personalised Medicine (2008). Due to variation in the human genome, medical treatment including drugs and therapies may only be for a specific group of people. Hence, while scientists determine the human genome to cure intransigent diseases such as cancer, serious ethical dilemmas are fast facing humanity. Solving the paradox to this issue will enable us determine the prospects of personalised medicine. Through the development of research organization, and the use of personalized pharmacogenomics, "a branch of genetics that studies the genetically determined variations in responses to drugs in humans or laboratory organisms" WordNet 3.0 Princeton University(2006), medical professionals are developing many sub populations for complex diseases and physical conditions such as Diabetes, Cancer, Alzheimer's and heart diseases. "Genetic mapping has been said to derive the causative of a disease even before the symptoms of the disease develop" and hence the doctor and the patient, with the use of technology-based medicine, will be able to take a plan of action to prevent and cure the disease before the symptoms appear.
An overview of personalised medicine and a look into its future (Personalised medicine is beyond the Human Genome.)
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Cancer is a disease that is caused by the polygenic disorder where different genes mutate and hence facilitate development of cancerous cells. Factors such as environmental and the gene profile of every individual make each case unique in that variation in how drugs are absorbed, metabolized and used in the human body is entirely on the distinctiveness of the DNA. Chemotherapy has been a way that oncologists came up with where drugs are administered hoping to diagnose the cancerous cells and treating the affected cells. However side effects such as hair loss occur when the drugs are targeting fast growing tumour cell and since hair follicles are one of the fast growing cells, hair loss becomes a drawback to the type of treatment. This and many other side effects have been experienced by patients since the drugs are not specific to their genomics. ''The problem we have is the complexity of cancer. No two tumours are the same, even within the same type of cancer. They may look the same under the microscope, but their molecular aberrations vary greatly'' Science Daily (2010). When treating a cancer, a person is given a drug that is most likely to work; within the limitations of our current understanding. The drug may not work for that individual (due to the difference in the immensity and variance in the genome composition), even though it works for the majority of patients with the same kind of cancer. If the treatment fails, a second-line treatment is considered, which might also fail. By the time we get to the treatment that's actually going to work, it might be third or fourth down the line and the cancer may have advanced. In the case of pancreatic cancer, the patient has probably died.
Due to the realization of the Human genome, cancer can now be cured and thus medical treatment personalised. Scientists at the UK-based Wellcome Trust Sanger Institute catalogued the genetic maps of skin and lung cancer and have pinpointed the specific mutations within DNA that can lead to dangerous tumours. Researchers predict these maps will offer patients a personalized treatment option that ranges from earlier detection to the types of medication used to treat cancer. By identifying all the cancer genes scientists will be able to develop new drugs that target the specific mutated genes and work out which patients will benefit from these novel treatments '' Phil Han, CNN (2009). Oncologists all over the world are in cooperation screening a range of therapeutics against the vast array of human cancer cells and the associating drug sensitivity with the broad genomic data. This will hence fasten the drive towards a personalised medicine.
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Doctors have always known that patients experience varied reactions towards different drugs such as painkillers, depressants and many other such drugs for diseases such as asthma and hypertension. Pharmacologists and biotechnologists incorporating genomics are now revolving more towards a personalised medication to facilitate the approval of new drugs as well as to advance the drug development process. "Pharmacogenomics examines the inherited variations in genes that dictate drug response and explores the ways these variations can be used to predict whether a patient will have a good response to a drug, a bad response to a drug or no response at all." This is in transit to finding the right drugs for the right sub-population of individuals with similar gene sequence responsible for the disease and hence administering of the right dosage for specific people while reducing the side effects from being experienced by patients. Scientists have used both human and non-human genes in the process of discovering new prescriptions and therapies hence through the use of technology and scientific innovation, realizing that whether the human body is responding to stimuli in the environment such as viruses or toxins, ''All diseases have a genetic component!'' The genome project is also believed to enable high quality personalised medication and avoiding expensive futile drugs which in turn will reduce the adverse effects that occurs due to drug administration.
In the past, the challenge was to acquire information about the human genome; the challenge now is to manage the bulk of information being produced every day, be able to test and use it in an apt way. As much as interpreting the human Deoxyribonucleic acid DNA to cure diseases is strongly desired, research will have boundaries due to ethical and moral issues that arise with it. A person's genetic information is massive and can be used for other things that may be devastating. Thus issues of confidentiality and social control take this matter into economic and political realms, referring to whether the genetic information should be private or available to other institutions such as the Insurance companies that may end up denying the customers the benefits of health insurance.
Accessibility and affording personalised medicine for the common man. If the genome profile for every individual is capable to be mapped, both prognostics and diagnostic tests, how many will be able to afford it? Will insurance be able to reimburse all patients for the profiling of all their genes? The future of personalised medicine is at risk of becoming a reality and thus, just as expensive the treatment of diseases will be for the government, so will be the costs for social awareness of the treatment to different personalised medication. On the other hand, the World Health Organization (WHO) points out that "90 per cent of all health research expenditure is targeted at problems that affect only 10 per cent of the world's population.''This matter depicts the inequality that already exists in the field of medicine whereby even the cheapest drugs targeted curing common diseases such as Malaria are inaccessible or/and exorbitant to patients in most developing countries. Hence the future of an effective personalised medicine becomes more uncertain.
This paper aims to define the prospects of personalised medicine. It discusses how the knowledge of the human genome has led to the provision of some level of achievement in treating and improving health specific to every individual or subpopulation. It also tackles how technology has led to the discoveries of medical therapies that have been able to eliminate diseases in a personalised way, such us the use of Nanotechnology and its impacts on medicine. For a future where personalised medicine exists, technology in medicine will need to be implemented. Knowledge in computers, biotechnology in genomics will be joined for the same mission. Development in molecular medicine technologies will change the face of medical health care both in a strategy and the use of drugs and therapies personalized to a specific patient's genotype and in the prevention of pandemics. These developments will require an unending cooperation and efforts in the public and private sectors as well as the organizations and improvement in the systems of education to all. Policies, regulations, ethical issue will advance as medicine becomes more personalised and thus man's innovativeness will always be challenged. Unlike in the past, information technology is fast improving and we will soon live in an era where a number of patients with similar genome profile will be treated using the technology of computer based decision making. The storage and safety of the patient genome profiles will be achieved in the process and hence an effective and preventive personalised medicine.
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