Thoughts on Personalized (Lifestyle) Medicine after the Personalized Medicine World Conference 2014
“The medicine of the past is reactive. The medicine of the future is proactive.”
– Ralph Snyderman, MD — Chairman Emeritus, Duke University
I don’t think I’ve ever been to a place as unique as San Jose, California, the heart of Silicon Valley. You can feel this area pulsating with the birth of ideas and technology delivery with the potential to change the world. Together with Dr. Jeff Bland, I attended the Personalized Medicine World Conference (PMWC) in this hotbed of discoveries at the end of January. I wasn’t sure what to expect. Usually I travel in the circles of practitioner-focused, lifestyle-medicine-based conferences, not in biotechnology think tanks. I arrived feeling like an outsider, but as I became more immersed in the presentations, I suddenly felt we were now insiders on the verge of something significant and profound. A relatively new conference, the attendance at PMWC has grown to 1000 attendees (a 50% increase from the previous year) representing 26 countries. There were several concurrent tracks to choose from, and it was difficult to pick and choose from this novel intellectual buffet. Every room was densely packed–like a microchip–with people and information.
As the name of the conference suggests, the focus of the meeting was personalized medicine, with a rather strong slant toward the field of cancer (from even the very earliest discoveries in genetic testing, an alignment of these disciplines has been apparent). One of this year’s speakers, Eric Green, MD, PhD, the Director of the National Human Genome Institute, predicts that the most active areas currently in PM are the following in this order:
- – Cancer genomics,
- – Pharmacogenomics,
- – Genomic medicine ‘Test Drive’ programs,
- – Prenatal and newborn genomic analyses,
- – Clinical genomics information systems, and
- – Ultra-rare genetic diseases diagnostics.
As I sat through the sessions, I quickly realized that the presentations made for a mosaic of perspectives on everything from computation, biotechnology, and next-generation sequencing to clinical translation to the patient through clinical trials and even case studies. There was definitely dynamic tension in the system, as I noted that there was debate about how one’s genome sequence should be used in medicine. Several cases were described in which DNA sequencing had saved people’s lives.
One case that made an impression on me was the story of a young girl who had a number of health issues – stunted growth, abnormal hair and skin presentation, fatigue, and overall failure to thrive. Her parents were exhausted and fragile in their search for an answer. Finally, their quest led them to a research hospital where genomic screening was done, and their daughter was diagnosed with an extremely rare condition that influences the liver. In fact, this condition is so rare that only 4 other people in the world are known to have it. She received gene therapy with specific proteins and went on to have a much better quality of life. This child’s story was told in a video. Seeing her transform was quite remarkable and heart-wrenching.
Another case was a woman who discussed her inheritance of BRCA1 (the breast cancer gene) from her father. In addition to herself, three out of her five sisters had breast cancer in their thirties. She told the story of how having this genetic information “saved her life” and gave her hope. Her 21-year old niece had the genetic test done and found out just five days before the conference that she is positive for the gene. She is now going to live a life of proactive health rather than being reactive later in life if the gene should express and turn on.
Dr. Bland gave an excellent presentation on personalized lifestyle medicine and stirred up much thinking about this revolutionary concept. In fact, no other presence – no booth, no presenter – had focused on any aspect of lifestyle medicine with respect to personalization, which surprised me. There were hints of talk about nutrition by some speakers, but truly nothing of great significance. I could tell from the people visiting the PLMI exhibit booth that this idea was a new concept for them to process. One physician from Canada came to the PLMI booth and said to me, “YOU are the reason I am here!” As I inquired further, she told me how excited she was to see what we were doing with becoming the meeting ground for patients and practitioners on this cutting-edge concept of PLM. There were conversations about whether there is enough evidence for PLM, and, of course, I referred them to our scientific paper written for the Scientific World Journal in 2013, in which Dr. Bland and I write about the varying levels of evidence. Based on what I know, it seems that nutrition will be one of the first areas to go personalized, perhaps more than some of the others. We are on the edge of something big…
As I left San Jose behind, I reflected on what I felt was a gift—to experience a short, 2-day window into the future trajectory of healthcare. There is some exciting that we are on the verge of that will change our lives, enabling us to move into being empowered to take charge of our health in new ways we haven’t yet considered.