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Harrison offers ‘personalized medicine’ for cancer

Harrison Medical Center patients who are diagnosed with breast, colon or lung cancer are able to receive a treatment based specifically on their genetic makeup. People react differently to medication because of their genetic and other factors — by using a treatment that takes into account specific genes, physicians are able to treat these patients more efficiently.

This approach is called personalized medicine, a term that came more or less out of the media, and may be a bit misleading, since one would think all medicine is personalized. The term “personalized medicine” refers to a new field in medicine that has been made possible by the Human Genome Project that mapped the human DNA a few years ago, and by advancing technology.

“What we’re really talking about is a paradigm shift in medicine,” says Dr. Greg Henderson, MD, PhD, president and medical director of Pathology Associates of Kitsap County and medical director of Dynacare/Harrison Medical Center Laboratory in Bremerton. “With this new tool of being able to look at people and their diseases at the DNA level, we’re able to make medicine more personalized.”

Henderson says the technology that has evolved around the genome sequencing is tantamount to the invention of the first computer, and it will change the way patients are treated for various diseases.

In cancer, for example, pathologists like him used to examine tissue under the microscope in an effort to answer four questions: Is it cancer? What kind? How big? How bad? Now, for lung, breast or colon cancer, Henderson also tries to answer the question: To what drug will this cancer respond the best?

To be able to answer that question, physicians can order a relatively inexpensive test to decode the patient’s genome. The decoding is done at a laboratory in California, then the results are sent to Harrison for analysis. Harrison Medical Center has had these capabilities for about a year now, and Henderson, who spearheaded personalized medicine at the center, says he is amazed how fast the local medical community has adopted it.

“Last summer, I never thought we’d be at this level of testing we are now, with all the oncologists in town,” he says. “…It has changed the way I practice, and brought me one step closer to the patient.”

The reason Harrison only does the testing for those three types of cancer is because these cancers are the only ones with FDA-approved medications that work well based on those tests. But this will change once more drugs are approved by the FDA. “We want to be ahead of the curve in the delivery of those drugs,” Henderson says.

Pharmacogenics, which studies the relationship between genetics and pharmaceuticals, is seeing rapid advances. Cancer is by far not the only disease that would be affected by research conducted in pharmacogenics. Henderson gives as an example the drug called Coumadin (or generic warfarin) used as an anti-coagulant. It’s difficult to manage — too much or too little can have serious, even deadly, side effects. But doctors can now order a genetic test prior to prescribing the drug, because they know the genes responsible for a person’s reaction.

“’One size fits all’ medications may soon be a thing of the past,” according to an article in the Johns Hopkins Medicine health alert newsletter. “The science of pharmacogenics holds the promise that one day medications might be tailor-made to a patient’s unique genetic profile.” The article called advances in pharmacogenics so important, that “the U.S. Food and Drug Administration issued new guidelines urging drug companies to conduct pharmacogenomic tests as they develop new medication.”

Henderson notes that the concept of personalized medicine is being implemented at such a fast pace that there is new information almost monthly, which means physicians have to keep educating themselves about advances. “I’ve never seen such a quick change in medicine,” he says, and notes that in our area, the only other institution already using personalized medicine is the Swedish Medical Center (which introduced it after Harrison).

“We are ahead of the curve,” he says. “It’s very exciting.”

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