Personalised Healthcare To Constantly Monitor Health and Identify Future Disease

Aug 15 2006

We are beginning to believe in a world where medical science should provide the answers to all our needs: we expect to be healthy, disease-free and long-lived and we expect that we can be cured of disease. Can these expectations ever be realised? Dr Amanda McMurray from CPI discusses society's expectation of medical science and looks to the future and to what it will bring to us over the next 50 years.

Future Healthcare

In 50 years time, we will have become accustomed to a very different style of healthcare. We are now, used to being checked occasionally and screened and monitored when these irregular checkups show that something may be wrong. In a few years time we will be monitored constantly through a human-materials interface, providing us with information on our health, our comfort and our wellbeing.

Constant Health Monitoring

A wealth of information will be brought together into an ¡§electronic nervous system¡¨ bringing a new meaning to 'quality of life'. Any deviations from our normal 'healthy' state will be screened against a lifetime's worth of data on our health, and corrective actions will be taken automatically to restore us.

This view of a truly personalised medicine seems so remote as to be almost science fiction. But believe it or not, we are moving quickly towards it.

Genetics and Health

We already understand that a person's genetic makeup may, in some cases, determine how certain diseases affect them. It may also affect how they respond to certain therapeutic drugs. The genetic basis of many diseases is still not clear; it is also apparent that an understanding of genetics alone will not, in many cases, be sufficient to determine a person¡¦s risk of certain diseases. However, despite that, we already have a good understanding of some genetically 'simple' diseases, such as cystic fibrosis, and this enables us to take precautions against transmission of the disease, if we so choose.

Cancer

In other cases we are beginning to understand the complexity of diseases. Cancer, once thought of as one disease, is now understood to be hundreds of different diseases each with its own genetic risk profile. However, even in this complicated disease, we can already in certain cases, identify clear genetic profiles, and in certain cases we can provide patients with therapeutic drugs that have been designed specifically for their particular disease profile.

Therapeutic Drugs

Therapeutic drugs have traditionally been designed and tested so as to be safe for everyone, regardless of genetic profile; whereas this means that it is unlikely that anyone will suffer adversely from them it can also mean that most people will not gain any particular benefit at all from treatment. However, where the genetic basis of a disease risk is understood, drugs are already designed for patients with a specific genetic profile, hence being designed not only to be safe, but also to be highly effective for that particular patient group. The patient is tested to determine whether they are a suitable candidate for the drug, or whether their particular disease can be treated. If the test confirms suitability then treatment can begin. In the future we envisage that a bank of treatments will be developed, each designed to be highly effective to a particular patient or disease profile.

Personalised Medicine

So there are clear signs that we are moving towards an age of personalised medicine, where each patient will be treated according to their genetic profile. Each person will understand their risk of developing any disease and if at risk, what their prognosis might be. Disease management will be automatic, with vital signs recorded and analysed and the appropriate responses initiated.

In the meantime we must be wary. We can offer personalised medicine only where we understand the genetic profile and are able to respond accordingly. Where there is no response, it is better, perhaps, to leave well alone....for the moment.