Presidential Address| Volume 146, ISSUE 6, P971-978, December 2009

Personalized medicine: The future is not what it used to be

  • Michael J. Demeure
    Reprint requests: Michael J. Demeure, MD, MBA, Virginia G. Piper Cancer Center, 10460 N 92nd Street, Suite 200, Scottsdale, AZ 85258.
    Translational Genomics Research Institute and Endocrine Tumors Center, Scottsdale Healthcare, Scottsdale, AZ
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      People want personalized medical care. I would like to think that we doctors have always treated our patients based on their individual health status, including factors such as their medical history, family history, laboratory data, results of imaging, and patient wishes. Personalized medicine, as a term, has evolved to indicate that the results of various forms of genomic analysis are applied to tailor an individual patient's medical care. Patients don't know, and indeed, most doctors don't understand the future that the emerging molecular technologies can bring to the practice of medicine. Still, there are clear advantages that supplement but do not replace traditional clinical medicine. These advantages include the potential for predicting susceptibility to disease and as a result, more detailed screening or prophylactic preventive treatment. Personalized medicine also offers the potential for the diagnosis of disease at an early and more effectively treated time when the sequelae of the disease may be ameliorated. This is particularly true in the cancer field, where we work. Potential beneficiaries of the novel technologies will primarily be our patients but those who pay for medical care will also benefit. There are immense business opportunities for companies that develop diagnostics, drugs, or methods for data analysis. My message today is to focus on how we as surgeons have an opportunity and a responsibility to become involved and influence the development of personalized medicine as a field of discipline. Already several medical schools have developed institutes, programs, or curriculum focused on personalized medicine. Companies have been formed marketing individual analyses that purport to predict one's risk of the development of a myriad of diseases ranging from Alzheimer's disease or diabetes to male pattern baldness. In my address, I plan to review the current state of the field as it relates to our practice as endocrine surgeons.
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