Documenting the dramatic evolution of personalised medicine

In her book ‘Advancing Healthcare Through Personalized Medicine’, science writer Dr Priya Hays has compiled an authoritative and highly detailed account of how technology is changing healthcare.

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Hello and welcome to Research Pod! Thank you for listening and joining us today.

In this episode, we will be discussing the latest publication of science writer Priya Hays. In her book Advancing Healthcare Through Personalized Medicine, she goes into depth around how personalised medicine might tackle cancer and break new ground in other diseases, while addressing the biggest challenges to implementing a person-centred approach to medicine.

Humans aren’t cars. That’s an obvious statement, but worth reiterating when talking about medicine. When something ‘goes wrong’ with a human, there’s no predetermined fix per its model. Each human is unique – a wondrously complex interplay of genetic history, current natural state and the myriad external factors making their mark. Properly fixing humans when they ‘go wrong’ should therefore require a unique intervention that considers and addresses this entangled interplay. That may sound like wishful thinking, but it’s a burgeoning reality.

Dr Priya Hays is an experienced writer with an eye for the remarkable narratives unfolding within science. Of particular interest to her is how technology is changing healthcare. Usually, technological advances are like building blocks, adding to our evolving understanding of healthcare; every now and then, there’s a seismic shift. But dramatic leaps in previously considered unconnected technology are now converging to overturn the historical fundamentals of healthcare. Hays can see this and has compiled an authoritative and highly detailed account in her book Advancing Healthcare Through Personalized Medicine. Aimed at the scientific community, academics, laypersons, and policymakers, the most recent edition includes significant developments since the first edition was published in 2017 – only five years ago. As Hays says, the second edition has ‘benefitted appreciably’ from these advances.

Healthcare is now at the heart of a rapidly expanding realm of sectors beyond those traditionally associated with medicine. To give you an idea about the scope of this book, don’t imagine a typical clinical setting; think data – and lots of it. Consider connected devices, big-tech companies corralling information, biotech pioneers unlocking mysteries within genomic data sets, and ethicists and regulators scrambling to keep up. Tumbling out of this highly energised melee are the exciting prospects in personalised medicine previously considered only within the province of science fiction. Trying to keep track of it must be challenging, but Hays is committed – the latest edition is over 700 pages long.

Such depth is essential. Personalised medicine is not a monogrammed pill; it’s a complete rethink of how to treat patients, and if there’s a trigger point, it’s The Human Genome Project. Codifying the human body by genomic sequencing not only unlocked new avenues for targeted therapies; it brought new players into the game. In her book, Hays sets the scene created by the tentative spread of genomics into various sectors within healthcare, such as pharmacogenomics and oncology, before focusing on how big data and artificial intelligence led to new frontiers and steered the focus beyond standard frameworks. This expanded playing field has demanded new alliances between knowledge structures and the digitisation of precision health. If there’s a poster boy for personalised medicine, it’s a patient’s watch, not a doctor’s stethoscope.

It would be tempting to focus on the tech, but a large part of this book’s heft lies in its detail. Hays goes into depth around how personalised medicine is tackling a disease that has hitherto largely defied our most concerted efforts: cancer. The book examines the new fronts in the fight, such as personalised and precision oncology, immunotherapy, and molecular diagnostics. Instead of carpet bombing the body with chemicals, doctors can now target the specific genetic signalling pathways that lead to erratic cell growth. Hays shows how such tactics are plenteous and unrelenting, and amidst the detail and data on the pages is a real sense of promise. The book also highlights how personalised medicine is breaking new ground in other diseases, such as Alzheimer’s, Parkinson’s, diabetes, arthritis, multiple sclerosis, cardiac disease and HIV, and crippling psychiatric conditions such as schizophrenia and bipolar disorder.

Of course, not all discoveries are cures, and new frontiers harbour all manner of complications. Hays points out some of the biggest challenges in advancing healthcare through personalised medicine, and they are largely attitudinal, not technical. Data is a double-edged sword in medicine. As much as it opens us up to whole genome and whole exome sequencing, it must be shared between providers, researchers, and patients to do so: enter the role of established regulators and other authorities claiming to speak on behalf of patients, and the new regulators and authorities forming around novel technologies. According to Hays, they encourage us to confront uncomfortable questions and consider unsettling scenarios: what are the ethics of epigenetics, where are the limits of your privacy, who owns your data, and what happens if it ends up in a courtroom as part of a patent dispute?

Beyond those calling for circumspection about personalised medicine are healthcare professionals and patients eager for progress. They see its promise and witness its benefits every day. Hays devotes due space to their stories and, in the process, provides a more personal touch. We are reminded not to be distracted by technology; the patient must remain centre stage.

The days when medicine was akin to a car owner’s manual and had a pill for all people with the belief that it should work for most, definitely for some, are now past. Healthcare providers can now tailor treatment and prevention strategies to people’s unique characteristics, including their genome sequence, microbiome composition, health history, lifestyle, and diet. As such, Advancing Healthcare Through Personalized Medicine is an detailed, honest appraisal of how the future of healthcare is already here.

That’s all for this episode – thanks for listening, and stay subscribed to Research Pod for more of the latest science. See you again soon.

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