5: Won’t genetic testing – and ‘personalized medicine’ – mean doctors can work out the specific treatment needed in every individual and make all this unnecessary?
Although the idea of being able to work out the specific treatment needed in every individual is undoubtedly attractive, and may be possible for a few conditions, it seems very unlikely that this approach will become the main way of treating people.
As we explained when discussing genetic tests most diseases depend not only on complex interactions involving several genes, but also on the even more complex interactions between genes and environmental factors.
The results of genetic analyses have been important in informing decisions in families and individuals with inherited disorders, such as Huntington’s disease, thalassaemias (inherited blood disorders), and some other (mostly rare) diseases. This genetic information has been a great boon in counselling families with these conditions. However, as far as the more common diseases to which we are all subject are concerned, genetic analysis adds little to information already available from family history and clinical examination. Although this situation is likely to change, our limited current knowledge means that we need to be careful not to overinterpret risks for common diseases predicted on the basis of genetic analysis.
We should declare that none of the authors have had their genetic profiles done, nor are we considering doing so. So it shouldn’t surprise you that we would generally advise against genetic testing unless someone has (i) a family history that suggests a specific known genetic disorder, or (ii) one of the few currently known conditions in which a gene or genes clearly predicts who will respond to a treatment.
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