Have you heard this phrase, “personalized medicine?” Everything is better when it’s personalized, right? The question to ask is not whether this customization is good or not (it is), but who exactly the customer is.
The conventional medical model states that you are a collection of cells containing DNA, and that this DNA determines your biologic fate. Thus, control the DNA and your control a person’s health. So, the customer, the “person” in the personalization is your DNA, not you as a person with feelings, thoughts, experiences, and memories interacting with an environment altered by your food, water, air, changes of seasons, stage of life, etc.
Genetic determinism is appealing to some physicians because it seems to hold the promise of the ultimate cure. If you can attribute a disease to a single gene, you can create a highly targeted treatment using gene therapy. Unfortunately gene therapy has had very limited success after decades of trials and billions of dollars in research, and even some tragic deaths and disabilities of test subjects, some of whom were children.
Insurance companies are pushing for pharmaceutical companies to use genetic tests to figure out which drugs are likely to work for a patient. This is really more about saving the insurance company money for expensive drugs, but it’s a good start.
Entrepreneurs like the idea of genetic determinism because they can sell gene kits to anxious medical consumers. While they have profited handsomely from these pseudo-science endeavors, our health has not profited from these tests.
In her 2010 article in Newsweek, science writer Sharon Begley observed, “An estimated two thirds of the early studies linking an aberrant form of a gene to a particular disease turned out to be mistaken.” Back to the Genetic Future, Newsweek, 11/14/2010
According to Begley, family history of disease is a better predictor of disease than genetic tests with respect to diabetes and heart disease. Most of the studies linking a single gene to a single disease did not pan out in predicting actual disease risk. (For example, these studies and this large international study investigating heart disease and genetics.
Endobiogeny is a theory of terrain, the ecosystem of the body. The terrain in endobiogeny is based on your genetic heritage. But what we are interested in is how your genes are being expressed by your hormones due to the demands of your internal and external environment. Genes matter, but so do hormones, lifestyle, thoughts and emotions. Personalized medicine MUST be focused on the person.
Think about it. Little boys don’t grow mustaches or get prostate cancer—because the genes related to these activities are not “turned on” in childhood.
Here’s another consideration: people whose heritage is from one country, say India, but grow up in the US have increased rates of certain cancers and decreased rates of other cancers based on whether or not they live in India or the US. Why is that? It’s speculated that in part, the change in climate, food and lifestyle changes the pattern of genes expressed to reveal new risks for diseases (or reduced risk) that were hidden in prior generations.
In the endobiogenic approach to medicine, it is not unusual to spend one hour or longer on your medical history—including family history. The timeline of your disease(s) is a better indicator of how certain genes were turned on or off, intensified or dampened. This detailed personalized history reveals crucial information about your biologic individuality, which cannot be obtained with laboratory testing, imaging studies or genetic analysis. It’s important to understand the person who has the disease and not the disease that has the person, as Sir William Osler said.
What’s so important about genetics and why should we care? The subject of my next blog…