"Personalized medicine is an emerging practice of medicine that uses an individual's genetic profile to guide decisions made in regard to the prevention, diagnosis, and treatment of disease. Knowledge of a patient's genetic profile can help doctors select the proper medication or therapy and administer it using the proper dose or regimen. Personalized medicine is being advanced through data from the Human Genome Project." -NIH
Thankfully that conversation is changing with genomics and Personalized Medicine. When you understand the biology and biochemistry of our bodies – and the genes that run them, it is very clear that there is much more that can be done to alter the perceived fated outcome. But the scientific studies have lagged behind – until now.
But now that is changing. In this research study, they looked at 3 diseases with a strong genetic link: hereditary breast and ovarian cancer, familial hypercholesterolemia, and Lynch syndrome. They evaluated more than 80,000 individuals of primarily European ancestry to examine the interaction between SNPs in multiple genes in other systems (polygenic) and single gene (monogenic) mutations for these specific inherited diseases.
The study showed that there was a wide range of risk as to whether someone who carried one of these mutations actually developed the disease. The probability of disease by the age of 75 ranged from 17% to 78% for coronary artery disease; 13% to 76% for breast cancer; and 11% to 80% for colon cancer (Lynch syndrome). And the explanation was the influence of this polygenic model on the effect of the genetic mutation.
This may make a difference as to what surveillance and intervention strategies are chosen for an individual. Perhaps equally or even more importantly, it opens up the opportunity to use a person’s genomic blueprint to be able to lower a person’s risk. By leveraging the function of these genes and their biological systems through targeted diet, lifestyle, supplement and even perhaps medication strategies, we can potentially alter the course of what was once thought to be an inevitable outcome.
Now we have the start of what promised to completely change how we approach genetic diseases, and what those of us practicing Personalized Medicine have been seeing for years in our practices - certain genetic mutations may not leave us as helpless as we thought. While there is still much scientific study that needs to be done, we have the tools and the power right now to make a difference.
References: Fahed, A.C., Wang, M., Homburger, J.R. et al. Polygenic background modifies penetrance of monogenic variants for tier 1 genomic conditions. Nat Commun 11, 3635 (2020). https://doi.org/10.1038/s41467-020-17374-3
MODERN HEALTH STRATEGY: INTEGRATIVE MODALITIES By: Dr. Jonathan Kirschner, Physiatrist- Hospital for Special Surgery, NYC There's no one-size-fits-all solution and a lot of what we're trying to do is individualize our treatments to the patient. One of the most important things I try to assess when I'm meeting a patient is to ask “what are your goals? What are your expectations? How can we meet those?” A lot of it is education to let them know what's realistic and what's not. A lot of my treatment strategies involve therapeutic exercise, engaging in physical therapy and there are different modalities even within that. There's manual therapy, there are different electrical therapies, there are ultrasound therapies to name a few. Other tools include complementary and alternative medicine and mind-body treatment which I'm a big proponent of because when you have physical issues, they can exacerbate the psychological side and vice-versa. Tools like acupuncture can be helpful for some people, but again, there isn't as I one-size-fits-all. We try to follow evidence based medicine protocols and an integrative approach. (See Dr. Kirschner's complete feature article on the 2022 LIFE EXTENSION REVIEW at Health & healing 101) |
How to Choose the RIGHT DOCTOREdited by: Noelle Cutter, PhD
Power Doppler Sonography adds increased accuracy to breast imaging evaluation over ordinary ultrasound because it shows higher blood flow speeds, often a sign of cancerous activity in the breast. Studies have shown that suspicious blood flow identified by pre-surgery Power Doppler scans corresponds very well with the size, location and aggression of actual tumors that are then surgically removed. Thus, Power Doppler brings an important clinical dimension to breast cancer detection. 3D sonography clearly shows tumor margins and 3D Doppler affords an index of cancer aggression and metastatic potential.
Breast Sonograms and Ultrasound offers the following advantages:
• Highest accuracy in dense (lumpy, cystic) breasts
• Non-invasive-no radiation exposure
• Cost effective
• Can distinguish cysts (fluid-filled masses) from cancerous tumors without needle sampling
• Ease of image guidance for breast biopsy
Women who should consider ultrasound scanning of the breast include those at risk of breast cancer because of personal or family history and the presence of fibrocystic (dense) breast tissue which increases cancer risk by as much as 400%. (See complete program- LINK)
WHY CANCER COMES BACK (Source: NIH- National Cancer Institute) When cancer comes back after treatment, doctors call it a recurrence- or recurrent cancer. Finding out that cancer has come back can cause feelings of shock, anger, sadness, and fear. But you have something now that you didn’t have before—experience. You’ve lived through cancer already and you know what to expect. Also, remember that treatments may have improved since you were first diagnosed. New drugs or methods may help with your treatment or in managing side effects. In some cases, improved treatments have helped turn cancer into a chronic disease that people can manage for many years.Recurrent cancer starts with cancer cells that the first treatment didn’t fully remove or destroy. This doesn’t mean that the treatment you received was wrong. It just means that a small number of cancer cells survived the treatment and were too small to show up in follow-up tests. Over time, these cells grew into tumors or cancer that your doctor can now detect.
Recurrent cancer starts with cancer cells that the first treatment didn’t fully remove or destroy. This doesn’t mean that the treatment you received was wrong. It just means that a small number of cancer cells survived the treatment and were too small to show up in follow-up tests. Over time, these cells grew into tumors or cancer that your doctor can now detect.
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