Complete Podcast and Panelist Bios at Helix Health

What what is the future of genomic and personalized medicine? In this panel organized by Helix Health, five experts discuss what new developments in pmed advances in breast and ovarian cancer management, what they means for patients, doctors, and the health industry, and how these treads apply to all health care.

“This [genomics] revolution is akin to the discovery that bacteria cause disease.” begins Dr. Steven Murphy, an expert in genomic medicine. Yet, “how did medicine advance so technologically, yet fail to keep us informed? … I’m amazed how difficult it is to translate this wealth of technology into truly effective patient care.”

And “we are in the beginning of an enormous tsunami of new [genomic] information that’s just beginning to hit,” says author David Duncan, who has subjected himself to “The Experimental Man” project to take every test to learn what can be learned about one’s body. These tests are expensive today, the BRCA breast cancer gene test costs upwards of $2500, but like microchips “technology is making these tests cheaper and easier —even including full genome sequencing.”

But who in the medical community needs to learn this information? “Everyone, so everyone is liable.” says Gary Marchant, J.D. By the “loss of chance doctrine,” simply by not discussing all the new genomic information to patients, “today, it’s any doctor who is potentially liable, from the general physician to the family physician to any kind of specialist.”

Yet, “such a small amount of physicians who are genetically knowledgeable,” says Steve, “there are less than 100 trained adult genetics specialists.” And while genomic education is truly empowerment to practice better health, medical students experience what Steve dubs “genomic knowledge erosion:” students know less about genomics after medical school than before and even less after residency. Gary adds, “Most doctors practicing today probably didn’t have genetics in medical school. If you’re an older doctor practicing in some rural community, this issue is all foreign to you.”

“Those doctors should then retire,” rebukes patient advocate Jessica Quller. “Perhaps fear of litigation will force doctors on a national level to become educated in their field and force them to present these options to patients.” Jessica’s mother died of preventable ovarian cancer, prompting Jessica to take the BRCA breast cancer gene test. Testing positive, she underwent a prophylactic mastectomy and oophorectomy. “The year is now 2004: no doctor had ever mentioned that I should be tested, and my sister and I essentially lived in NYU hospital with my mom for two years during her illness… Only my high school friend mentioned the [BRCA test] to me.”

“For 2004, I certainly would have hoped that in New York City, somebody would have talked to you about genetic testing in light of your mom’s illness.” exclaims Dr. Barbara Ward, a surgical oncologist. While “about 7% to 8% of [breast cancer] is inherited… we do believe that [the BRCA 1 & 2] genes reflect most of the inherited breast cancers… as high as 87% of women carrying the BRCA 1&2 gene will develop breast cancer. I look forward to the day that we’ll look back and we’ll say ‘can you actually believe we did prophylactic mastectomy for gene carriers?’ But at this point in time it’s the best we can offer.” But will insurance companies pay for tests like this including breast MRIs? “We definitely struggle… it’s VERY frustrating. Sitting in my desk right now I have a chart of a lady who’s HAD breast cancer, has had a mastectomy, and her insurance company is refusing to screen her with a breast MRI… So, it is frustrating to realize that there’s a test that’s available and realize that you may not be able to get it.”

Thank you to the panelists and Helix Health for conducting this excellent session about genomic medicine and breast cancer management.