Sunday, 9 November 2014

The Good News - and the Bad News !

The Garvan Institute has announced that advances in genomic testing have lowered the costs of a full screening to less than two thousand dollars, and there is the likelihood that if it is phased in under Medicare it will drop to a far lesser amount as volumes increase.

The good news is that the old method of describing cancer by the organ involved  - bowel cancer - breast cancer - pancreatic cancer - is being replaced by identifying the genetic mutation that is taking place.   As a result, instead of the "shotgun "approach in treatment, the "rifleman " method of specifically putting that mutation in the cross hairs and delivering a sniper's concentrated fire to achieve a "clean kill ".     It promises a great leap forward in life saving results by reducing the collateral damage to other organs presently common with the range of treatments available.

Genomic testing can deliver a window into the future - that all people may not welcome.  As a young person starting our journey in life we are able to find out with a high degree of accuracy if we will develop cancer, diabetes, heart disease - and the huge range of medical conditions that are foretold in the genetic combinations that exist in our bodies.  In some cases, advance warning may make it possible to adopt lifestyle changes to stop the onset of such given diseases, but there is a danger that this knowledge can be a total game changer in how we live our lives.

There is a certain protection in the present unknown.    If we can foresee the future, it can have an enormous influence on many of the decisions we will make.  More to the point, if that knowledge ends up in the hands of other people, their decisions will have a multiplier effect on the avenues of opportunity that are open to us.  A future employer would hesitate to start the development of a promising young executive if that person had genetic defects that indicated an early death - or the likelihood that such a person would succumb to alcohol addiction.

The very fact that this sort of testing is now available is a threat to individual privacy.  It is certainly something the insurance industry would welcome when considering applicants for life insurance cover -  and it could easily become a requirement in many types of commercial activities.   The bank manager considering granting a mortgage for a home purchase would certainly hope the applicant lives long enough to pay off that loan.

Then there is the human side of the relationships we make.   Certainly the decision to have children would be affected, as would the choice of partner .  It could easily become a matter of genetic testing of both parties being a requirement in the formation of a relationship.  The ripples from this pool of information becoming available are far reaching.

Whether we like it or not, genetic testing is fast advancing as a medical reality and sooner rather than later it will become standard procedure the moment we present at an emergency department for treatment.   The medicos obviously need to know what makes us tick to decide on the necessary treatment and just as a standard blood test is now the first thing performed, a genetic sample will be rushed to the laboratory in future to provide what will become one of the "basics ".

In all probability, the moment a baby is borne the health people will take a genetic sampling and that will be entered on that persons health record for the rest of their life.  In these early stages, we may have the right of refusal, but there is a certain inevitability about science - if it exists it's benefits cut through all forms of red tape - until it becomes a necessity.

The only real option - is to get used to it !

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