I began my functional medicine journey over three decades ago because I knew there had to be a better way than what I saw in conventional medical settings. Bio-individuality and the firm belief that there is no “one size fits all” have always guided my approach to wellness.
That’s why functional medicine is so exciting to me: it actively acknowledges the potential that exists to use our own bodies’ information to prevent, diagnose, and treat health conditions (even if mainstream medicine isn’t quite there yet.)
There’s something relatively new in the medical world that has potential to change the way we all (functional and conventional practitioners alike) determine our best clinical practices: precision medicine.
Precision medicine has been called a “broad-based research program that is focused on creative approaches for individual patients.” Massive studies are underway that could result in recommendations which would then be tested and used to build an evidence base that can more effectively guide clinical practices.
That may sound technical or scientific, but what it really means is that, finally, individual health statistics would be tracked in a massive database. If this happens, we could more easily begin to learn from what we already know about others who face the same conditions or share similar genes.
The Precision Medicine Initiative
In 2015, President Obama launched the Precision Medicine Initiative, a long term research endeavor by the National Institutes of Health (NIH) and many other research centers, with a goal of understanding the way that an individual’s genetics, environment and lifestyle can help practitioners decide on the best approach for treating and preventing disease.
The mission of the initiative is “To enable a new era of medicine through research, technology, and policies that empower patients, researchers, and providers to work together toward development of individualized care.”
That’s a powerful statement, isn’t it? I think it’s long overdue!
Individualized care is so important, and we simply cannot ignore the specific factors that impact each person’s health. What a valuable resource it would be to have pertinent information that could help us care for patients as individuals at our fingertips.
While the short term goals of the Precision Medicine Initiative center is on cancer treatment, the long term goal is to apply precision medicine to all areas of health and healthcare.
But let’s back up a bit before we talk about that too much, and discuss what precision medicine really means.
What is Precision Medicine?
Precision medicine is a new term for an old concept, one that functional medicine practitioners have been using for decades. It’s all about preventing and treating disease by considering the variants in genetics, lifestyle and environment for each individual person.
A precision medicine approach allows practitioners to better determine which treatment and prevention strategies will be most effective for particular people, rather than developing strategies for the “average” person without considering the wide range of differences that exists between individuals.
There are already some broad applications of precision medicine used today.
For instance, we’ve known about different blood types, and the importance of matching these blood types when giving transfusions for quite a long time. Some differences between human bodies are openly acknowledged and understood by everyone.
But extending that blood type idea even further and applying it more broadly to acknowledge variances among our proteins, metabolites, genes, cellular assays (secretions) and more on a person by person basis, is an exciting concept to consider!
How Can Precision Medicine Impact Health Care?
Could we ever know enough about our individual body functions to be able to target prevention and treatment strategies that are unique to our own physiology? Someday, I think so.
Precision medicine is already having an impact on the treatment of cancers. Many cancer incidence rates are increasing and cancers are among the leading causes of death both here in the U.S. and all over the world.
We now understand from research that there are characteristics that are universal across all cancers but there are others that are unique to each particular kind of cancer: every cancer has its own “genomic signature.”
And we are learning more every day about those signatures.
Research tells us that cancer is predominantly a lifestyle disease, resulting from damage to the genes based on things like our food choices, exposure to chemicals and toxins and stress. But we also know that there is a genetic component and that inherited gene variations can play a significant role in cancer development.
Knowing this, precision medicine scientists are already adjusting their risk assessments, their diagnoses and therapeutic strategies based on the variances among the genes that they observe, enabling targeted therapies, drugs and antibodies to be developed that are already having incredible results.
Imagine what they’ll be able to do when they have access to a huge database of information that they can study!
We are just starting… and as we analyze more cancer genomes and conduct more trials, the precision medicine initiative hopes to build a “cancer knowledge network” to store the data and the conclusions and enable scientists, health care workers — and even patients — to access it.
This will enhance existing cancer treatment practices, making them more precise, and may also improve preventative measures. It will also empower patients to take more control of their own health.
And that’s just the beginning. With ongoing long-term research, more benefits will be discovered all the time.
These may include new tools for building, analyzing and sharing large sets of medical data; building partnerships between scientists in a broad range of specialties, universities, patient advocates, and pharmaceutical companies, among others; improved ability to use genetic and molecular information as part of routine health care; better understanding of disease mechanisms; and improved approaches to diagnose, prevent and treat numerous diseases.
Comprehensive research could result in amazing breakthroughs
As with any ambitious health initiative, solid research data is imperative for advances in precision medicine.
As amazing as the foray into bio-individuality in the cancer realm is to me, the really exciting part of all this is what may be coming down the road: scientists hope to build a database and a longitudinal “cohort” of over a million Americans to gather and track health information and eventually develop better understandings of disease mechanisms, disease risk, and optimal therapies. To work towards this goal, the NIH has launched the All of Us Research Program.
They hope to include a wide range of biomedical information, including genomic, cellular, behavioral, molecular, clinical, environmental and physiological parameters.
What that means is that researchers can use details our bodies can give us, from our genes to our cells to our lifestyles, gather the information into a database where it can be studied and cross-referenced, and then they can develop some powerful applications using advancing technologies.
For example, one possible application might be a high-tech solution such as real-time monitoring of blood pressure, cardiac rhythm and glucose via your mobile phone. Another possibility might address the case of a woman who received a fecal transplant and became obese as a result: fecal sampling might determine the specific patterns of gut microbes contributing to obesity.
Blood tests might be able to reveal tumor cells or enable early detection of cancer through tumor DNA. Or we may be able to use genotyping to uncover the specific variants among genes that lead to certain conditions, enabling more effective treatment, earlier detection and ultimately, prevention.
While the greatest benefits will likely take some time, it is also hoped that another shorter-term benefit may be found in pharmacogenetics: getting the right drug to the right patient in the right dose. For those on medications, this can be very impactful.
Merging functional and precision medicine
I have always always known that every woman is different; my philosophy has always been to meet each woman wherever she is and work with her own unique physiology, biology, lifestyle and “story.” I treat the whole person and accept that there is no one size fits all approach.
But over the last thirty plus years, I’ve also come to see first-hand that while there is always some tweaking and adjusting patient by patient, certain lifestyle and dietary choices, along with key nutritional supplements, seem to bring tremendous results universally for almost every woman.
The information precision medicine can provide will help us with the individual tweaking, as we continue to emphasize the importance of lifestyle choices for optimal health.
Attention to lifestyle is essential for optimal health
I see every day the impact that lifestyle and food choices make to our health.
Food is the most powerful drug (for both harm and for healing) out there. At the Women to Women clinic, we’ve spent more than almost four decades identifying the common denominators that help virtually all of our patients restore hormonal balance, thyroid and adrenal health, and overall wellness.
I’ve helped thousands of women alleviate mood swings, fuzzy thinking, hot flashes, anxiety and other debilitating symptoms and finally feel like themselves again. You don’t have to wait or feel badly even one more day. I can help you too!
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Reviewed by Dr. Mark Menolascino, MD