Personalized Medicine

In an earlier blog post I spoke about how the first doctor who diagnosed Rachana assured us that cancers, which were terminal a few years ago, can now be cured with predictable results. After a full diagnosis at the end of March, our Oncologist suggested a 80-90% chance for Rachana to make a full recovery. We know that even though there was no detectable Leukemia after the first month of treatment, Rachana will be bombarded with potent drugs at high frequency till November. I personally am skeptical if all these drugs are really necessary, given the nasty side effects. Chemotherapy drugs are basically carpet bombing all cells rather than targeted killing of cancer cells. SmartChemo is what we need so they don’t kill the good cell along with the bad; easier said than done I’m sure. The current research points to good success rates for the CALGB treatment regimen she’s on, and we are in no position to second guess and experiment with alternative medicines.

Drugs are created with the basic understanding that all humans and their diseases are fundamentally the same. But we also know that the deeper we go the more differences we find. Genomic testing is built of this fact. What if studying the genetic characteristics of each individual’s disease cells can result in personalized and predictive medicine rather that a one size fit all solution that cause unnecessary side effects? There is a possibility to personalize our medicines to suit the individual’s unique genetic makeup. Rachana’s bone marrow sample from March, which had 80% of leukemia cells, was sent to a lab in Boston, MA called FoundationOne. They are testing and sequencing this sample to create a genetic profile of her leukemia cells which can tell our Oncologist the genetic makeup of her mutations (bad cells). This genetic profile can also point to proven methods to target them and these can be included in her treatment if she ever relapses. This site has fantastic resources and videos to easily understand this heady topic. This kind of genetic test leading to personalized treatment is new and comes with mis-steps and risks but it’s definitely promising and will only improve with time. It was remarkable to read in an article from 2012 that only 25% of cancer drugs are effective and that means $60 billion of the $80 billion spent annually on cancer drugs is probably a waste. Talking about costs, we didn’t have to pay anything for the creation of this genomic profile of Rachana’s leukemia as UTSW (Rachana’s hospital) has a understanding with FoundationOne to absorb the costs if our insurance does not cover it. Currently most insurance won’t cover genomic sequencing but that’ll change when these new methods starts to deliver on its promises.

This week has progressively become worse for Rachana. Her hemoglobin has been dropping all week. On Thursday it was 7.7 and that usually has a direct effect on her energy levels; she feels good when it’s around 9 or 10. Next week it’ll probably drop under 7 and that’ll trigger transfusing a unit of blood. The main issue, mid week, was stomach ache and for the last 2 days it’s headache that is troubling her the most. The meds she takes to manage these symptoms give her 2 good hours, then the meds slow down and by hour 4 the aches are pretty bad; she takes the pills every 4-5 hours and the cycle repeats.

Overall this phase has been good so far. She does not have any chemo sessions next week, so perhaps things will be get better.

2 thoughts on “Personalized Medicine

  1. Sangu, Hats off to FOUNDATION ONE. Their contributions to this world r unltd and so r incredible. When will we get Rachana’s feedback ? AGL to all of us. Thanks for sharing such a valuable info.

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