“Precision to the Patient”: What is Precision Medicine to YOU?
— Casey Quinlan (@MightyCasey) September 21, 2016
In a #HCLDR chat (healthcare leadership) on Twitter in September, my friend Casey Quinlan (who also has a QR code containing a link to her password-protected medical records tattooed on her chest!) tweeted this awesome thought: Precision medicine is precise to the patient.
While I also think of certain things like Quantified Self as being a part of the Precision Medicine movement—that is, if they allow an individual to make changes to our medical care that lead to small changes to create better outcomes—for the most part, I think most of us who have read a bit about precision medicine see it as a big thing where we target individual cells in order to treat a chronic disease.
For instance, a biologic drug that targets the exact type of cells that are causing issues with a person’s asthma, such as Xolair for high IgE, or the newer anti-IL drugs, such as Nucala (mepolizumab—an anti-IL-5), or lebrikizumab—anti-IL-13 (still in the research phase), for severe asthma.
We are just now beginning to see the beginnings of precision medicine, on a big scale, when it comes to asthma in regard to these anti-interleukin (IL) biologics, that require an understanding of exactly what is going on inside your body, to correctly target the cells involved. When the right cells are hit with these drugs, often people with asthma have very good results. I would also consider, on a smaller scale, lumping allergy desensitization shots in to precision medicine for asthma.
For myself, I have fairly non-allergic asthma. Maybe there is something more at a cellular level going on, and I plan to see what I might be able to learn about that when I next see my asthma specialist. This is where Quantified Self comes in, and technology (or other notes) that help me figure out what is going on with my asthma.
Precision medicine does not have to mean extracting cells and doing things in labs. Precision medicine can be running blood tests to determine what sort of asthma drugs will work best, but I believe it can also be done outside of a lab—after all, and though not very precise, I’ve experimented with enough different medications to find what works best for me. Like other types of precision medicine, this also takes collaboration between patient and healthcare provider to find the best results.
To me, precision medicine is about being able to experiment, have choices, and find what works best. Do i wish It was more precise? Sure. But I am still in control of the process. Just like my friend Emily is, who founded Emily’s Entourage to help fund and develop treatments for her specific genetic mutation associated with her cystic fibrosis. The stories are different, but, they still fall under the umbrella that is Precision Medicine.
What is precision medicine to you? Let’s hear your thoughts in the comments.
What has your experience with Singulair been like?