Newspaper article THE JOURNAL RECORD

Genetics, Preventive Pharmacology: A Wave of the Future

Newspaper article THE JOURNAL RECORD

Genetics, Preventive Pharmacology: A Wave of the Future

Article excerpt

One of the early lessons of the genetic screening "business" has been that "if you can't fix it, there is little market for genetic testing." Progress is being made on both fronts: We can predict with more and more precision who is going to develop a disease, and we have more and more options for treating (or in reality "preventing") than ever.

In many diseases, if an affliction occurs in a first-degree relative, even with little other information, a physician can surmise that the patient has an approximately 1-in-10 chance of developing the disease. In fact, in conditions such as Type I or juvenile diabetes, Type II or adult onset diabetes, bipolar disease, schizophrenia and breast cancer, geneticists are now able to predict the occurrence of disease about 50 percent of the time.

These advances have come in the last decade, and the promise of the future is that the accuracy of these predictions will improve even more. However, with the "risks" now approaching 50:50, many patients are being offered "preventive medicine" -- that is, "treatment" before the onset of overt symptoms. Sometimes, in addition to genetic testing, other tests are performed. For example, in juvenile diabetes, in addition to genetic testing, physicians test for antibodies to specific molecules that are part of the pancreas, specifically the islet cell, which makes the insulin, the lack of which is the primary cause of the disease.

The treatment end has been revolutionized in these diseases as well. The general concept is that a low dose of a "therapeutic" can be used to delay or even prevent the onset of disease. Approaches such as this have been used in juvenile diabetes for about five years, and now they have been used in several other conditions including breast cancer. Here, if a woman has a first-degree relative with breast cancer and has a genetic susceptibility test that shows positive, thus giving her a 50:50 chance of developing breast cancer, the drug tamoxifen can be used to "prevent" the development of disease. …

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