Is the one-size-fits-all approach over? Let's learn about the future of medicine (Precision Medicine) in a simple way!

Imagine that you and your best friend both have the same disease, for example, high blood pressure. When you both go to the doctor, they both give you the same type of medicine. But the strange thing is, your friend's blood pressure is controlled beautifully with that medicine without any side effects. But when you take that medicine, you get dizzy, or you get some other side effect, and your blood pressure is not controlled properly. Why is that? Even though we are two people, our bodies are very different inside, aren't they? This latest medical concept that we are talking about today, which is called Precision Medicine, comes to the fore as a solution to that problem.

Simply put, what is Precision Medicine?

Precision Medicine can be translated into Sinhala as "precision medicine". But it is more important to understand the concept than the word.

Let's start with a simple example. Imagine you go to a store to buy a shirt. There are many shirts in the same size, "Small", "Medium", "Large". You pick up the "Medium" and try it on. It might be too tight, or a little too big, or the sleeves might be too long. But you have no choice, so you buy it. This is the traditional "one-size-fits-all" approach.

Now imagine you go to a good tailor. He takes all your measurements, like your height, weight, arm length, and shoulder circumference, and tailors a shirt specifically for you. How beautifully and comfortably will it fit your body? That's what Precision Medicine is all about.

There is another name for this, which is "Personalized Medicine." But the term Precision Medicine is now more accurately used.

How is this different from the traditional method?

Let's do a small comparison to clearly understand the difference between these two methods.

What benefits do we get from Precision Medicine?

This modern method is set to revolutionize medicine. Here are some of the main benefits it will bring:

• The right medicine for you, at the right dose: Using your genetic information, your doctor can determine exactly which medicine will work best for you, with the fewest side effects, and the right dose to give it.
• Gaining a deeper understanding of why diseases develop: Why are some diseases passed down from generation to generation? Why do only some people develop cancer? Genetic information is very helpful in finding answers to questions like these.
• Preventing disease before it happens: If your genetic testing could predict that you are at higher risk of developing diabetes, heart disease, or a certain type of cancer in the future, how much more likely would it be to change your lifestyle to prevent it? Precision Medicine is the way to go.
• More accurate diagnosis: Sometimes, even though symptoms may be the same, there may be two completely different diseases on the inside. When tested at the genetic level, it is possible to identify the exact disease.

What fields are already using Precision Medicine?

This is not just something that will come in the future. Doctors in developed countries around the world are already successfully using this method in several fields. Let's look at some of the main ones.

1. Cancer Treatment (Precision Oncology)

This is the largest and most successful application of Precision Medicine to date. In the past, we used to classify cancer based on where it originated. For example, "lung cancer" or "breast cancer."

But now scientists have discovered that even cancers that develop in the same place can have different molecular fingerprints . Just like our fingerprints. That means that two people with lung cancer can have different genetic changes (mutations) in their cancer cells.

So, in Precision Oncology, a small sample of the patient's tumor (biopsy) is taken, and the genetic changes are examined. Then, the patient is given a drug (targeted therapy) that attacks only that specific genetic change .

2. Cancer Immunotherapy

This is another amazing step forward in cancer treatment. Our bodies have an army that fights disease. We call it the immune system . This army can recognize and destroy abnormal cells, that is, cancer cells, that grow in our bodies.

But some cancer cells are very cunning. They are well disguised, hiding from our immune system.

Immunotherapy works by "training" our own immune system to recognize and attack these hidden cancer cells. It's like giving our military a new radar system that can spot hidden enemies. This has enabled us to use our own body's defenses to control or even cure cancer.

3. Pharmacogenomics

Although this word may seem a bit difficult, the concept is very simple.

Pharmaco = medicine (medicine)

Genomics = Genetics

That means studying how your genes respond to the medications you take.

We all have slightly different genes, so the same drug will work differently in our bodies.

• Some people's bodies break down and eliminate a drug very quickly. For them, the normal dose may not be enough.
• Other people's bodies break down the drug very slowly. For them, even a normal dose can be toxic.

Pharmacogenomics involves taking a small amount of your genetic information through a simple blood test before prescribing a drug, and seeing how your body will react to that drug in advance. This allows your doctor to determine the most appropriate drug and dosage for you. This can help avoid unwanted side effects and ineffective treatments.

4. Rare Diseases

There are very rare and unusual genetic diseases in the world. Sometimes even doctors cannot identify the exact cause of the disease. There are families who suffer from this disease after going to hospitals for years and undergoing various tests, but they are unable to find out what the disease is.

Precision Medicine has brought great hope to people like this. It is now possible to examine a patient's entire genetic makeup (Genomic Sequencing) and find a very small "letter mistake" (genetic mutation) in that DNA chain. That small mistake is the cause of the entire disease. When the exact cause of the disease is found, it becomes easier for researchers to find a cure for it.

How will Precision Medicine change our lives in the future?

This technology is still in its infancy, but its potential is enormous. In the future, when you go to see a doctor, he will have your genetic information along with your routine blood test results.

• Before prescribing a medication for you, the doctor looks at the report and decides, "Oh... he might be allergic to this medication, so we'll give him this."
• If you develop a disease that no one in your family has, you can find out if the cause is environmental influences, a mistake in your lifestyle, or a new genetic change.
• We will all be able to create a health plan that is unique to us.

This is no longer science fiction. This is the future of medicine. It will take some time for these technologies to come to Sri Lanka and become commonplace. But already, targeted therapies like this are being used to some extent for some cancer patients in our country. Therefore, it is very important to be aware of this.