Questions & Answers
Q: What is personalized medicine, and how long has it been available?
A: The genome is all the genetic information contained in your DNA, and it serves as an instruction manual for every cell in your body. This book has 6 billion letters arranged in 46 chapters.
Cells are constantly replicating, and the body has its own repair system when something goes wrong. For example, smoking just three cigarettes or sitting out in the sun too long can cause a single genetic mutation. Repetitive exposures will bring cumulative genetic changes that are so great and so rapid that repair processes are overwhelmed.
The science of medicine was transformed in 2001 with the sequencing of the first human genome. That was followed by the sequencing of the first cancer genome in 2009.
We can sequence the DNA in a tumor cell, and compare it to normal DNA in a blood cell. We compare both sequences to figure out exactly what changes took place at the cellular level, and match specific targeted therapy to these changes.
Q: Why is genomic science important in cancer care?
A: Our health is a combination of our DNA and our environment. Our DNA is that inherited “instruction manual” that makes us unique individuals. Our environment is comprised of what we eat, the microbes or chemicals we were exposed to, and so on. Understanding the genetic component is very powerful in identifying what causes human disease.
Q: What patients are you working with at Avera?
A: We work with patients who have all types of cancer, with a specific focus on breast cancer that is metastatic or resistant to treatment.
Q: How is this care different than a typical approach?
A: Doctors typically prescribe cancer treatment based on what we think will work for a particular type of cancer. The trouble is, we commonly don’t know until several weeks or months into the treatment whether it’s working or not.
With personalized medicine, we can better predict up front what treatments are likely to work, or more importantly, what treatments are likely not to work.
Q: Are there other programs like this in the United States?
A: Yes and no. Genomic oncology programs typically exist at large national cancer centers, and ours is similar in several ways. Yet Avera’s program is set apart by several factors. First, most programs use only one type of test – or platform – to find genomic changes. We use multiple tests to be as precise as possible. We’re also set apart by the diversity of our team and our collaborative partners, and our aggressive approach to match targeted therapy to genetic changes. We’re committed to a 14-day turnaround time whenever possible, when most programs might take up to three months to provide answers.
Right here in the Northern Plains, we are building a genomic oncology program that rivals any other program worldwide. Regionally, there is no other cancer program offering this level of care.
Q: What actually takes place with personalized medicine?
A: Patients are referred to our program, or they can also self-refer by contacting Avera Medical Group Oncology & Hematology at 605-322-6900. If the decision is made to go ahead with genomic sequencing:
- We send samples from the tumor biopsy and blood tests to both the pathology lab at Avera McKennan, and Avera’s specialized Genomic Oncology lab. This lab is located in La Jolla, Calif., to be closer to the top experts who collaborate with us.
- DNA is extracted from the tumor cell and normal cell.
- DNA samples are sequenced and compared to find changes.
- Experts on a multidisciplinary sequencing tumor board match targeted therapy to genetic changes. This tumor board makes a recommendation to Avera Cancer Institute’s disease specific conferences.
- The clinical team in Sioux Falls collaborates with Avera oncologists to carry out the treatment plan.
Q: Who makes up the genomic medicine team?
A: Our diverse team of experts includes a clinical physician, doctor of pharmacy, research scientists, experts in bioinformatics, nurse practitioners and more. We also collaborate with many of the top experts in the world. Cancer patients we work with have a tumor board of around 40 people looking at their particular case.
Q: What’s the future of personalized medicine in cancer care?
A:This type of care is still mostly in the research phase. In the future, it will absolutely revolutionize cancer care. Five years from now, it will be routine for cancer patients to have genomic testing soon after diagnosis, so cancer treatment can be matched to the cell changes early on in the cancer care journey. We are excited that Avera is investing in this field now to offer more hope for treating cancer effectively.
*Coverage for genomic medicine varies among insurance providers.