Personalized Medical Treatments

Much of the genetic data available direct to consumers is incomplete and preliminary, but in coming years, it will be tested and validated.

A few genetic tests are well validated and already a part of the standard of care. Genentech's breast cancer drug Herceptin, for instance, is indicated only for patients who test positive for an over-expression of the HER2 gene.

Other companies, mostly in stealth mode, are plotting to tease out details of people's protein signatures and the impact of environmental influences.

A host of books documenting the personalized medicine revolution are already in the works. Tom Goetz of Wired and Misha Angrist of the Duke Institute for Genome Sciences and Policy are writing about their own experiences of being genetically screened for diseases and other traits, and what these tests will mean for people in the future.

Geneticist Francis Collins, one of the architects of the human genome project and until recently the director of the National Human Genome Research Institute, is writing a book on personalized medicine.

My own book on being genetically screened for health and environmental influences—Experimental Man: What One Man's Body Reveals About His Future, Your Health, and Our Toxic World—will be out this spring.

(I've also written a series of columns on this subject for Portfolio.com.)

New groups are forming, including the Quantified Self, founded by technology guru and Wired magazine's "senior maverick" Kevin Kelly and Wired contributing editor Gary Wolf. Members share their experiences in gathering data about themselves—from diet to sleep patterns and beyond—in monthly meetings held in the San Francisco Bay Area.

A raft of new technologies will help make this new age happen, creating a world where one day a doctor's exam will include a quick scan of our bodies that tells us hundreds or thousands of bits of data seamlessly integrated by a computer into a health score card. Think of the sickbay on the starship Enterprise.

Or maybe we'll have our own handheld device—let's call it an iHealth (with apologies, or perhaps a suggestion, to Apple)—that will keep track of our genomes, incorporate the most recent scans of our brain and body, and record real-time environmental data about what we are exposed to as we walk around, eat, and work. This could include levels of mercury and benzene, say, as well as exposure to ultraviolet rays.

This information will be synched up at home with sophisticated biomonitors that daily record levels of thousands of chemicals, proteins, and other substances inside us.

Our iHealth could download the data, assess our current health, and determine up-to-the-minute probabilities for acquiring various diseases and exposures. At the same time, it could assess risks for everything from eating a steaming piece of swordfish to walking in an environment teeming with hidden chemicals.

While we're waiting for all of the data to sync we can play a game, check emails, or watch a video on a futuristic version of YouTube.

The impact of such a device and the intimate information it will provide is hard to fathom, much as people in Robert Frost's day had no idea what antibiotics would mean to future generations.

The poet who contemplated which road to take in a wood couldn't have imagined that tuberculosis, whooping cough, and other diseases that terrified his era and cut lives short would largely disappear in the West, and that millions of people would remain alive and vibrant into their 70s and 80s.

I suspect that some people will obsessively check their iHealths and will be terrified to go outside, and others will love having the information.

Everyone will worry about privacy, health-hackers, and new forms of identity theft that will make today's fears seem quaint.

Yet this era is coming, and 2009 may well be the year people remember as the moment when we stepped onto a path never before traveled.

I for one can't wait to see what difference this will make.

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