Genomics and Medical Tourism - Use In The Clinical Setting

What is Genomics?

Genomics, a recent contribution to the medical field and how we view clinical care, is the study of the mapping, structure, function, and editing of genomes. Genomes are the complete set of genetic DNA and information that makes up an individual – a bunch of proteins that are uniquely individualized for each person on a molecular level, grouped into genes.

With a field that helps to understand the genetic material and how it works together to produce proteins, genomics has paved the way to understand better and advance the fields of pharmacology, oncology, and infectious disease. Additionally, it is also useful in aiding in the diagnosis and management of rare illnesses.

The Use of Genomics in the Medical Setting

But what is the use of genomics in the medical setting? Genomics is split into two broad categories – translational genomics and clinical genomics. Clinical genomics is involved in the way drugs and drug manufacturing can be better tailored to the human body by using the study of genomics, whereas translational genomics deals with genetic mutations that make specific diseases.

Clinical genomics has helped us to individualize patient treatment. Patients can receive the proven best treatment which is specific to their unique genetic code via genomics and the decoding of their genetic material, giving us a step into precision medicine. We are more frequently seeing the benefit of precision medicine in the fact that, oftentimes, generalized treatment for a disease can produce vastly different effects and results in different people.

Pharmacologists have always posed the question as to why this is the case. Why is it that some patients on narrow therapeutic range drugs like phenytoin display more side effects or toxicity than others? Why is it that some selective serotonin reuptake inhibitors work better in some people than in others? Up until recently, the answer as to what is best for which patient has always been the “trial and error” concept. Patients are trialed on medication; if it is not effective, they’re moved onto the next “wonder drug.”

In fact, the answer to all these questions has all come down to genomics – the slight molecular individual variances make a notable difference in the management and treatment and efficacy of treatment in individuals. Therefore, precision medicine is in fact, more cost-effective, since it eliminates the cost of potential side effects and adverse events, therapeutic failure and long-term complications of the disease.

Clinical Genomics and Genetic Testing

As clinical genomics and genetic testing in the context of pharmaceuticals become more readily available, it is predicted that there will be a boom in medical tourism. Medical tourism is the concept where people undergo or seek medical care from a country other than their own out of the assumption that it will be of a higher quality or more affordable. Therefore, states that make genomics a standard of therapeutic care available, there is sure to be an influx of patients trying to access these services.

With cancer being the leading cause of death and still no breakthrough in a generic cure, pharmacology and medicine have been called into question about how this global endemic can be stopped. The answer is simple: genomics. To understand why it is imperative to understand what cancer really is. Over the course of life, cells, which contain genetic material, divide and die as part of normal cell growth. When there is damage to the cell, every time it splits, there is the risk of minor genetic mutations. Over multiple divisions, these mutations multiple, until the cell is no longer able to regulate its own growth. At this point, cells rapidly replicate, without regulation.

From this; it is easy to understand that cancer is, in fact, a genetic problem, at which point the solution obviously becomes a genetic one. Genomics can compare cancerous genetic material to that of normal cells and understand where the mutations arose and thereby, decide on the most effective treatment of each patients’ mutations. Examples of precision medicine already in use in cancer treatment are the use of anti-EGFR antibodies in certain colon cancers which present the KRAS surface protein.

It is clear that, from a clinical perspective, genomics is the best way forwards in terms of individualizing our patient care to produce the best health results at the most cost-effective rate.

Human Genome Project (HGP)

A very ambitious International research project was a milestone in biology led by Francis Collins launched in 1990. HGP aimed to map out entire human genome, to map all genes in the human body and to discover all 3 billion base sequences.

Genomic Medicine Destinations

Having in mind that more than half of the global population above 65 years of age resides in the Asia-pacific region, it’s no wonder why to precision medicine market focuses this part of the world. The amount of money governments of India and China spend for the precision medicine research, makes those destinations as fastest growers on the market of precision medicine providers globally. As the Eastern economies show a steady growth in the last couple of decades, Europe and North America are not exclusive consumers of the expensive (but cost- effective!) treatments of all sorts (medical included).

Hong Kong

Medical biotechnology sector in Hong Kong has developed so much; it can accommodate the needs of millions of patients annually using cutting edge technology. At the moment, Hong Kong is among the most significant providers of precision medicine services in the world (if not the biggest).

Thailand

Another region in the Asia Pacific region that recognized the potential of precision medicine and puts tremendous effort to become the leader in this part of the world. Thailand holds the largest share of Asian medical tourism market (followed by India and Singapore). This is why the 12th Asia Pacific Conference on Human Genetics was held there in November 2017.

Malaysia

Another Asian country that makes excellent results in medical tourism and presents cutting-edge innovations in precision medicine. In 2016, the Sunway University hosted International Conference on Precision Medicine. World’s highest echelons in biomedical science gathered there to discuss implications of precision medicine.

India

India is a serious player at the Asian medical tourism market. Having more than 15 prestigious medical centers for precision medicine throughout the country, it tries hard to catch up with other competitors on the market. Being the biggest medical tourism market in the East, India wants to secure that reputation by investing in the precision medicine packages as well.