Personalized medicine operates under a conflicting premise. It aims to customize healthcare while reducing costs, but as it becomes more individualized, prices inevitably soar. Consequently, patients are left with a difficult choice: forego treatment or face financial ruin.
Luckily, our family was in a favorable position. My parents were financially secure, had comprehensive health insurance, and were conveniently located near a prominent hospital network. Additionally, my father benefited from his skin color. Research shows that White lung cancer patients are more likely than Black patients to receive a diagnostic test that determines the compatibility of drugs like erlotinib. Moreover, individuals from affluent neighborhoods have greater access compared to those from poorer areas.
Consequently, my father was able to leave the hospital and continue his care at home. He underwent physical therapy and indulged in his passion for tying flies, hoping to one day return to the Delaware’s chilly spring waters. However, subsequent tests the following summer revealed the regrowth of his tumors. Sadly, he never regained his ability to stand or practice his beloved fly fishing. On September 23, 2012, just over a year after awakening paralyzed, my father passed away.
Media reports frequently depict personalized medicine as a groundbreaking force poised to revolutionize healthcare through miraculous medical advancements. However, drugs like erlotinib usually provide temporary relief rather than a cure, and when cancer resurfaces, it often does so aggressively. Oncologists can now prescribe newer, more expensive medications in response. Still, the survival rates for advanced lung cancer patients like my father remain alarmingly low five years after initial diagnosis.
Genetic insights into patients’ conditions are most effective in cases where diseases are known to be caused by simple genetic mechanisms, making conditions like spinal muscular atrophy and chronic myelogenous leukemia ideal candidates for targeted interventions. However, these instances are exceptions rather than the norm in the field of medicine. When we consider common and complex diseases such as hypertension, Parkinson’s, diabetes, or asthma, where there isn’t a single gene responsible for the condition, the potential for personalized medicine to revolutionize treatment for the majority of patients is severely constrained.
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