Cover by Anthony Pascarella 

The New Wave: Precision Medicine

By Emily Hauk

Being a STEM major usually means my sense of logic outwits my imagination, but every so often I am compelled to suspend disbelief in the face of remarkable scientific achievement. This is one of those times. It’s a concept that sounds like it jumped right out of a science fiction novel—analyzing your genomic sequence to uniquely tailor your medical treatment may have been something of which Ray Bradbury and Jules Verne could only dream, but for modern medical researchers, precision medicine is the emerging approach for disease treatment and prevention. 

So, what is precision medicine, and how does it contrast with the “one-size-fits-all” approach that has been the norm for the majority of the modern medical age? According to Dr. William Saunders, a professor and researcher at the University of Pittsburgh, the nature of precision medicine centers around the idea that “there’s a lot of differences genetically between individuals…which certainly plays a role in their biology…so it would also play a role in how they respond to different medicines.” The essential context is this: throughout history, treatments have been designed to necessarily benefit as many people as possible—this is the “one-size-fits-all” model. The problem with this model is there will always be individuals who do not fit that “standard size,” and in worst-case scenarios Saunders says “the people that don't benefit [not only] have no effect, but they have a deleterious effect; they get worse when you give them the treatment.” On the other hand, precision medicine focuses on the individual patient’s genetic makeup in order to build a more comprehensive and personalized treatment and diagnosis plan. This can take a couple of different forms including tumor profiling, drug profiling, preventative measures for genetic disorders, and many more. 

A more individualized approach to medical treatment seems so beneficial that many may be wondering why we didn’t adopted it earlier. While it’s true that the human genome was fully sequenced many years ago, inherent challenges exist when attempting to implement this level of biotechnology on such a large scale. “The challenge with all bioinformatic systems is to collect enough data in an unbiased way…when you involve people…then you have a question of reliability and accuracy.” Furthermore, many of the technologies needed to effectively cement precision medicine as a reliable medical tool are still in the early stages of their development. 

Other issues plague precision medicine’s potential success as a practical treatment process, namely cost and ethical ramifications. Sequencing large quantities of DNA is not a cheap endeavor, and funding the execution of even the most baseline quantity of individuals will likely require millions of dollars. However, the ethics behind precision medicine are what draw the most controversy and criticism. Access to an individual’s detailed genome is valuable information, and protection of patient confidentiality is one of the most important aspects of healthcare. Additionally, fears over furthering the divisions in access to healthcare are central to the precision medicine debate. The idea that some individuals may be in what Saunders calls “a sort privileged status and get a certain subset of care,” while there are those who may not be able to afford a more tailored treatment program, poses a fundamental question regarding precision medicine and the implications it can have beyond medicine. Namely, will precision medicine further the deepening divide in access to healthcare? 

Regardless of these debates, precision medicine’s potential impact on the medical community is undeniable and it could change the way diseases are treated forever. Although precision medicine biotechnology is not available for wide use, Saunders encourages individuals to implement the theory behind precision medicine in their everyday interactions with healthcare. According to Saunders, adopting a new attitude when interacting with health care providers is most beneficial. “You might be able to ask them what about [your] medical profile suggests that [treatment] might be helpful or not…if they’re just treating you like a generic person, they give the same advice they would give anyone else, then they’re not doing their homework.” Whether precision medicine is months, or years away from practical implementation, exploring options that exist outside of the “one size fits all” model could prove fundamental to changing the way we prevent, diagnose, and treat disease.