You wouldn't think twice about a cholesterol test, would you? Your doctor says it's time, so you dutifully roll up your sleeve and they draw your blood for a look.
The same is true for a host of other diagnostic tests that physicians order by the millions daily. About 70 percent of medical decisions are influenced by diagnostic test results. Those decisions are being increasingly viewed in a whole new manner, thanks to the emergence of personalized medicine -- the buzz phrase in health care.
In one sense, the personalization of health care is not new -- the cholesterol test above is an example. What is new in this picture is your genome, the collective term for the three billion letters of DNA found in virtually every cell of your body. Because we've sequenced the genome and now have the tools to assess what may be wrong at the DNA level in disease, we are developing drugs to target exactly where the system breaks down.
Don't worry, this isn't genetic engineering. The beauty of these personalized therapies is that they will only target the problem areas -- the leukemic cells in your blood, the plaque producers in your arteries, the cancerous cells in a breast.
It's been suggested that the drug-industry pipeline is quickly moving toward a tipping point, after which the majority of new drugs will focus on a specific molecular target within the diseased DNA.
And don't pity the pharmaceutical companies, either. They won't need to develop assembly lines for John Smith's disease or Mary Jones's disease.
Instead of the current model where drugs are developed with a one-size-fits-most approach, drugs will be developed for everyone with a particular form of leukemia, coronary artery disease or breast cancer. Drugs will only be administered if they match, at the molecular level, the particular disease in question.
So what's the new thing? It boils down to you.
Unless you have an identical twin, your DNA makes you different from every other individual on the planet. For the most part, we suffer disease because of a change in DNA, something in our blueprint that causes things to go badly. Cancer, heart disease, diabetes and other diseases are caused by multiple errors in your genome that in turn generate problems in your cells, namely disease.
The personalized-medicine revolution under way to address such problems would actually be more accurately termed as personalized therapeutics.
With our knowledge of the genome and what causes disease at a molecular level, more-personalized, tailored therapies will be available to better suit your disease's unique characteristics. Rather than diagnosing disease X and prescribing drug Y to treat it because we have always done it that way, molecular diagnosticians will identify a full molecular signature for your disease so that the right drug to target that signature can be prescribed. The result will be far fewer shots in the dark when it comes to selecting treatment options.
This signature-seeking test is part of the new area of growth in molecular diagnostics, or MDx, called companion diagnostics -- a diagnostic test done in conjunction with potential prescription of a therapeutic drug.
So, stay tuned. Companion diagnostics are the new thing in MDx and will undoubtedly take the field to a new level from its current $3 billion a year.