Personalized Medicine and the Art of Medicine
Written by:
In all there are fashions, also in medicine. One of the expressions most used lately in modern medicine is personalized medicine, everyone talks about it and, apparently, all doctors practicing. To the extent that there are medical journals devoted exclusively to "personalized medicine". But what it is, what is personalized medicine? More prosaically How to know if we are treated under the principles of personalized medicine?
To begin with, there is no single definition for personalized medicine. In the English language there is an expression that some do not hesitate to apply to "personalized medicine". The word is buzzword and refers to words or expressions that are fashionable, sound good and are repeated everywhere without its meaning is entirely clear. To complicate matters further, next to "personalized medicine" other expressions such as "evidence-based medicine", "medicine precision", "stratified medicine", "molecular medicine", "sequential medicine" or "omic medicine" They are used to refer virtually the same concept.
Most appropriate treatment for each patient
The Medical Dictionary and the National Cancer Institute defines "personalized medicine" as one that "takes into account the unique molecular characteristics of the patient and disease for treatment" or, more extensively, "which takes into account the characteristics genetic people, proteins and environmental circumstances to prevent, diagnose and treat diseases, looking at each moment the most appropriate and least toxic treatment for each patient. "
The best treatment for each patient, who would you stick to this? Is not that what doctors have always pursued? The current boom of "personalized medicine" applied to oncology is due to progress in the understanding of the biology of tumors and the identification of genetic mutations and other markers that predict the evolution of a tumor and whether it will respond or not to a particular treatment.
Unfortunately, in medicine there is no reliable prognostic factor 100%. Medicine is the science of uncertainty and the art of probability (William Osler), hence the so-called "uncertainty principle" part of it. As a result, clinical practice can not rely solely on algorithms, clinical guidelines, protocols, expert opinions and other tools, however useful these are. In fact, the concept of "personalized medicine" as far analyzed, is an enormous paradox, since apparently put aside the main raison d'etre of medicine, ie the sick person, the unique and unrepeatable human being, with their concerns fears and desires. Where was the current "personalized medicine" the old aphorism "there are no diseases but sick"?
How do I know if I will be treated according to the dictates of personalized medicine?
If the doctor asks and listens, scans (not limited to request and look diagnostic tests), asks about their concerns, fears and hopes, you can be sure it will be treated in accordance with the principles of authentic personalized medicine, it ie one in which the "person" is the most important. And always of course taking into account the characteristics of the tumor, its biomarkers and the latest advances in the diagnosis, prognosis and treatment, but not only that.
