Personalized medicine recognizes that each of us may be different from every other individual. Where those differences are discovered, it seeks unique therapies. What I call cookbook medicine urges doctors to treat all patients with similar symptoms the same way. It implicitly assumes we are all alike.
Right now science is headed in the direction of personalized medicine. ObamaCare is pushing us in the opposite direction. Your life could hang in the balance.
Take the case of Dr. Lukas Wartman, a St Louis physician who developed a rare form of leukemia that is usually rapidly fatal and for which there is no effective treatment. He and his colleagues at Washington University refused to accept defeat. They worked round-the-clock for many days using the universitys 26 sequencing machines and a supercomputer. As descried by Gina Kolata in The New York Times:
[T]hey discovered a single gene mutation in his cancer cells that was producing a protein that appeared to be stimulating the cancers growth. It turned out that a new drug existed that was targeted specifically at shutting down the offending protein, a drug that to that point had been used only for kidney cancer. When they administered the drug to Dr. Wartman, his cancer went into complete remission.
In contrast to this case, consider what happens in a typical clinical drug trial, under the FDAs traditional guidelines. An experimental group receives the drug and a control group receives a placebo. Then the drug is approved if the experimental group significantly improves relative to the control group, on the average. If there is no significant difference, the drug is rejected as not effective.
But wait a minute. Usually when a drug is found to be ineffective, there are a few experimental patients who react positively to it. Why are we ignoring them? The answer: randomized controlled trials implicitly assume that all the patients are alike. So if one or two patients get better, thats assumed to be an anomaly. If the drug were responsible, it would have worked for all the other patients as well. Interestingly, almost all the best research on cancer care these days is rejecting the FDA approach. If some patients respond favorably to a drug even when most do not researchers want to know if genetic differences explain the results.
Gina Kolata reports:
One study at Memorial Sloan-Kettering Cancer Center tested a drug called Everolimus that is approved for kidney and breast cancer. Researchers asked if it could treat bladder cancer. Forty-five patients received the drug. Two responded.
Under ordinary protocols, researchers would have decided the drug doesnt work. But in this case, they tried to find out why two patients got better. In the case of one patient:
The investigators found out why. Her cancer had a mutation in a gene that made it dependent on a protein, mTOR, for growth. Everolimus squelches the activity of mTOR. The woman is still taking Everolimus, and her cancer has not recurred.
Read the original:
Personalized Medicine Versus Obamacare
- Yes, But. The Annotated Atlantic. [Last Updated On: November 7th, 2009] [Originally Added On: November 7th, 2009]
- Health Insurance Benefit Costs by Region [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- For an Operator, Please Press... [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- Pollyanna With a Pen: Maine Governor Signs 18 New Health Care Bills into Law [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- AMA Sounds the Alarm, Medicare Making Yet Another Attempt to Cut Reimbursement [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- Mass Governor Asks Blue Cross to Keep Higher Employer Contribution [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- Lifespan and Care New England Plan Monopoly (Again) [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- Dirigo Health: Con Artists, Liars, and Thieves? [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- New Orleans: Health Challenges [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- August a Flurry of Activity [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- Maine's Dirigo Health Savings One-Third of Original Estimate [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- “Methodolatry”: My new favorite term for one of the shortcomings of evidence-based medicine [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- Suzanne Somers’ Knockout: Dangerous misinformation about cancer (part 1) [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- A science-based blog about GMO [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- A Not-So-Split Decision [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- Military Medicine in Iraq [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- The effective wordsmithing of Amy Wallace [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- A Science Lesson from a Homeopath and Behavioral Optometrist [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- Join CFI in opposing funding mandates for quackery in health care reform [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- Mainstreaming Science-Based Medicine: A Novel Approach [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- Those who live in glass houses… [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- J.B. Handley of the anti-vaccine group Generation Rescue: Misogynistic attacks on journalists who champion science [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- When homeopaths attack medicine and physics [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- The cancer screening kerfuffle erupts again: “Rethinking” screening for breast and prostate cancer [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- All Medicines Are Poison! [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- When Loud Wins: Will Your Tax Dollars Pay For Prayer? [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- It’s All in Your Head [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- The Skeptical O.B. joins the Science-Based Medicine crew [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- The Tragic Death Toll of Homebirth [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- What’s the right C-section rate? Higher than you think. [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- Recombinant Human Antithrombin – Milking Nanny Goats for Big Bucks [Last Updated On: December 13th, 2009] [Originally Added On: December 13th, 2009]
- Does C-section increase the rate of neonatal death? [Last Updated On: December 13th, 2009] [Originally Added On: December 13th, 2009]
- Man in Coma 23 Years – Is He Really Conscious? [Last Updated On: December 13th, 2009] [Originally Added On: December 13th, 2009]
- Why Universal Hepatitis B Vaccination Isn’t Quite Universal [Last Updated On: December 13th, 2009] [Originally Added On: December 13th, 2009]
- Ontario naturopathic prescribing proposal is bad medicine [Last Updated On: December 13th, 2009] [Originally Added On: December 13th, 2009]
- Naturopaths and the anti-vaccine movement: Hijacking the law in service of pseudoscience [Last Updated On: December 13th, 2009] [Originally Added On: December 13th, 2009]
- The Institute for Science in Medicine enters the health care reform fray [Last Updated On: December 13th, 2009] [Originally Added On: December 13th, 2009]
- Neti pots – Ancient Ayurvedic Treatment Validated by Scientific Evidence [Last Updated On: December 13th, 2009] [Originally Added On: December 13th, 2009]
- Early Intervention for Autism [Last Updated On: December 13th, 2009] [Originally Added On: December 13th, 2009]
- A temporary reprieve from legislative madness [Last Updated On: December 13th, 2009] [Originally Added On: December 13th, 2009]
- A critique of the leading study of American homebirth [Last Updated On: December 13th, 2009] [Originally Added On: December 13th, 2009]
- Lose those holiday pounds [Last Updated On: December 13th, 2009] [Originally Added On: December 13th, 2009]
- Endocrine disruptors—the one true cause? [Last Updated On: December 13th, 2009] [Originally Added On: December 13th, 2009]
- Acupuncture for Chronic Prostatitis/Chronic Pelvic Pain Syndrome [Last Updated On: December 13th, 2009] [Originally Added On: December 13th, 2009]
- Evidence in Medicine: Experimental Studies [Last Updated On: December 13th, 2009] [Originally Added On: December 13th, 2009]
- Midwives and the assault on scientific evidence [Last Updated On: December 13th, 2009] [Originally Added On: December 13th, 2009]
- The Mammogram Post-Mortem [Last Updated On: December 13th, 2009] [Originally Added On: December 13th, 2009]
- An Influenza Recap: The End of the Second Wave [Last Updated On: December 13th, 2009] [Originally Added On: December 13th, 2009]
- The End of Chiropractic [Last Updated On: December 13th, 2009] [Originally Added On: December 13th, 2009]
- Cell phones and cancer again, or: Oh, no! My cell phone’s going to give me cancer! (revisited) [Last Updated On: December 20th, 2009] [Originally Added On: December 20th, 2009]
- Another wrinkle to the USPSTF mammogram guidelines kerfuffle: What about African-American women? [Last Updated On: December 20th, 2009] [Originally Added On: December 20th, 2009]
- Acupuncture, the P-Value Fallacy, and Honesty [Last Updated On: December 20th, 2009] [Originally Added On: December 20th, 2009]
- The One True Cause of All Disease [Last Updated On: December 20th, 2009] [Originally Added On: December 20th, 2009]
- Communicating with the Locked-In [Last Updated On: December 20th, 2009] [Originally Added On: December 20th, 2009]
- Are the benefits of breastfeeding oversold? [Last Updated On: December 20th, 2009] [Originally Added On: December 20th, 2009]
- Measles [Last Updated On: December 20th, 2009] [Originally Added On: December 20th, 2009]
- Radiation from medical imaging and cancer risk [Last Updated On: December 21st, 2009] [Originally Added On: December 21st, 2009]
- Multiple Sclerosis and Irrational Exuberance [Last Updated On: December 21st, 2009] [Originally Added On: December 21st, 2009]
- Medical Fun with Christmas Carols [Last Updated On: December 22nd, 2009] [Originally Added On: December 22nd, 2009]
- Lithium for ALS – Angioplasty for MS [Last Updated On: December 23rd, 2009] [Originally Added On: December 23rd, 2009]
- “Toxins”: the new evil humours [Last Updated On: December 24th, 2009] [Originally Added On: December 24th, 2009]
- 2009’s Top 5 Threats To Science In Medicine [Last Updated On: December 24th, 2009] [Originally Added On: December 24th, 2009]
- Buteyko Breathing Technique – Nothing to Hyperventilate About [Last Updated On: December 26th, 2009] [Originally Added On: December 26th, 2009]
- The Graston Technique – Inducing Microtrauma with Instruments [Last Updated On: December 29th, 2009] [Originally Added On: December 29th, 2009]
- The “pharma shill” gambit [Last Updated On: December 29th, 2009] [Originally Added On: December 29th, 2009]
- Ginkgo biloba – No Effect [Last Updated On: December 30th, 2009] [Originally Added On: December 30th, 2009]
- Oppose “Big Floss”; practice alternative dentistry [Last Updated On: January 1st, 2010] [Originally Added On: January 1st, 2010]
- Causation and Hill’s Criteria [Last Updated On: January 3rd, 2010] [Originally Added On: January 3rd, 2010]
- The life cycle of translational research [Last Updated On: January 10th, 2010] [Originally Added On: January 10th, 2010]
- The anti-vaccine movement strikes back against Dr. Paul Offit [Last Updated On: January 10th, 2010] [Originally Added On: January 10th, 2010]
- Osteoporosis Drugs: Good Medicine or Big Pharma Scam? [Last Updated On: January 10th, 2010] [Originally Added On: January 10th, 2010]
- Acupuncture for Hot Flashes [Last Updated On: January 10th, 2010] [Originally Added On: January 10th, 2010]
- The case for neonatal circumcision [Last Updated On: January 10th, 2010] [Originally Added On: January 10th, 2010]
- A victory for science-based medicine [Last Updated On: January 10th, 2010] [Originally Added On: January 10th, 2010]
- James Ray and testosterone replacement therapy (TRT) [Last Updated On: January 10th, 2010] [Originally Added On: January 10th, 2010]
- The Water Cure: Another Example of Self Deception and the “Lone Genius” [Last Updated On: January 12th, 2010] [Originally Added On: January 12th, 2010]
- Be careful what you wish for, Dr. Dossey, you just might get it [Last Updated On: January 13th, 2010] [Originally Added On: January 13th, 2010]
- You. You. Who are you calling a You You? [Last Updated On: January 15th, 2010] [Originally Added On: January 15th, 2010]
- The War on Salt [Last Updated On: January 16th, 2010] [Originally Added On: January 16th, 2010]
- Is breech vaginal delivery safe? [Last Updated On: January 16th, 2010] [Originally Added On: January 16th, 2010]