Chapter 23: The New Personalized Care
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Description
In this Chapter Dr. Mendelsohn defines personalized care and offers an historical sketch of its development. Originally, Dr. Mendelsohn explains, doctors had few tools to treat cancer, so they offered care. Now it is possible to profile a disease in individual patients at the molecular and cellular level so physicians can hand-tailor care to what is wrong with an individual.
Identifier
MendelsohnJ_03_20121017_C23
Publication Date
10-17-2012
City
Houston, Texas
Interview Session
John Mendelsohn, MD, Oral History Interview, October 17, 2012
Topics Covered
The Interview Subject's Story - OverviewThe Clinician Overview Definitions, Explanations, Translations Patients The History of Cancer Research and Care The History of Health Care, Patient Care
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.
Disciplines
History of Science, Technology, and Medicine | Oncology | Oral History
Transcript
Tacey Ann Rosolowski, PhD:
I wanted to shift gears a little bit, because we didn’t bring the story of your interest of translational research and personalized care to a conclusion, and certainly you have this new role as Director of the Institute of Personalized Care, so I wanted to speak a bit about that. First, I was hoping you could give me a snapshot of what exactly personalized care means.
John Mendelsohn, MD:
Care is always personalized, because it’s a compact between a doctor and a patient. Some people like to use the word targeted or precision care today. The fact is that even in the time of William Osler, 1890, there were no antibiotics and few effective medications. The most common causes of death were pneumonia and tuberculosis. Operas today are about AIDS. The operas in the 1900s were about tuberculosis. The hero of La Boheme dies of tuberculosis. The hero of La Traviata dies of tuberculosis. You read the biographies of the famous composers, and their brothers died of tuberculosis. It was very common. Doctors didn’t have many tools. Personalized cancer care back then meant caring for the person more than curing the disease. In the last 100 years, we’ve gotten much more sophisticated in ways to intervene with illness. The surgery got more sophisticated. Radiation therapy was invented in the last 100 years. Chemotherapy was invented in the last 50 or 60 years. So now the personalized care involves bringing a whole lot of new toolboxes in and hand tailoring the care to what’s wrong with that particular individual person. Then along comes this new revolution in genomics, and we now understand that each cancer is a little different because its group of 4 to 6 aberrant genes are different from the genetic mutations in another cancer of the same type. Whereas we would look at a breast cancer patient and on the basis of what the pathologist sees in the microscope and correlating that with what we know about the outcomes of the disease, now, the pathologist also provides a genetic profile, and we know that gene aberrations caused that patient’s cancer. We can now say to a patient, “We can profile your disease not just looking at the pathology in the microscope and not just looking at where it is in your body with CT scans and MRI scans and PT scans, which we do incredibly well now. We can also say what’s the biochemical mechanism causing your cancer to act the way it’s acting,” which may be different in 2 breast cancer patients that otherwise were the same under the microscope. Personalized therapy today means, in many people’s eyes, taking advantage of what we are now learning about an individual patient’s disease at the molecular and genetic level and using that information to design their therapy plan, which you can call it precision. You can call it personalized, you can call it targeted.
Recommended Citation
Mendelsohn, John MD and Rosolowski, Tacey A. PhD, "Chapter 23: The New Personalized Care" (2012). Interview Chapters. 1439.
https://openworks.mdanderson.org/mchv_interviewchapters/1439
Conditions Governing Access
Open
