A New Era in Healthcare: Precision Medicine

A new era has begun in healthcare: precision medicine! You may ask where this new concept came from when we have not yet fully absorbed "personalized treatment" and "targeted treatment." The saying repeated by many medical authorities, "There are no diseases, only patients!", is now better understood. What do the increasingly familiar concepts of "individual health," "personalized treatment," "precision health," and "targeted treatment" mean?

Preventing many diseases before they arise or treating them completely does not currently seem possible. Finding the best possible treatment depends on understanding disease mechanisms, or biology, better. At this point, precision health (precision medicine) emerges as an increasingly important approach to disease treatment and prevention that considers each person's genes, environment, and lifestyle.

An even newer concept than precision health is the patient taking an active role in treatment (self management). Studies show that patients actively participating in treatment experience greater treatment satisfaction. Taking an active role in one's own health provides more comprehensive information about outcomes and possible side effects and alleviates future concerns, ultimately benefiting treatment.

Undoubtedly, the greatest step paving the way for individualized treatments was the Genome Project, begun in 1990 with initial results announced in 2000. Although this major scientific event has not yet borne all its fruits, it sheds light on the causes of many diseases, particularly cancer, and therefore offers the chance to treat many more patients. Precision medicine was first discussed worldwide in 2009. In 2009, hoping for a new treatment, scientists took Nicholas Volker, a 4-year-old boy with advanced disease, and all of his protein-coding DNA was sequenced to screen for a point mutation that might have caused the disease. This allowed them to identify a risky option that nevertheless almost completely treated the disease. After this study, scientists decided to replace the term used for nearly 10 years, individualized medicine (personalized medicine), with precision medicine (precision medicine). Disease boundaries began to change with precision medicine: a drug used for kidney cancer could become the only hope for another patient with treatment-resistant blood cancer.

As is known, the general name for the drugs we use to treat cancer is chemotherapy. However, cancer treatment consists of more than chemotherapy administration. Diagnostic and therapeutic imaging, pathological examination for definitive diagnosis, psycho-oncology, cancer surgery, radiotherapy, hormone therapy, immunotherapy, targeted treatments, oral chemotherapies, regional treatments, supportive treatments, and end-of-life patient care are among its many components. At this point, the medical oncologistis the physician who recommends the most appropriate of these seemingly complex and increasingly numerous treatment options to the patient in the correct sequence.

Conventional chemotherapy drugs are injected intravenously into the body every 2 or 3 weeks. Besides these drugs administered intravenously in hospital, particularly over the last 15 years, increasing numbers of chemotherapy drugs taken orally as pills have become an important part of cancer treatment. Oral chemotherapy pills may differ from conventional intravenous chemotherapy in both effectiveness and side effects. These new-generation oral chemotherapy drugs are preferred by patients and healthcare professionals because they are easy to use. Other advantages include effectiveness similar to intravenous drugs and safety. While intravenous chemotherapy is administered by healthcare workers (usually oncology nurses), oral chemotherapy is administered by the patient or a relative. For this reason in particular, patients and their families should understand oral chemotherapy drugs better.

Particularly for our patients taking oral chemotherapy drugs, with new ones appearing every day, the changing and developing understanding of cancer treatment and precision medicine should ensure that they take an active role in their own treatment. This will improve adherence and reduce treatment side effects. Ultimately, treatment success and satisfaction will increase. The first requirement is to convey accurate information about these treatments.

In subsequent articles, I will continue to describe new-generation treatments, the patients who find hope and life through them, how these new drugs are used, and their possible side effects...