Personal Genome

Take a seat.

For most of the history of medicine, treatment has been built on averages. A drug is tested on a population, a recommended dose is established, a guideline is issued, and that guideline is applied — more or less uniformly — to individuals whose biology may differ from an average for which the guideline was designed. This approach has produced remarkable results. It has also reached the limits of what averages can do for individuals.

The next significant development in medicine is already underway. It is the shift toward treatment and intervention based not on what works for most people, but on what is appropriate for a specific person’s specific biology.

At the centre of that shift is the genome — the complete set of genetic instructions that makes you, in biological terms, uniquely you.

Genomic sequencing — reading that genetic code in full — is no longer the exclusive territory of research laboratories. It is becoming increasingly accessible through medical channels and a growing number of reputable providers, at costs that continue to fall. What it offers is biological self-knowledge: an understanding of your individual predispositions, vulnerabilities, and the specific ways in which the hallmark processes of ageing are most likely to affect you.

That knowledge has direct practical implications for the interventions, medications, and lifestyle choices most likely to be effective for you — as distinct from the population average.

The case for individual medicine is perhaps most starkly illustrated by cancer. Tumours are approximately 97% genetically distinct — and sometimes from each other, even within the same body. The idea that a single treatment protocol is the optimal response to what is, in biological reality, a highly individual disease is one that oncology is already moving away from. 

The development of individually tailored cancer vaccines — treatments designed around the specific genetic profile of a patient’s own tumour — is not a distant prospect. It is happening now, built on the mRNA technology that most people encountered for the first time during the COVID pandemic.  mRNA was developed to assist with individual medicines for the treatment of cancer  just in time to be adapted to the Covid pandemic

It had been in development for cancer treatment for years before COVID presented an urgent new application. The speed with which mRNA vaccines were deployed for COVID surprised many people. It should not have — the platform was already mature. It is now returning to its original purpose, and the implications for individually targeted cancer treatment are considerable.

All of this is relevant to anyone thinking seriously about their health in retirement. Understanding your own genome is not a guarantee of anything. It is not a medical intervention in itself. But it is a foundation — a piece of self-knowledge that is likely to become increasingly useful as individual medicine develops, and which very few people have yet thought to acquire.

That will change. Being already in possession of this knowledge in the future is likely to be as invaluable to your medical advisers  as removal of the delay might be to you.  The question is whether you are among those who act early or among those who wonder later why they waited.

Jack Lack’s Listening Chair is always here, as is your welcome.