Biology assignment help essay: Era of Personalized Medicine

Personalized Cancer Therapy: Current Status and Use

The medical approach of ‘one size fits all’ is an anomaly in the case of personalized medical care. This indicates that every person’s body reacts in a different manner to the disease and requires different treatment based upon their genetic build up. This is done with the help of molecular testing of each individual and studying their reactions to different diseases and medications (Current applications of personalized medicine, 2012).

 In recent scenario the doctors are putting their best efforts to personalize a treatment by studying a person’s unique genetic makeup. But it is an exciting waiting game because first they have to wait for someone to fall ill and then the patient can be cured accordingly. However understanding the genetic differences of the patients would lead us to diagnose and prognosis of diseases like Cancer, Alzheimer’s and Diabetes.

The world has been fighting a long battle since time immemorial to find a specific cure for various kinds of cancer and the fight is still on and we need to win this war against cancer once for all. Currently personalized medicine applications are used for following purposes:

Blood Clots

The dosage of wrafarin is considered to be dangerous as it could result in clotting of blood and excessive bleeding. But with the advent of molecular testing now it can be controlled to a great extent.

Colorectal Cancer

The patients of colon cancer can take a sigh of relief with the invention of biomarker which after certain easy tests tells us, how a tumor can respond in future to certain drugs.

 Breast Cancer

In the case of breast cancer the breast tumors can be screened to ascertain which receptors are being contained by the tumor cells of women.

The most important aspect of the entire revolution is the acceptability of personalized care approach by the society. However it is quite debatable, that what can be the possible ramifications of such approach and its legal and ethical aspects as well.

‘The College of American Pathologists supports the appropriate use of molecular testing by pathologists for accurate cancer diagnosis and patient prognosis’ (Molecular Testing for Cancer Prognosis and Outcome, 2007). The medical practitioners and pathologists are the people who not only manage diseases but are also able to use molecular tests for diagnosis and prognosis according to the DNA makeup of a particular person. Currently such tests are available for breast cancer, colon cancer, prostrate and other types of cancers.

The idea of such advances is to understand and cure the patient according to the unique genetic set up he/she has, thus curing in a more substantive way. The molecular tests can be conducted by using either blood samples or cancer affected tissue of the patient.

If we take Lung Cancer as the focal point of study for the molecular tests, then the Lung Cancer Mutation Analysis Project (LC-MAP), which is a program started by Memorial Sloan-Kettering Cancer Center (Kris, 2010) would be the one which has gained huge success in its pilot stage only. Dr. Mark G. Kris (Kris, 2010) of the institute says, ‘the knowledge gained from these tests maximizes the chance of treatment success for each patient’. He also talks affectionately about the institute’s efforts in inventing new therapies to overcome the genetic disorders of people and treating them in a unique manner.

There has been debate over the use of certain technologies in treating the patients like laser technology, artificial insemination etc. and the ethical aspects of such usage. The molecular test therapy and genetic disorder treatment in a specialized procedural way, is a step towards the advancement of medical science (Nordqvist, 2012). This gives a lot of scope for succeeding in what is considered traditionally as an incurable disease.

The other aspect of such study is based on the fact that how and what are the health behaviors and consequences of treating patients on the basis of genetic profiling (Dolan, 2012). It is also imperative to understand that since the actual potential of personalized medication is still not known and most of its benefits have been passed on, what shall be its genetic effect upon the patients in long run. Nursing is also plays a crucial role in multi-disciplinary application of personalized medication.

“Using a complete map of the molecular changes in tumors in a clinical setting is a world’s first application of this technology”, said Dr. Steven Jones, associate director of the Genome Sciences Centre and Professor, Simon Fraser University (Jones, 2012). This means the technology is still in a very juvenile stage at present.  Although the medical fraternity supports it for development in the future but depicts skepticism for its current application to maximum cases.

The other practical aspect of the application is that the advances in DNA sequencing and reducing cost of sequencing are serving as a great booster in the adoption of technology as consistent basis of effective cure.

Impact of Development in DNA sequencing on Cancer Therapy

DNA Sequencing

Till 1070’s DNA sequencing was considered to be a critical task, but in the mid of the decade developments in sequencing started and two prominent theories of sequencing were developed namely (Rosen, 2009):

Chemical DNA Sequencing

The theory was based on determining the sequence of DNA by labeling one strand of DNA and then dividing it into certain fractions and studying their reactions. The limitations attached with this sequencing were: the peril of exposing a DNA strand to chemical reactions and time taking process of the entire sequencing activity.

Synthesis DNA Sequencing

The method was performed by using radioactive nucleotides and film images. Sanger and his colleagues developed a method where DNA to be sequenced was enzymatically copied starting at a specific point using a DNA polymerase enzyme. This was done in the presence of mixtures of nucleotide precursors when mixed in the reactions where lower concentrations of similar nucleotides which had a chemical modification , once incorporated, made it impossible to extend the newly synthesized chain any further (Sanger, Nicklen, & Coulson, 1977).

Modern DNA Sequencing

The new sequencing methods like ‘Sanger’ method is being used widely in Modern DNA sequencing. However, currently the samples are sequenced through capillary electrophoresis machines.

Potential of New Sequencing Technology and Impediments Restricting its Uptake

With a number of genetic diseases present like Huntington’s disease (a brain disorder), fibro dysplasia ossificans progressiva (a disease in which a person’s muscles are replaced with bones) etc. the solution of mutation to such problems through a technique called as linkage analysis was adopted but it was found to be very cumbersome. The advent of new DNA sequencing technologies has provided a linkage based cost effective solution to the age old problem of genetic disorders (MacArthur, 2011).

The technologies work very harshly and specifically by targeting at the genes which are causing a tissue disorder like damaging mutation. Thus it paves the way for the pathologist to specifically cure the disorder by providing relevant medication. ‘Fortunately, most rare diseases (around 80 per cent, by some estimates) are caused by mutations found in a relatively small fraction of the genome: the pieces that code for proteins, known collectively as the exome’ (MacArthur, 2011).

The entire idea of a sequence based detection of a disease is very enthralling but its application is much more exciting, because the application talks about its latest developments and successful approach. The potential of sequence based detection of a disease is huge as the number of rare genetic disorders is numerous. However the difficulties faced with the application of sequencing has been not less e.g. identification of mutations is difficult as every person carries a lot of broken genes that actually do not cause any disease, thus the entire process becomes cumbersome and difficult.

However, there are certain problems which the new technology of sequencing faces which make it an impediment to be taken in clinical medicine. There aren’t issues which it faces from the medical fraternity but the societal impact of its application has created a concern like:

Rights and Privacy

DNA sequencing and analysis is widely used in unearthing of crimes and proofing of the incidents in catching criminals. Some of the examples where DNA sequencing is used are fingerprint testing, study of DNA samples and its matching with the collected samples from the scene of crime. This technique is widely used by forensic experts in differentiating suspects from innocent people. This certainly infringes ones right to privacy and security of biographical data.

Genetic Issues

The use of genetic sequencing and providing medication on the basis of genetic makeup of individuals is a worthy invention but its proper and ethical application cannot be ensured with certainty. A lot of people misuse the technology in deciding maternity and paternity issues illegally. However, this does not necessarily mean that the technology used is widely susceptible to abuse.

Legal Issues

The demarcation of authority and responsibility has still not been streamlined amongst the people who are considered to be the custodian. The laws do entrust a clear status as to the reach, limitation and safeguarding of rights and adherence of norms.

Commercialization of DNA Sequencing Technology

A DNA strand can reveal a lot of information about the biological stature of a person, his physical abilities to encounter situations which human beings are very vulnerable to. The particular manner in which a person reacts to a drug or a dosage, his ability to resist the high exposure to chemical treatments and at times finding out the traces of ancestral origin of a person is possible through DNA sequencing technology (Wills, 2012).

The primary objective of DNA sequencing was to study the mutations which cause the genetic disorder in a particular person or in the members/ ancestors of a particular family, however, it is important to understand how much essential it is to people in general?

The commercial application of DNA sequencing is the usage of the technology in diagnostics, biotechnology and genetics research. However there has been reduction in cost of DNA sampling recently, but the overall cost of the treatment is still expensive (Nanoparticle-based DNA Sequencing, 2012).

Biosensors technology, an invention of the hour is used for curing hereditary and genetic disorders in a person. The technology is used extensively for the following purposes:

Research and Development

 There has been major efforts and which have been put in research and development to find a breakthrough in the latest developments for this technology. The cancer research centers and medical institutions are doing extensive research in finding the causes of mutations for all the possible disorders and cancers. This has compelled the administration and companies to invest billions of dollars into these institutes for conducting research and also creating employment at the same time.

‘One expectation is that as the size of the machines shrinks and the sequencing price tag falls below the $1000 threshold, markets for genome sequencing will expand throughout the health-care system, where the machines can help doctors both prevent and treat illness’, says Balagadde (Balagaddé, 2012). This clearly shows that the cost of technology is creating way for its affordability.

Diagnostics, Treatment and Prognosis

The very objective for the advent of technology was to find a personalized cure for an age old incurable disease called cancer. The sequencing technology helps the pathologists in studying the sequencing through molecular tests by taking blood samples or tumor affected tissues.

A personalized treatment course is designed for every person depending on the results obtained through his genetic buildup samples. This is done over a period of time and is a slow process.

The pathologist is able to form an opinion about the causes of such diseases and what shall be the effect of such disorders in the long run to the concerned patient.

The cost of the entire process is still very expensive in countries like USA because the cost of treatment for anything is very expensive in U.S. anyways. On this ground the affordability of this technology for common man looks bleak but the cost is certainly reducing. This has created a lot of opportunity for medical practitioners to conduct research and to practice it as a specialized field.

Crime Investigation

Crime Investigation is another societal objective for the advent of technology. DNA samples are widely studied in forensic investigations for unearthing crimes. The authorities rely very heavily on the outcome of the study based on DNA samples from crime scene and helps in tracking down the culprit. this technology is widely used by investigating authorities in unearthing complicated crimes.

Opportunities opened up by Personalized Cancer Therapy

The usage of therapy has opened the gates for opportunities which are very huge. The idea of transforming the raw stage detection to a comprehensive treatment has created pathways for new avenues for many.

Peer Group Involvement

Dr. Robert C. Bast, Jr. University Professor for Cancer Research at the University of Texas M.D. Anderson Cancer Center says, ‘We need to invest in trials and infrastructure for sequencing, testing, and developing pathway-centered and organ-focused approaches in the laboratory, and we need to establish, sustain and retain translational teams that include not only physician-scientists and clinician investigators, but molecular imagers, molecular pathologists, translational scientists, pharmacists, biostatisticians and bio-informaticians, research nurses and data managers, and experts in regulatory affairs’ (Bast, 2011).

He clearly banks upon the involvement of lot of experts from wide domains in medical field thus creating lot of opportunity for research and growth.

Research and Development

As discussed earlier also a lot of opportunities have fallen before in terms of research and development that have been using DNA sequencing to cure cancer disorders. These opportunities will ensure the developments in the field and its application in the long run. The research is being done on the molecular tests that are being designed to counter almost every category of cancer known to man. Pharmaceutical companies are taking coercive steps with regard to the development of personalized therapy. Continuous testing and treatment has led to revealing of lot of disorders which require a systematic approach towards development of their combating drugs.

The other important aspect is a question to be answered that whether a small subgroup of patients in one indication can commercially support two almost identical drugs. This can be overcome by handling the hurdles like the clinical and commercial aspect of such drugs and its application to specific set of mutational disorder in patients.

 Personalized Treatment for Specific Curing can be described as the basic requirement of conducting such clinical research where it is required to treat patients according to the specific disorder which they have, hence personalizing the entire treatment. This gives a lot of hope to people who have been suffering illness due to ‘one size fit all’ approach. This means the scope for improvement over the available technologies and its advancement is there with a step in the direction of unique achievement. . Lot of people has disorders that are hereditary and hence genetically detectable. The marking of DNA strands and its intensive research paves a way to find out the exact causes of a particular disorder. These causes are then treated with sequencing techniques to treat in a specifically directed way. The technology is certainly a great revelation in the field of medicine and medical research, a path-breaking discovery leading to an overall improvement in human life resulting in higher life expectancy. The developments are still on the way and progress is still expected to cross every hurdle that comes in its way to be successful.

Era of Personalized Medicine

Personalized Cancer Therapy: Current Status and Use

The medical approach of ‘one size fits all’ is an anomaly in the case of personalized medical care. This indicates that every person’s body reacts in a different manner to the disease and requires different treatment based upon their genetic build up. This is done with the help of molecular testing of each individual and studying their reactions to different diseases and medications (Current applications of personalized medicine, 2012).

 In recent scenario the doctors are putting their best efforts to personalize a treatment by studying a person’s unique genetic makeup. But it is an exciting waiting game because first they have to wait for someone to fall ill and then the patient can be cured accordingly. However understanding the genetic differences of the patients would lead us to diagnose and prognosis of diseases like Cancer, Alzheimer’s and Diabetes.

The world has been fighting a long battle since time immemorial to find a specific cure for various kinds of cancer and the fight is still on and we need to win this war against cancer once for all. Currently personalized medicine applications are used for following purposes:

Blood Clots

The dosage of wrafarin is considered to be dangerous as it could result in clotting of blood and excessive bleeding. But with the advent of molecular testing now it can be controlled to a great extent.

Colorectal Cancer

The patients of colon cancer can take a sigh of relief with the invention of biomarker which after certain easy tests tells us, how a tumor can respond in future to certain drugs.

 Breast Cancer

In the case of breast cancer the breast tumors can be screened to ascertain which receptors are being contained by the tumor cells of women.

The most important aspect of the entire revolution is the acceptability of personalized care approach by the society. However it is quite debatable, that what can be the possible ramifications of such approach and its legal and ethical aspects as well.

‘The College of American Pathologists supports the appropriate use of molecular testing by pathologists for accurate cancer diagnosis and patient prognosis’ (Molecular Testing for Cancer Prognosis and Outcome, 2007). The medical practitioners and pathologists are the people who not only manage diseases but are also able to use molecular tests for diagnosis and prognosis according to the DNA makeup of a particular person. Currently such tests are available for breast cancer, colon cancer, prostrate and other types of cancers.

The idea of such advances is to understand and cure the patient according to the unique genetic set up he/she has, thus curing in a more substantive way. The molecular tests can be conducted by using either blood samples or cancer affected tissue of the patient.

If we take Lung Cancer as the focal point of study for the molecular tests, then the Lung Cancer Mutation Analysis Project (LC-MAP), which is a program started by Memorial Sloan-Kettering Cancer Center (Kris, 2010) would be the one which has gained huge success in its pilot stage only. Dr. Mark G. Kris (Kris, 2010) of the institute says, ‘the knowledge gained from these tests maximizes the chance of treatment success for each patient’. He also talks affectionately about the institute’s efforts in inventing new therapies to overcome the genetic disorders of people and treating them in a unique manner.

There has been debate over the use of certain technologies in treating the patients like laser technology, artificial insemination etc. and the ethical aspects of such usage. The molecular test therapy and genetic disorder treatment in a specialized procedural way, is a step towards the advancement of medical science (Nordqvist, 2012). This gives a lot of scope for succeeding in what is considered traditionally as an incurable disease.

The other aspect of such study is based on the fact that how and what are the health behaviors and consequences of treating patients on the basis of genetic profiling (Dolan, 2012). It is also imperative to understand that since the actual potential of personalized medication is still not known and most of its benefits have been passed on, what shall be its genetic effect upon the patients in long run. Nursing is also plays a crucial role in multi-disciplinary application of personalized medication.

“Using a complete map of the molecular changes in tumors in a clinical setting is a world’s first application of this technology”, said Dr. Steven Jones, associate director of the Genome Sciences Centre and Professor, Simon Fraser University (Jones, 2012). This means the technology is still in a very juvenile stage at present.  Although the medical fraternity supports it for development in the future but depicts skepticism for its current application to maximum cases.

The other practical aspect of the application is that the advances in DNA sequencing and reducing cost of sequencing are serving as a great booster in the adoption of technology as consistent basis of effective cure.

Impact of Development in DNA sequencing on Cancer Therapy

DNA Sequencing

Till 1070’s DNA sequencing was considered to be a critical task, but in the mid of the decade developments in sequencing started and two prominent theories of sequencing were developed namely (Rosen, 2009):

Chemical DNA Sequencing

The theory was based on determining the sequence of DNA by labeling one strand of DNA and then dividing it into certain fractions and studying their reactions. The limitations attached with this sequencing were: the peril of exposing a DNA strand to chemical reactions and time taking process of the entire sequencing activity.

Synthesis DNA Sequencing

The method was performed by using radioactive nucleotides and film images. Sanger and his colleagues developed a method where DNA to be sequenced was enzymatically copied starting at a specific point using a DNA polymerase enzyme. This was done in the presence of mixtures of nucleotide precursors when mixed in the reactions where lower concentrations of similar nucleotides which had a chemical modification , once incorporated, made it impossible to extend the newly synthesized chain any further (Sanger, Nicklen, & Coulson, 1977).

Modern DNA Sequencing

The new sequencing methods like ‘Sanger’ method is being used widely in Modern DNA sequencing. However, currently the samples are sequenced through capillary electrophoresis machines.

Potential of New Sequencing Technology and Impediments Restricting its Uptake

With a number of genetic diseases present like Huntington’s disease (a brain disorder), fibro dysplasia ossificans progressiva (a disease in which a person’s muscles are replaced with bones) etc. the solution of mutation to such problems through a technique called as linkage analysis was adopted but it was found to be very cumbersome. The advent of new DNA sequencing technologies has provided a linkage based cost effective solution to the age old problem of genetic disorders (MacArthur, 2011).

The technologies work very harshly and specifically by targeting at the genes which are causing a tissue disorder like damaging mutation. Thus it paves the way for the pathologist to specifically cure the disorder by providing relevant medication. ‘Fortunately, most rare diseases (around 80 per cent, by some estimates) are caused by mutations found in a relatively small fraction of the genome: the pieces that code for proteins, known collectively as the exome’ (MacArthur, 2011).

The entire idea of a sequence based detection of a disease is very enthralling but its application is much more exciting, because the application talks about its latest developments and successful approach. The potential of sequence based detection of a disease is huge as the number of rare genetic disorders is numerous. However the difficulties faced with the application of sequencing has been not less e.g. identification of mutations is difficult as every person carries a lot of broken genes that actually do not cause any disease, thus the entire process becomes cumbersome and difficult.

However, there are certain problems which the new technology of sequencing faces which make it an impediment to be taken in clinical medicine. There aren’t issues which it faces from the medical fraternity but the societal impact of its application has created a concern like:

Rights and Privacy

DNA sequencing and analysis is widely used in unearthing of crimes and proofing of the incidents in catching criminals. Some of the examples where DNA sequencing is used are fingerprint testing, study of DNA samples and its matching with the collected samples from the scene of crime. This technique is widely used by forensic experts in differentiating suspects from innocent people. This certainly infringes ones right to privacy and security of biographical data.

Genetic Issues

The use of genetic sequencing and providing medication on the basis of genetic makeup of individuals is a worthy invention but its proper and ethical application cannot be ensured with certainty. A lot of people misuse the technology in deciding maternity and paternity issues illegally. However, this does not necessarily mean that the technology used is widely susceptible to abuse.

Legal Issues

The demarcation of authority and responsibility has still not been streamlined amongst the people who are considered to be the custodian. The laws do entrust a clear status as to the reach, limitation and safeguarding of rights and adherence of norms.

Commercialization of DNA Sequencing Technology

A DNA strand can reveal a lot of information about the biological stature of a person, his physical abilities to encounter situations which human beings are very vulnerable to. The particular manner in which a person reacts to a drug or a dosage, his ability to resist the high exposure to chemical treatments and at times finding out the traces of ancestral origin of a person is possible through DNA sequencing technology (Wills, 2012).

The primary objective of DNA sequencing was to study the mutations which cause the genetic disorder in a particular person or in the members/ ancestors of a particular family, however, it is important to understand how much essential it is to people in general?

The commercial application of DNA sequencing is the usage of the technology in diagnostics, biotechnology and genetics research. However there has been reduction in cost of DNA sampling recently, but the overall cost of the treatment is still expensive (Nanoparticle-based DNA Sequencing, 2012).

Biosensors technology, an invention of the hour is used for curing hereditary and genetic disorders in a person. The technology is used extensively for the following purposes:

Research and Development

 There has been major efforts and which have been put in research and development to find a breakthrough in the latest developments for this technology. The cancer research centers and medical institutions are doing extensive research in finding the causes of mutations for all the possible disorders and cancers. This has compelled the administration and companies to invest billions of dollars into these institutes for conducting research and also creating employment at the same time.

‘One expectation is that as the size of the machines shrinks and the sequencing price tag falls below the $1000 threshold, markets for genome sequencing will expand throughout the health-care system, where the machines can help doctors both prevent and treat illness’, says Balagadde (Balagaddé, 2012). This clearly shows that the cost of technology is creating way for its affordability.

Diagnostics, Treatment and Prognosis

The very objective for the advent of technology was to find a personalized cure for an age old incurable disease called cancer. The sequencing technology helps the pathologists in studying the sequencing through molecular tests by taking blood samples or tumor affected tissues.

A personalized treatment course is designed for every person depending on the results obtained through his genetic buildup samples. This is done over a period of time and is a slow process.

The pathologist is able to form an opinion about the causes of such diseases and what shall be the effect of such disorders in the long run to the concerned patient.

The cost of the entire process is still very expensive in countries like USA because the cost of treatment for anything is very expensive in U.S. anyways. On this ground the affordability of this technology for common man looks bleak but the cost is certainly reducing. This has created a lot of opportunity for medical practitioners to conduct research and to practice it as a specialized field.

Crime Investigation

Crime Investigation is another societal objective for the advent of technology. DNA samples are widely studied in forensic investigations for unearthing crimes. The authorities rely very heavily on the outcome of the study based on DNA samples from crime scene and helps in tracking down the culprit. this technology is widely used by investigating authorities in unearthing complicated crimes.

Opportunities opened up by Personalized Cancer Therapy

The usage of therapy has opened the gates for opportunities which are very huge. The idea of transforming the raw stage detection to a comprehensive treatment has created pathways for new avenues for many.

Peer Group Involvement

Dr. Robert C. Bast, Jr. University Professor for Cancer Research at the University of Texas M.D. Anderson Cancer Center says, ‘We need to invest in trials and infrastructure for sequencing, testing, and developing pathway-centered and organ-focused approaches in the laboratory, and we need to establish, sustain and retain translational teams that include not only physician-scientists and clinician investigators, but molecular imagers, molecular pathologists, translational scientists, pharmacists, biostatisticians and bio-informaticians, research nurses and data managers, and experts in regulatory affairs’ (Bast, 2011).

He clearly banks upon the involvement of lot of experts from wide domains in medical field thus creating lot of opportunity for research and growth.

Research and Development

As discussed earlier also a lot of opportunities have fallen before in terms of research and development that have been using DNA sequencing to cure cancer disorders. These opportunities will ensure the developments in the field and its application in the long run. The research is being done on the molecular tests that are being designed to counter almost every category of cancer known to man. Pharmaceutical companies are taking coercive steps with regard to the development of personalized therapy. Continuous testing and treatment has led to revealing of lot of disorders which require a systematic approach towards development of their combating drugs.

The other important aspect is a question to be answered that whether a small subgroup of patients in one indication can commercially support two almost identical drugs. This can be overcome by handling the hurdles like the clinical and commercial aspect of such drugs and its application to specific set of mutational disorder in patients.

 Personalized Treatment for Specific Curing can be described as the basic requirement of conducting such clinical research where it is required to treat patients according to the specific disorder which they have, hence personalizing the entire treatment. This gives a lot of hope to people who have been suffering illness due to ‘one size fit all’ approach. This means the scope for improvement over the available technologies and its advancement is there with a step in the direction of unique achievement. . Lot of people has disorders that are hereditary and hence genetically detectable. The marking of DNA strands and its intensive research paves a way to find out the exact causes of a particular disorder. These causes are then treated with sequencing techniques to treat in a specifically directed way. The technology is certainly a great revelation in the field of medicine and medical research, a path-breaking discovery leading to an overall improvement in human life resulting in higher life expectancy. The developments are still on the way and progress is still expected to cross every hurdle that comes in its way to be successful.

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