WEBVTT - How Personalized Medicine Works 0:00:00.600 --> 0:00:02.759 All right, josh. So the first part of our winter 0:00:02.840 --> 0:00:07.400 tour is over a lot of fun. But we are 0:00:07.440 --> 0:00:11.520 going back out this weekend next to Atlanta. While we're 0:00:11.520 --> 0:00:14.120 not going anywhere, well, we're going down the road ten 0:00:14.160 --> 0:00:18.079 minutes from my house. Sure, Atlanta, Birmingham. We would still 0:00:18.079 --> 0:00:20.200 love to see you, and you can still get great seats. Yeah, 0:00:20.239 --> 0:00:22.440 and this is a brand new show. Unless you were 0:00:22.480 --> 0:00:25.680 in San Francisco, San Diego, Austin, or Dallas, you ain't 0:00:25.680 --> 0:00:28.880 seen the show. And it is bringing down the house 0:00:29.000 --> 0:00:32.320 all over the country eventually probably all over the world. Yes, 0:00:32.360 --> 0:00:34.239 and you can get tickets. You can just go to 0:00:34.360 --> 0:00:36.680 s y s K live dot com. It's our square 0:00:36.680 --> 0:00:39.320 space powered site and they were powering our tour and 0:00:39.320 --> 0:00:43.360 they were they're powering me on a daily basis. So 0:00:43.440 --> 0:00:47.920 we will see you guys very soon. Welcome to Stuff 0:00:47.920 --> 0:00:56.680 you should Know from House Stuff Works dot com. Hey, 0:00:56.720 --> 0:00:59.880 and welcome to the podcast. I'm Joshua m clark. There's 0:01:00.080 --> 0:01:07.000 Charles w Wayne, Chucker's Chuck Tran Bryant Chuck Trand I 0:01:07.040 --> 0:01:09.800 remember that and then that one never even made sense. No, 0:01:10.240 --> 0:01:13.440 who said that me? Yeah, I don't get it. It 0:01:13.480 --> 0:01:16.520 doesn't mean anything. That's why I never made sens. And 0:01:16.520 --> 0:01:22.880 then there's Jerry Chairs, Jerome Rolling, Jair Tran, and Josh Tran. Yeah, 0:01:23.080 --> 0:01:26.759 the trans I'm excited to record this and then leave 0:01:26.959 --> 0:01:30.440 because I just quickly on my phone saw that Billy 0:01:30.520 --> 0:01:33.080 Joel did Ado performance in the commercial break of IT 0:01:33.680 --> 0:01:36.880 talk show and the video was up. Oh yeah, so 0:01:36.920 --> 0:01:41.240 I got things to do. Okay, well, let's go personalized medicine. Chuck, huh, 0:01:41.560 --> 0:01:45.720 So let's take it back. Let's take away back. Okay, 0:01:45.800 --> 0:01:47.920 let's talk about medicine in general. Right, are we way 0:01:47.920 --> 0:01:50.040 back machining it or no? No, no, no, all right. 0:01:50.440 --> 0:01:57.160 So there's this idea that um two best understand how 0:01:57.200 --> 0:02:01.360 to treat a person, you should understand. Critique said, it's 0:02:01.400 --> 0:02:04.320 far more important to know what person the disease has 0:02:04.600 --> 0:02:07.639 than what disease the person has. Boy, that is smart 0:02:07.720 --> 0:02:10.119 for back then it is you know, and I think 0:02:10.160 --> 0:02:13.920 that this was the original idea behind medicine, that we 0:02:13.919 --> 0:02:16.760 we can understand a disease, but when you apply it 0:02:16.800 --> 0:02:19.000 to a person, it's going to be different than when 0:02:19.040 --> 0:02:23.120 you apply it to another person. And that is the 0:02:23.160 --> 0:02:28.840 heart of personalized medicine, is that understanding. Unfortunately, for many 0:02:29.160 --> 0:02:32.919 hundreds of years. Well actually for a shorter time than that. 0:02:33.520 --> 0:02:36.799 But in Western medicine, the idea has been that if 0:02:36.840 --> 0:02:40.000 it works for most people, it will probably work for you, 0:02:40.400 --> 0:02:43.200 or that's good enough for us. Yeah, it's called a 0:02:43.240 --> 0:02:46.959 trial and error approach, and that should scare you to death. 0:02:47.200 --> 0:02:52.519 Well I get it, because until we until the Human 0:02:52.560 --> 0:02:55.720 Genome Project, we didn't have a lot of choices as 0:02:55.760 --> 0:02:59.640 a society other than to do our best for the majority. 0:03:00.760 --> 0:03:04.119 You know. Well, yeah, like that changed everything. It did, 0:03:04.160 --> 0:03:06.240 but even before that, it was it was like, that 0:03:06.320 --> 0:03:08.880 was what two thousand, two thousand one, something like that, 0:03:08.919 --> 0:03:11.600 the Human Genome Project. Yeah, I mean before that, there 0:03:11.639 --> 0:03:14.160 were some precursors to personalized medicine, like let's look at 0:03:14.160 --> 0:03:17.480 family histories and stuff like that. Yeah, but even like 0:03:17.520 --> 0:03:20.680 it's that's not that old. It wasn't until World War 0:03:20.720 --> 0:03:25.120 Two that people started noticing huh. You know, different people 0:03:25.240 --> 0:03:28.840 have different reactions to different kinds of medicine. There's actually 0:03:28.880 --> 0:03:32.080 an anti malarial drug that was given to troops in 0:03:32.160 --> 0:03:35.760 World War two, American troops, and um, if you're an 0:03:35.760 --> 0:03:39.160 African American, there's a high likelihood that you might develop 0:03:39.200 --> 0:03:42.720 anemia after you were given this anti malarial drug. But 0:03:42.840 --> 0:03:46.200 that wasn't that didn't show among um. White troops and 0:03:46.320 --> 0:03:49.720 doctors thought, what's behind this? And they went and looked 0:03:49.720 --> 0:03:53.640 and saw that genetically speaking African Americans were less likely 0:03:53.920 --> 0:03:57.480 to have a gene active that produces a protective enzyme 0:03:57.800 --> 0:04:00.640 that keeps you from developing anemia when you're giving this 0:04:00.720 --> 0:04:03.760 particular anti malarial drug. And that in the middle of 0:04:03.760 --> 0:04:06.520 the twentieth century, it was the first time we really 0:04:06.600 --> 0:04:11.600 started in the Western medicine tradition thinking that no, people 0:04:11.680 --> 0:04:15.000 have different reactions to different types of treatments and can 0:04:15.080 --> 0:04:18.080 have different experiences with different types of disease. Did they 0:04:18.080 --> 0:04:21.160 do something about it in that case? I don't know. 0:04:21.760 --> 0:04:23.680 I was curious. It depends on the time period in 0:04:23.680 --> 0:04:27.080 this country. Shamefully, they might have said, like, yeah, but 0:04:27.120 --> 0:04:32.680 who cares. Yeah. At the same time, the Tuskegee Um, yeah, exactly, Yeah, 0:04:33.320 --> 0:04:36.520 the Tuskegee experiments were going on. We're also infecting people 0:04:36.560 --> 0:04:42.920 in Guatemala with syphilis. Crazy crazy stuff. Um. So you 0:04:42.960 --> 0:04:47.960 mentioned Hippocrates, um, more than two thousand years ago. He 0:04:48.000 --> 0:04:53.800 was pretty advanced for thinking that jerkxes needs bleeding, but 0:04:54.240 --> 0:04:58.599 uh uh Zeus does not. Zeus never needs a bleeding 0:04:58.600 --> 0:05:02.000 by that, But it was lightning bowl at the problem exactly. 0:05:02.880 --> 0:05:04.440 But he was way ahead of his time to be 0:05:04.480 --> 0:05:07.599 thinking that way back then. Um, some other pioneers since then, 0:05:08.160 --> 0:05:12.680 I think we talked about these two, Reuben Otenberg and 0:05:12.800 --> 0:05:17.359 Ludvik hick Thorne job. I don't know that was not 0:05:17.520 --> 0:05:22.760 good hicktoin uh in nineteen o seven, and I think 0:05:22.760 --> 0:05:24.880 in our blood episode we might have talked about this. 0:05:25.200 --> 0:05:27.120 That was such a good episode, it was a really 0:05:27.120 --> 0:05:29.200 good one. I think, Um, they were the first ones 0:05:29.279 --> 0:05:31.719 to say, you know what, people have different blood types 0:05:31.760 --> 0:05:34.520 as it works, so that's why people keep dying. Well, 0:05:34.560 --> 0:05:37.000 now we're putting this blood into someone that doesn't have 0:05:37.040 --> 0:05:39.479 the same blood. So that was land Steiner who came 0:05:39.520 --> 0:05:41.240 up with the idea that way. It wasn't blood types. 0:05:41.360 --> 0:05:45.840 These two were the ones who first started to match people, like, well, 0:05:45.920 --> 0:05:48.719 let's match these people. That's the that's yeah, that's a 0:05:48.760 --> 0:05:53.520 pretty good first example of personalizing medicine on the most 0:05:53.560 --> 0:05:58.800 basic level, like let's not kill people with blood right uh. 0:05:58.839 --> 0:06:01.480 And then like I said, um, family histories and such, 0:06:01.600 --> 0:06:04.080 they finally started saying, hey, you know what, maybe we'll 0:06:04.080 --> 0:06:06.680 look at your father and your mother and your grandparents, 0:06:07.520 --> 0:06:09.719 because if they have this disease, you might have it 0:06:09.720 --> 0:06:13.920 as well. But everything changed when the Human Genome Project 0:06:13.960 --> 0:06:17.400 came along, and UH, all of a sudden, we found 0:06:17.400 --> 0:06:20.440 out we could learn a lot more about our predisposition 0:06:20.839 --> 0:06:25.039 for certain diseases. Yeah, because if you think about it, 0:06:25.160 --> 0:06:29.880 um are reactions to different diseases, and also the same 0:06:29.880 --> 0:06:35.080 medicines that treat different diseases. UH, can be traced down 0:06:35.080 --> 0:06:38.279 to the to the genetic level, to the molecular level, 0:06:38.880 --> 0:06:41.320 to whether a gene is turned off and expressing a 0:06:41.320 --> 0:06:45.600 certain kind of protein or enzyme um or whether our 0:06:45.680 --> 0:06:49.200 genes are going to allow for a tumor that expresses 0:06:49.240 --> 0:06:51.960 a certain kind of protein that can be tracked. If 0:06:52.000 --> 0:06:56.479 you conceivably can look at a person's genome sequence, the 0:06:56.480 --> 0:07:00.719 whole thing, analyze it, and then look it what genes 0:07:00.760 --> 0:07:03.760 are turned on or off, what proteins are being expressed, 0:07:03.760 --> 0:07:06.480 that kind of thing, then you if you also know 0:07:06.839 --> 0:07:10.320 that a certain kind of drug attracts a certain kind 0:07:10.360 --> 0:07:13.600 of tumor that's associated with that type of genome or 0:07:13.640 --> 0:07:18.520 genetic sequence, then you can put patient and drug together 0:07:18.960 --> 0:07:22.760 under its ideal form. Dude, we should stop and just 0:07:22.840 --> 0:07:26.800 walk away. That's a mic drop statement. I don't think 0:07:26.800 --> 0:07:29.880 we need anything else. Okay, I'm gonna go watch Billy 0:07:29.960 --> 0:07:33.560 Jolson do up. All right. So, if you think you 0:07:33.600 --> 0:07:36.280 go to the doctor and you get personalized medicine, in 0:07:36.280 --> 0:07:38.080 a sense, you sort of are. But what we're talking 0:07:38.120 --> 0:07:40.880 about is what Josh has said, which is your own 0:07:40.920 --> 0:07:46.080 individual biology being the most overriding factor in how you 0:07:46.080 --> 0:07:50.280 were treated. Your biology, not just you know, you're a 0:07:50.360 --> 0:07:53.440 human being. Yeah, this works on human beings and horses. 0:07:54.200 --> 0:07:56.400 And your mom had cancer, your grandma had cancer, so 0:07:56.440 --> 0:07:59.720 you might have cancer. No, we're talking about looking inside 0:07:59.800 --> 0:08:02.320 of you to find out what your likelihood to get 0:08:02.320 --> 0:08:04.280 these things are, and like you said, matching you with 0:08:04.360 --> 0:08:07.440 the best treatment plan, right, one of those UM one 0:08:07.440 --> 0:08:09.800 of those courses of study. There's a lot of different 0:08:09.840 --> 0:08:13.520 things that really kind of fall under personalized medicine UM. 0:08:13.560 --> 0:08:17.400 But one of those sub fields is called pharmacogenetics, right. 0:08:18.200 --> 0:08:21.120 And that is again, if you can take a person's 0:08:21.200 --> 0:08:25.320 genome and then uh analyze it, you can say, well, 0:08:25.400 --> 0:08:28.160 I see the sequence right here would react very well 0:08:28.200 --> 0:08:32.160 to this particular drug. That's pharmacogenetics matching the drug to 0:08:32.240 --> 0:08:35.840 the person, right, yeah, which is the opposite of hey, 0:08:35.840 --> 0:08:37.560 it works for eight out of ten people, and if 0:08:37.600 --> 0:08:40.920 you're just one of those, the T S T S 0:08:41.120 --> 0:08:44.400 and that seriously, that is the basis of western medicine 0:08:44.440 --> 0:08:46.480 as it stands right now. It's it called it's a 0:08:46.520 --> 0:08:51.080 trial and error approach. And they don't usually stop at ts. No, 0:08:51.840 --> 0:08:54.880 they just say like, oh, you survived that round of drugs, 0:08:54.880 --> 0:08:58.400 but it didn't Let's try something else. Maybe maybe this 0:08:58.480 --> 0:09:01.520 other one that doesn't work for it tends to work 0:09:01.559 --> 0:09:04.560 for that might work for you. And then it just 0:09:04.600 --> 0:09:06.640 goes on and on and on until they finally hit 0:09:06.720 --> 0:09:10.479 upon that drug hopefully that that doesn't work. I say hopefully, 0:09:10.520 --> 0:09:13.760 because within that trial and error period a lot of 0:09:13.800 --> 0:09:18.120 people die. Sometimes that first time, that first trial results 0:09:18.120 --> 0:09:20.520 in a fatal error, and those are called a d 0:09:20.840 --> 0:09:25.760 S or adverse drug UM events. There's seven hundred and 0:09:25.800 --> 0:09:29.920 seventy thousand people in the US alone they either die 0:09:30.080 --> 0:09:33.480 or are injured by an a d E every year 0:09:33.840 --> 0:09:38.679 in the US alone, almost a million people, seven hundred 0:09:38.679 --> 0:09:41.040 and seventy thousand people every year. You give that person 0:09:41.080 --> 0:09:44.520 a drug and they might die. And the one of 0:09:44.520 --> 0:09:49.280 the goals of UM of pharmacogenetics is to avoid a 0:09:49.400 --> 0:09:52.000 d e s so that you can say, before you 0:09:52.040 --> 0:09:55.760 give anybody a drug, like this won't kill you, Yes, exactly, 0:09:56.280 --> 0:09:58.800 this won't kill you. We know that because we scanned 0:09:58.800 --> 0:10:03.400 your geno. We're not guessing here. We know you genetically 0:10:03.640 --> 0:10:06.160 will not die from this drunk. Yeah, I think we 0:10:06.200 --> 0:10:09.160 should caveat here when we say things like guessing and 0:10:09.200 --> 0:10:11.160 like I don't want to paint the medical industry is 0:10:11.840 --> 0:10:16.319 you know, just throwing darts with a blindfold. They've done 0:10:16.360 --> 0:10:18.160 They did the best job they could, I think, to 0:10:18.720 --> 0:10:23.040 treat massive amounts of people in the most efficient way possible. 0:10:23.760 --> 0:10:27.360 But things are getting better now because of the human 0:10:27.400 --> 0:10:30.360 biome or the human genome and what we've learned about it. 0:10:30.600 --> 0:10:32.680 Like when I look about the future of medicine, it 0:10:32.800 --> 0:10:37.000 is like it's super rosy. Yeah, I agree, you know, 0:10:37.080 --> 0:10:38.839 like a hundred years from now, it's it's gonna be 0:10:38.880 --> 0:10:42.040 amazing what we're gonna be doing, maybe like thirty Like 0:10:42.080 --> 0:10:45.560 we're right there on the cusp right now, where we 0:10:45.600 --> 0:10:48.360 went through a fairly dark age as far as medicine goes, 0:10:48.400 --> 0:10:51.120 where we were taking shots in the dark, figuring things 0:10:51.120 --> 0:10:53.720 out as we went along, and now we are right 0:10:53.760 --> 0:10:55.720 there at the age where we're about to just take 0:10:55.720 --> 0:10:59.160 off like a rocket and really understand health and wellness 0:10:59.440 --> 0:11:02.080 and treatment of disease. All right, well, I feel like 0:11:02.080 --> 0:11:04.360 we're on the cusp of the message break as well. 0:11:04.520 --> 0:11:28.760 I think you're right, So, Chuck, I was talking about 0:11:28.760 --> 0:11:34.000 pharmacod genetics, right, there's actually some examples of pharmacogenetics already 0:11:34.160 --> 0:11:37.360 taking place. This isn't necessarily in the future, like this 0:11:37.480 --> 0:11:43.640 is already starting. Yes, I think it started in the nineties, right, yeah, 0:11:43.720 --> 0:11:45.280 And and we'll get to this later. One of the 0:11:45.280 --> 0:11:48.880 big reasons that things are cooking now, cooking with gas, 0:11:49.000 --> 0:11:53.600 as my dad used to say, is because the massive 0:11:53.920 --> 0:12:00.320 drop in cost for mapping your genome. Yeah, like assive. 0:12:00.360 --> 0:12:04.760 In fact, i'll go ahead and tease you here and uh, 0:12:05.080 --> 0:12:07.160 the first time it was done to James Watson in 0:12:07.200 --> 0:12:10.520 two thousand seven, that was two seven, not even the 0:12:10.600 --> 0:12:13.360 human genome that was two thousand one. Two thousand seven 0:12:13.440 --> 0:12:16.560 was four. A time they mapped the person in full 0:12:17.120 --> 0:12:21.439 cost a million dollars. Now you can get it done 0:12:22.360 --> 0:12:24.600 a good A good one, not a full You know, 0:12:24.679 --> 0:12:28.320 you can't map out the entire genome for this amount 0:12:28.320 --> 0:12:33.240 of money. You can, you can you can sequence it. 0:12:33.480 --> 0:12:36.240 You can sequence it for that's the caveat less than 0:12:36.280 --> 0:12:41.400 two dollars, and pretty soon it's going to be about fifty. 0:12:41.559 --> 0:12:44.400 And then from what I saw in that, I think 0:12:44.400 --> 0:12:47.200 that was like a Business Insider article, there was a 0:12:47.240 --> 0:12:51.560 dude who gave this this really interesting lecture. Um. He 0:12:51.960 --> 0:12:58.400 very strongly asserted that they were pretty confident by thanks 0:12:58.400 --> 0:13:03.640 to economies of scale, Uh, genome sequencing will cost about 0:13:03.640 --> 0:13:07.320 a penny. Yeah, they won't. Won't cost a penny, Like 0:13:07.440 --> 0:13:09.880 you won't pay a penny. I guarantee you that. No, No, 0:13:10.080 --> 0:13:12.880 but it'll be but it might be like fifty bucks 0:13:13.760 --> 0:13:17.200 and someone will be makingfit. No. The I think what 0:13:17.240 --> 0:13:18.920 he was saying was if you take all of the 0:13:18.960 --> 0:13:22.200 genomes that are sequenced in a year, ultimately that's what 0:13:22.280 --> 0:13:24.360 it will have cost. It's about a penny each, right, 0:13:24.880 --> 0:13:28.400 But they it's gonna pop up in in different ways 0:13:28.400 --> 0:13:31.000 than what you have now. Like this is a pretty 0:13:31.000 --> 0:13:34.440 common thought that you will pee into your toilet, and 0:13:34.440 --> 0:13:37.480 your toilet will have a genome sequencer attached to it, 0:13:37.760 --> 0:13:40.560 and when you pee, your urine will be analyzed for 0:13:40.640 --> 0:13:43.520 any changes from that morning or the night before or 0:13:43.559 --> 0:13:47.199 anything like that, so that your baseline health is monitored 0:13:47.600 --> 0:13:51.080 on a like a several times a day basis. Right, 0:13:51.120 --> 0:13:53.000 if my toilet starts telling me to cut down on 0:13:53.040 --> 0:13:56.160 my drinking, then I'm gonna start peeing outside. I imagine 0:13:56.200 --> 0:13:58.079 that you can probably set it to kind of take 0:13:58.120 --> 0:14:00.400 it easy on this area, you know that kind of 0:14:00.440 --> 0:14:02.640 And when I say start being outside, I mean full time. 0:14:02.640 --> 0:14:06.200 I p outside almost every night, off of my deck. 0:14:07.320 --> 0:14:11.200 Sometimes you even stand up. Yeah, that's Raymond mcaulay, by 0:14:11.240 --> 0:14:15.280 the way, he's the bio technology and bio and for 0:14:15.559 --> 0:14:24.320 Maddox chair Singularity University, what's their mascot, the uh fighting 0:14:24.360 --> 0:14:27.960 curs wild. So he's a smart guy, and he's the 0:14:27.960 --> 0:14:30.600 one that is saying that this is just getting cheaper 0:14:30.600 --> 0:14:33.160 and cheaper. And when you look at the graph in 0:14:33.200 --> 0:14:35.960 two thousand seven, it took a nose dive in price, 0:14:36.280 --> 0:14:38.680 Yeah it did. He compared it to Moore's law, where 0:14:38.840 --> 0:14:41.840 um Moore's law is like the amount of computing power 0:14:41.960 --> 0:14:46.000 doubles every eighteen months or something like that, twenty four months. 0:14:46.040 --> 0:14:50.160 They can't remember, um. And it was pointed out that 0:14:50.280 --> 0:14:53.680 genome sequencing was actually moving in a rate of five 0:14:53.720 --> 0:14:57.320 to ten times the rate of Moore's law. That's awesome. 0:14:57.560 --> 0:15:00.600 That is awesome as far as genome sequencing concerned. The 0:15:00.600 --> 0:15:05.000 problem is computing powers still following Moore's law. And here's 0:15:05.040 --> 0:15:07.680 the big problem. This is why we're not all getting 0:15:07.680 --> 0:15:11.520 our genome sequenced right now. Because it might be very 0:15:11.600 --> 0:15:16.840 cheap to sequence human genome, it's still very expensive because 0:15:16.840 --> 0:15:21.440 it requires a lot of computing power to analyze that genome. Yeah, 0:15:21.440 --> 0:15:24.800 that's the main stumbling block is you can't sequence your genome, 0:15:25.160 --> 0:15:27.400 stick it in a machine and have it say you'll 0:15:27.440 --> 0:15:32.600 get cancer. Yet. That's the future, but not too far off. No, 0:15:32.680 --> 0:15:36.120 that's like Gattica. Yeah, but the I mean this guy 0:15:36.360 --> 0:15:39.080 Macaulay was saying, probably in about ten years they will 0:15:39.120 --> 0:15:41.080 have machines like that. Yeah, which is what we need. 0:15:41.120 --> 0:15:43.160 That's the main stumbling block right now is there's so 0:15:43.240 --> 0:15:46.480 much data that computers can't even keep up. So right 0:15:46.480 --> 0:15:50.800 now you could conceivably get a decent genome sequenced and 0:15:50.920 --> 0:15:56.000 analyzed for like fifteen grand, which is not I mean, 0:15:56.040 --> 0:15:58.440 that's not all the realm of it's not the reach 0:15:58.480 --> 0:16:03.400 of everybody. You have to be people that, Um, the 0:16:03.400 --> 0:16:08.480 the the big change will come when all of us 0:16:09.320 --> 0:16:14.080 get our genome sequence basically for free. And the holy 0:16:14.120 --> 0:16:16.440 grail in the not too distant future is to not 0:16:16.480 --> 0:16:21.600 only have a genome sequencer and analyzer in your toilet, 0:16:22.000 --> 0:16:24.760 but also you'll be wearing like a wearable or have 0:16:24.840 --> 0:16:28.680 an implanable something, yeah, but or maybe something that's under 0:16:28.720 --> 0:16:34.040 the skin that is like fitbit, but that's analyzing everything, um, 0:16:34.080 --> 0:16:37.400 including your hormone levels things like that. So you're not 0:16:37.440 --> 0:16:40.400 only analyzing your p you're also analyzing your body in 0:16:40.480 --> 0:16:42.680 a moment to moment basis. And all this stuff is 0:16:42.760 --> 0:16:46.400 run through an app you have on your phone that 0:16:46.720 --> 0:16:50.200 is tied in to your health records and other kinds 0:16:50.200 --> 0:16:55.200 of medical data um that you control and you share 0:16:55.240 --> 0:16:58.680 with your healthcare provider rather than the opposite. That's another 0:16:58.720 --> 0:17:01.120 big change coming that we talk sucked about in Will 0:17:01.160 --> 0:17:05.680 Computers Replace My Doctor episode, that that medical information about 0:17:05.680 --> 0:17:09.280 the person is going to be wrestled away from healthcare 0:17:09.720 --> 0:17:12.600 and healthcare providers and insurance companies and placed in the 0:17:12.600 --> 0:17:14.760 hands of the individual. And that's going to be a 0:17:14.840 --> 0:17:18.000 huge change that will probably come from this personalized medicine 0:17:18.040 --> 0:17:21.480 exactly one of the positive changes. All right. So there 0:17:21.480 --> 0:17:25.120 have been some early stories that have given us all 0:17:25.119 --> 0:17:27.760 hope for the future when it comes to looking at 0:17:27.760 --> 0:17:32.399 these biomarkers UM for potential of disease, and one of them, 0:17:32.760 --> 0:17:35.720 there was a drug called U k A l y 0:17:35.840 --> 0:17:39.479 d e c O kellidico kalitico I think so UH 0:17:39.520 --> 0:17:41.960 in two thousand twelve to treat a rare form of 0:17:42.000 --> 0:17:46.360 cystic fibrosis UM, which is a deadly lung condition. And 0:17:46.520 --> 0:17:49.000 the FDA here in the U S approved this drug 0:17:49.720 --> 0:17:53.679 UM basically because they found out certain people have genetic markers, 0:17:53.680 --> 0:17:57.320 these biomarkers that they wouldn't respond to other drugs treating 0:17:57.880 --> 0:18:00.639 UH cystic fibrosis. So they said, this is a new 0:18:00.720 --> 0:18:04.440 drug that will work for you. Success story boom, and 0:18:04.520 --> 0:18:07.600 this like this is the future of personalized medicine all 0:18:07.600 --> 0:18:10.879 over the place. Right. It covers about four percent of 0:18:10.880 --> 0:18:15.000 cystic fibrosis patients. So in the US, it's people that 0:18:15.080 --> 0:18:18.320 the drug was targeted for, right, because you would think 0:18:19.080 --> 0:18:20.800 I'm just cynical, but you would think that's so few 0:18:20.800 --> 0:18:23.080 people that somebody be like, a why bother, I'll bet 0:18:23.160 --> 0:18:25.840 it costs a bunch of money for the drug, But yes, 0:18:25.880 --> 0:18:28.720 you're right, UM. And then secondly, it also kind of 0:18:28.760 --> 0:18:33.200 shows how personalized medicine shifts our understanding of disease to right, 0:18:33.480 --> 0:18:36.480 the reason these people with cystic fibrosis didn't respond to 0:18:36.520 --> 0:18:40.679 regular medicine is because their cystic fibrosis was developed because 0:18:41.119 --> 0:18:45.359 their genes didn't that regulated salt and water movement across 0:18:45.359 --> 0:18:48.960 the surface of their lungs were mutated and not functioning properly. 0:18:49.280 --> 0:18:52.960 So this specific drug that targets these four percent of 0:18:53.000 --> 0:18:56.920 cystic fibrosis patients goes in and messages with that gene. Well, 0:18:56.960 --> 0:18:59.960 if you do the other ninetent of cystic fibrosis patient, 0:19:00.480 --> 0:19:04.359 their salt and water um movement is just fine. That's 0:19:04.359 --> 0:19:07.480 not why they have cystic fibrosis. So it changes your 0:19:07.560 --> 0:19:11.920 understanding of cystic fibrosis. It's not like you have cystic fibrosis. 0:19:12.200 --> 0:19:14.080 This is why you have it. This is how your 0:19:14.119 --> 0:19:17.760 body is showing that you have cystic fibrosis. You have 0:19:17.840 --> 0:19:20.440 cystic fibrosis, and you can have all these you can 0:19:20.480 --> 0:19:24.359 have it under these different mechanisms. That's what personalized medicine 0:19:24.440 --> 0:19:27.560 is changing too. It's changing our understanding of disease itself. 0:19:28.200 --> 0:19:32.720 Same with cancer, right, certain tumors express certain proteins and 0:19:32.840 --> 0:19:36.439 although yes, you have an out of control growth that 0:19:36.560 --> 0:19:39.000 makes a cancer. It really doesn't bear that much of 0:19:39.000 --> 0:19:42.639 a resemblance to this other kind of cancer. And the 0:19:42.720 --> 0:19:46.199 more we dig into how people respond differently to cancer 0:19:46.200 --> 0:19:49.000 treatments and how they can host different kinds of tumors 0:19:49.200 --> 0:19:51.720 is changing our understanding of cancer. And a lot of 0:19:51.760 --> 0:19:54.000 people are like, cancer is too big of an umbrella. 0:19:54.200 --> 0:19:57.560 These are really almost different diseases. Yeah, And I think 0:19:57.800 --> 0:20:01.720 the Macaulay guys said the hope one day is to 0:20:01.760 --> 0:20:04.840 stop cancer before it even starts at such a small 0:20:05.440 --> 0:20:10.040 molecular level with these advanced Uh. I guess like a 0:20:10.040 --> 0:20:12.760 blood test. Yeah, basically the blood test will be so 0:20:12.840 --> 0:20:16.080 advanced that let's say, you know you're going to develop 0:20:16.160 --> 0:20:19.440 cancer in five years, Like we can tell that already, 0:20:19.480 --> 0:20:22.920 So let's just stop it now before there's a yeah, 0:20:23.040 --> 0:20:26.960 or before it gets big enough that it's a problem. Yeah, exactly. Uh. 0:20:27.000 --> 0:20:29.760 If you have type one diabetes, I think it is 0:20:30.400 --> 0:20:35.320 um good news. There is a new system. It's a 0:20:35.600 --> 0:20:40.639 basically an artificial pancreas device and they are wearable and 0:20:41.000 --> 0:20:44.119 the clinical developed by u v A and Harvard Go 0:20:44.320 --> 0:20:53.160 Cavaliers and Crimson, the Crimson Smarties. That's Harvard. Right, they're 0:20:53.160 --> 0:20:55.600 not the Crimson Tide too, are they? No, not the Tide, 0:20:55.640 --> 0:20:59.960 They're just Crimson's the Crimson. I think you guys left 0:21:00.080 --> 0:21:02.720 part off their Harvard. Well, they do have a mascot, 0:21:02.760 --> 0:21:05.040 I think, like John Harvard, but it's not like it's 0:21:05.040 --> 0:21:07.760 just a square of Crimson. I don't know. I think 0:21:07.760 --> 0:21:10.280 so maybe they're above it. They don't need a Crimson 0:21:10.320 --> 0:21:16.280 Knights Crimson Knights. No, is that Rutgers. That's Scarlet Knights. Anyway, 0:21:16.400 --> 0:21:19.919 uv A and Harvard developed this thing together. Uh. And 0:21:20.000 --> 0:21:23.320 it starts clinical trials in like the next month or two. 0:21:24.160 --> 0:21:26.720 Uh and for six months, two forty people are gonna 0:21:26.760 --> 0:21:32.359 wear this thing, this artificial pancreas to tell your body, uh, 0:21:32.880 --> 0:21:36.560 exactly when you need the optimal level of insulin in 0:21:36.600 --> 0:21:39.960 your body at all times. Well, and introduces that optimal level. 0:21:40.520 --> 0:21:44.480 Oh does it? Uh? Huh? How so? So it's like 0:21:44.720 --> 0:21:47.959 it's monitoring your blood glucost level. Yeah. And you you know, 0:21:48.040 --> 0:21:50.880 if you have diabetes you have to inject insuline. Yeah, 0:21:51.040 --> 0:21:54.720 this stuff, say, is connected to report in your chest. Oh. 0:21:54.840 --> 0:21:56.840 I don't think this one particularly is this is just 0:21:56.880 --> 0:22:00.639 a wearable monitor. But I think eventually they're gonna have 0:22:00.680 --> 0:22:03.359 what you're talking about. I guess I'm just getting ahead 0:22:03.400 --> 0:22:09.040 of the ahead of myself. That's that's actually regulates, not 0:22:09.200 --> 0:22:11.879 monitors in the future, I think is what you're talking about, 0:22:12.000 --> 0:22:17.040 or injects like an optimal dose regulating your glucose so 0:22:17.080 --> 0:22:19.080 you don't have to do it. I think this is 0:22:19.119 --> 0:22:21.879 just a wearable monitor so you could just like press 0:22:21.960 --> 0:22:24.159 and say, okay, what kind of how much insulin do 0:22:24.200 --> 0:22:25.719 I need right now? And it tells you the exact 0:22:25.760 --> 0:22:29.280 like milligrams, so you still have to like a dope, 0:22:29.640 --> 0:22:33.520 go and inject it yourself, right, I think so. I 0:22:33.560 --> 0:22:35.400 don't see how it could be wearable on your arm 0:22:35.440 --> 0:22:40.600 and also be attached to your body like the insides 0:22:40.640 --> 0:22:44.359 of your body through like a an ivy. Yeah, I 0:22:44.359 --> 0:22:47.680 don't think that's what this is. All sounds like there's 0:22:47.680 --> 0:22:51.439 two different things, but it's still monitoring exactly what your 0:22:51.480 --> 0:22:54.680 blood glucoast level is. Absolutely and it's your blood loose 0:22:54.800 --> 0:22:59.760 coast level ergo, it's personalized medicine, that's right. If you 0:22:59.760 --> 0:23:04.399 have tendus like our buddy Aaron Cooper. Aaron Cooper, he 0:23:04.400 --> 0:23:06.000 probably didn't hear that. I'll heard it was a ringing. 0:23:06.040 --> 0:23:12.560 He just hurts. UM. They're working on customizable devices that 0:23:12.640 --> 0:23:15.440 adjust the audio signal that's unique to your own ear. 0:23:15.480 --> 0:23:18.040 In other words, hey just put this hearing aid in 0:23:18.080 --> 0:23:20.840 there that may or may not work for you, right 0:23:21.040 --> 0:23:23.720 from what I understand it actually so, UM, you know 0:23:23.840 --> 0:23:27.960 noise canceling headphones, Well, it kind of works like those. 0:23:28.359 --> 0:23:31.280 I guess it figures out what pitch you're hearing that 0:23:31.359 --> 0:23:33.359 tonight is that, and it just gets rid of it. 0:23:34.320 --> 0:23:36.840 I think that's neat. I do too, UM and then check. 0:23:36.880 --> 0:23:41.439 There's another early example of a good a big win. UM. 0:23:41.480 --> 0:23:46.960 There's something called herceptin, and the FDA said, yes, go 0:23:47.000 --> 0:23:51.760 ahead with this. UM. They figured out that this particular 0:23:51.880 --> 0:23:56.440 drug worked for a specific group of people UM whose 0:23:56.480 --> 0:24:00.200 tumors expressed a specific protein, and it was a breast 0:24:00.280 --> 0:24:06.040 cancer UM tumor targeting drug. But like again, it wasn't like, oh, 0:24:06.080 --> 0:24:10.080 you have breast cancer, here, try um her septin, it'll 0:24:10.119 --> 0:24:14.200 work for you. It's we we we believe that you 0:24:14.520 --> 0:24:17.800 have this kind of tumor because it's expressing this kind 0:24:17.800 --> 0:24:20.399 of protein. So her septin is going to treat this 0:24:21.040 --> 0:24:24.640