What does the future of medicine hold? Tiny health monitors, tailored therapies—and the end of illness.
Take a moment to imagine what it would be like to live robustly to
the ripe old age of 100 or more. You wouldn't die of any particular
illness, and you wouldn't gradually waste away under the spell of some
awful, enfeebling disease that began years or decades earlier.
It may sound far-fetched, but it is possible to live a long,
disease-free life. Most of the conditions that kill us, including cancer
and heart disease, could be prevented or delayed by a new way of
looking at and treating health. The end of illness is near.
Today, we mostly wait for the body to break before we treat it. When I
picture what it will be like for my two children to stay in good health
as independent adults in 10 or 20 years, I see a big shift from our
current model.
I see
them being able to monitor and adjust their health in real time with the
help of smartphones, wearable gadgets—perhaps like small, invisible
stickers—to track the inner workings of their cells, and virtual
replicas of their bodies that they will play much like videogames,
allowing them to know exactly what they can do to optimize every aspect
of their health.
What happens when I take drug x at dosage y? How
can I change the expression of my genes to stop cancer? Would eating
more salmon and dark chocolate boost my metabolism and burn fat? Can red
wine really lower my risk of heart attack?
From a drop of their blood, they will be able to upload information
onto a personal biochip that can help to create an individualized plan
of action, including both preventive measures and therapies for
identified ailments or signs of "unhealthiness." (Other body fluids—like
tears and saliva—might be routinely tested, too.) They would be on the
lookout for problems like imbalances in blood-sugar control, a risk
factor for diabetes, and uncontrolled cell growth, which could signal
cancer. Their doctors won't just examine them once a year; they will
continually monitor the next generation of patients, offering advice
along the way.
What is equally exciting is that this
patient data will be added to a universal database that can be
aggregated by powerful search engines like Google and constantly fed
into new trials and experiments—speeding up our understanding of which
drugs work best for which people. The database might show, for example,
that people with a particular genetic profile respond to one type of
cancer treatment but not another. As more people anonymously add their
health data, this database would become more and more effective as a
tool for preventive medicine.
Today, most people who are concerned about their health follow
sweeping, general guidelines. If you want to lose weight, you are likely
to pick a diet that advises eating more fibrous vegetables and cutting
back on processed sugar. If you want to reduce your risk for cancer, you
avoid tobacco smoke, exercise regularly and take early detection
seriously.
Ari Meisel suffered from the symptoms of
Crohn's Disease for years before he decided to overhaul his health-care
regimen. He's part of a movement of citizen scientists who are turning
their bodies - and their lives - into personal laboratories. WSJ's
Christina Tsuei reports.
The problem with health care today is that we
don't know enough about the body to practice preventive medicine
actively. With limited knowledge, diagnostic medicine makes sense. If we
don't know what we're trying to prevent or how best to do it, we have
to wait for an obvious symptom to emerge in order to take action. At
that point, we're usually treating a disease that has had ample
opportunity to progress.
We can do better. To start, we need to
appreciate the body for what it is: a very complex network, much of
which we don't yet fully understand. When you look at the body from this
systemic point of view, you begin to see that a lot of what we know
about health is gravely misunderstood.
In 2009, my colleague Danny Hillis—a former Disney engineer who
pioneered the development of so-called parallel supercomputers—and I set
up a way to measure 100,000 different types of proteins from a single
drop of blood. The goal is to evaluate and make sense of the body's
intricate inner workings in a way that's much more dynamic and
insightful than what DNA alone can provide. Proteins change in your body
every minute, depending on what's going on internally. Our ultimate
plan is to develop tests, based on protein levels, for illnesses like
cancer. Such tests could take the place of invasive techniques like
biopsies.
The new Telcare meter marks a significant step
toward bringing consumer medical devices closer to the world of modern
technology. Walt Mossberg reports.
With each passing year, the technology
necessary for this revolution in medicine is growing less expensive.
Last week, Life Technologies of Carlsbad, Calif., announced that it will
be able to map an individual's entire genetic sequence in one day, for
$1,000. Similar tests today cost many thousands of dollars. The ability
to follow day-to-day changes in your body's proteins and metabolites is
not far behind.
So how do we get to this future?
It has to start with data collection.
In 2004, Dell launched a company program called Well at Dell to
encourage healthy lifestyles. Employees receive alerts and information
customized to their health issues, incorporating their latest test
results and treatments and allowing them to make more informed
decisions. A newly diagnosed diabetic, for example, might get
information about how to monitor blood sugar and watch out for the
circulatory problems that often accompany the disease.
Not surprisingly, these corporate health-management tools have come
under fire, with most critics worrying about privacy. But we can't
expect the health-care industry to continue to innovate and grow if we
continue to hoard health information.
The federal agency that administers Medicare pays over half of the
medical bills in the U.S., but it doesn't retrieve, organize or mine
that data. Imagine how much better the Medicare system could be if all
this data were analyzed to improve public health. Or imagine databases
from many different sources, private and public, coming together in a
centralized network that would look for patterns and try to translate
them into new ideas for anticipating and preventing health problems.
Personalized medicine isn't as far
away as you might think. Consider what's already happening in genetic
profiling for individuals, which is available today for several hundred
dollars. I co-founded a genetic screening company and am a big proponent
of the technology. It allows us to take a broad look at DNA variations
and to assess your risk for certain ailments and what medications, at
what dosages, might work best, based on your metabolism. Just because
you have one or two markers of genetic risk does not mean that you will
definitely develop a particular condition, but the outcome can be
affected by changes in lifestyle, or in some cases, by taking
medication.
As these and other technologies advance, it will become progressively
easier to monitor and maintain our overall health. Then it will be up
to us. The promise of personalized medicine depends, finally, not on the
tools that become available but on our determination to be informed and
willing patients.
Source - Wall Street Journal