July 2012

Personalised Medicine

Affordability is the reason that we today are turning to personalised medicine.

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Dr Dinesh Pendharkar, Cancer Specialist, Asian Institute of Oncology, SL Raheja- Fortis Hospital

How do you think India has adopted innovative technologies for diagnosing cancer?
In India we are absolutely in tune with international research as well as diagnosis of cancer. In cancer diagnosis the basic test required is the histopathology and a tissue biopsy and the processing of that biopsy. To diagnose it, we need to investigate how far the cancer has spread. So far the best diagnostic tests are readily available in the country. So as far as diagnosis is concerned all pathological tests can be done and all radiological investigations can be done to find out the type of cancer and the extent of cancer.

How do medical oncologists react to the innovative technology available in the market today? How do you think the equipments or the diagnostic laboratory actually helps the cancer patients today?
As far as medical oncologists are concerned, they are absolutely user friendly and they adopt new technologies very fast. So if a new tool becomes available, we are right their to accept it. Diagnostic Laboratories help in a big way. The basic analysis with the cancer diagnosis test is that these tests actually help us in identifying a particular patient, for instance, if a patient has a breast cancer there are multiple drugs available. So the doctor needs to know which drug is suitable for this particular patient. Patient can get a drug which acts exclusively on these receptors in the cancerous cells. So these diagnostics will help us in modifying the treatment for cancer patients and using them for best results, so that the patient gets the maximum benefit out of the available drug. At the same time there is a cost saving. If the test is negative in a patient, the use of a particular drug may cost huge money. So the cost is saved because we perform this test and we know that this drug is not active for this particular patient. The test helps in modifying the treatment in various levels.

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Do you think that personalised medicine is a good approach to take up in the future?
Affordability is the reason that we today are turning to personalised medicine. Personalised medicine is a treatment that has been personalised according to the type of cancer the patient is suffering from. That particular cancer will be treated by a particular type of receptor according to the particular property it has. Each kind of drug can target exclusively the property of that cancer.

Can you name a few technologies that you think can actually revolutionise the way cancer can be diagnosed?
The best technologies which will really help us in diagnosis will be genomic technology, which is also known as micro array technology. And the second most important technology is the PCR technology. These micro array and genetic technologies can actually detect the genes which are defective, they can select and check multiple gene. These two three technologies will find out some genetic defects in a cell and can personalise the type of cancer with type of gene affecting the cells. The genomic and micro array technologies could be of great help.
I wish to develop a term which is personalised adaptive treatment, which means I should be able to adopt this treatment towards patients as a whole, not only to the cancer patients. If the patient is receptor positive I know this drug is working but may be this patient is so lean that he cannot take up this pressure, and then I have to adopt treating.May be today he cannot take it, but tomorrow he can take it. The bottom line is that that the system of treatment also needs to be personalised.

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