Cancer Patients Should be offered gene testing to find best treatment
Patients with cancer should be routinely offered DNA tests to help select the best treatments for them, according to England's chief medical officer.
Professor Dame Sally Davies says in her annual report that the NHS must deliver her "genomic dream" within five years. Over 31,000 NHS patients, including some with cancer, have already had their entire genetic code sequenced. Dame Sally wants whole genome sequencing (WGS) to become as standard as blood tests and biopsies.
Humans have about 20,000 genes - bits of DNA code or instructions that control how our bodies work. Tiny errors in this code can lead to cancer and other diseases. Sometimes these mistakes are inherited from a parent, but most of the time they happen in previously healthy cells.
WGS - which costs around £700 - can reveal these errors by comparing tumour and normal DNA samples from the patient. Dame Sally says that in around two-thirds of cases, this information can then improve their diagnosis and care. Doctors can then tailor treatments to the individual, picking the drugs that are most likely to be effective. WGS can also show which patients are unlikely to benefit, so they can avoid having unnecessary drugs and unpleasant side-effects.
Dame Sally wants DNA testing to become standard across cancer care, as well as some other areas of medicine, including rare diseases and infections. "I want the NHS across the whole breadth to be offering genomic medicine - diagnosis of our genes - to patients where they can possibly benefit," she stated in her report. This technology could also help speed up the diagnosis and treatment of patients suffering from rare diseases. Doctors are already using genetic tests to identify and better treat different strains of the infectious disease tuberculosis. Dame Sally gave assurances that patients genetic data would be stored securely and 'de-identified' so their privacy would be protected.
Over 10 years ago, international scientists reached a breakthrough in DNA work - sequencing the entire genetic blueprint of man. The Human Genome Project meant experts now had a catalogue of DNA code to explore and refer to. They began to understand which genes controlled which processes in the body and how these could go wrong. Doctors then started to 'read' a patient's DNA to get a better idea of what might be causing their symptoms and how best to treat their illness.
Genomic medicine - tailoring care based on an individual's unique genetic code - is now transforming the way people are cared for by the NHS. For example, genes can predict if a woman with breast cancer might respond to certain drugs, or whether radiotherapy is likely to shrink a tumour. Currently genetic testing of NHS patients in England is carried out at 25 regional laboratories, as well as some other small centres. Dame Sally wants to centralise the service and set up a national network to ensure equal access to the testing across the country. A new National Genomics Board would be set up, chaired by a minister, to oversee the expansion and development of genomic services. Dame Sally told BBC Breakfast that having centralised laboratories would be much more cost effective which would mean that more money could be used to keep up with the latest technology.
This article was originally featured on the BBC news website on 04/07/2017.