MUSCATINE, Iowa — In perhaps five years, our doctors will be able to tailor our medicine and our treatment plan specifically to us, because they’ll know everything about our genetic makeup.
That could be the dawn of a new age of generally healthier, longer lives, the dean of the Carver School of Medicine at the University of Iowa told the Muscatine Rotary Club Monday.
Dr. Paul Rothman, 53, said the ability to map the 3 billion base pairs of human genes, completed about 10 years ago, will forever change the doctor-patient relationship in a way he described as the four P’s: medicine will be more personalized, predictive, preventative and participatory.
“You’ll be an active partner in your own wellness,” Rothman said. “You’ll tell your doctor, ‘I’m predisposed to this disease. What are you going to do about it?’”
Even today, for about $199, people can swab saliva from their mouth, send it to a lab, and a thorough report will come back predicting which diseases and conditions they’re genetically predisposed to encounter as they age.
Rothman, a molecular biologist, said he hasn’t done that yet — “but my wife and I are giving it to each other as an anniversary present. Isn’t that romantic?”
Many doctors aren’t yet up to speed on personalized medicine, Rothman said, because the literature is still catching up with the science. That’s why he’s trying to educate Iowans on what he’s calling “a paradigm shift” in how doctors will soon practice medicine.
“If you know about this, you can have a better discussion with your doctor,” he said. “The question will be, ‘What can we do to help you decrease your risk?’”
There are ways of using the new information that aren’t necessarily helpful, and some may be downright scary, Rothman said.
If a company knows you’re not genetically predisposed for intelligence, will it hire you? Can you purchase health insurance from a company that knows you’ve got a decent chance, for example, of contracting Alzheimer’s disease or Parkinson’s disease?
Would you even want to know that, years from now, there’s an odds-on chance that you’ll contract a disease for which there’s no cure?
“This is powerful information, and it can be scary,” he said. “But don’t be scared. The good outweighs the bad.”
Preventative, personalized care will drive down the cost of health care, the dean predicted.
It will allow doctors to set dosage levels that are just right for the individual.
And already, gene-based, individualized maps are “the state-of-the-art in cancer therapy, especially lung, breast and some forms of brain cancer,” Rothman said.
“We’ll live healthier lives because of this, and that’s the bottom line,” Rothman said.
Mapping it out
Contact: Dr. Paul Rothman can be reached at email@example.com.
Visit: One of the websites that offers tests for risk factors for nearly 100 diseases is at www.23andme.com.
The future of medicine: Having one’s entire genetic map drawn is cost-prohibitive to most people right now, but Rothman said that in a few years, the price tag could come down to about $1,000.
It’s complicated: If you could remove all the genetic data from your body and somehow stretch those strands end to end, your genes would reach the sun and back — 30 times.