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Genetics and the Future of Medicine

What do Bill Clinton, Wilt Chamberlain and Mary Lou Retton have in common? Their genetics are 99.99 percent the same. In fact, each one of us is only 0.01 percent genetically different, and that is the piece that determines skin color, eye color, height and more. Genetics connect us more to our world than we realize. In fact, we are only 50 percent genetically different from a banana.

In medicine, the field of genetics is rapidly changing. Are you at risk for breast cancer? What medications will work best for you? These are all questions that genetic testing can answer today. And as this new and exciting field continues to evolve, the possibilities continue to grow.

Genetic testing can be used to confirm a suspected illness, predict the possibility of future illness or determine if family members are at risk for certain conditions such as cancer.

“We have 20,000 genes in our cells, and genetic tests are now available for a growing list of medical disorders,” said Kayla York, MS, LCGC, Certified Genetic Counselor with Avera Cancer Institute Sioux Falls.

Genetic testing can’t detect every type of cancer or condition. Some of the more common tests include testing for the BRCA and Lynch syndrome genes, which can both indicate a higher risk of certain cancers.

As genetic testing evolves, genetic counseling is becoming an important piece of the puzzle in helping patients not only determine whether the test is right for them, but also how to interpret the information once they have it.

The first step of genetic counseling is simply a conversation about family history and genetics. “We draw out a family history, and try to determine what the chances are that we would see a genetic mutation in a particular patient,” York said.

In working with patients, York said part of the conversation includes a discussion of the pros and cons. “Not everyone wants to know. For some people, knowing that there’s a genetic link would cause more anxiety. Yet for others, they can take that information and use it to be more proactive through increased cancer screening or additional surgeries.”

Many genetic tests are now covered by health insurance, but since the field is constantly evolving, it’s best to check with your insurance company before you have genetic testing done, and discuss the possible benefits of genetic testing with your physician.

Through what’s known as pharmacogenomics, genetic information can be used to prescribe the best possible medications, rather than a trial-and-error approach.

“Personalized medicine is a term which describes the use of genetic analysis to better manage a patient’s disease. For example, through a genetic analysis, we can take a ‘snapshot’ of how the liver metabolizes medication,” said Gareth Davies, PhD, Chief Scientific Officer with Avera Institute for Human Genetics.

Genomic sequencing can help doctors understand how your body processes drugs. Based on the enzymes in their liver, certain drugs aren’t metabolized well at all; other drugs are metabolized too quickly to be effective. “For instance, a genomic analysis can tell us whether you metabolize ibuprofen better – or Vicodin,” Dr. Davies said. “This particular approach is being used today to help determine the best drugs in specialties such as pain management, behavioral health and cancer. The possibilities for the future are amazing.”

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