There is a new vocabulary that is evolving in healthcare relating to genomic testing and treatment. The latest phase that I have come across is preventive genomics and its corollary, preventive genomic clinic. Below is a description of a clinic by this name that has opened at the Brigham and Women's Hospital in Boston (see: Preventive Genomics Clinic):
The Genetics and Genomic Medicine Service at Brigham and Women’s Hospital...is pleased to announce [opening of] the Preventive Genomics Clinic. The Preventive Genomics Clinic...provides innovative screening and cutting edge genomic information for healthy adults in order to predict and potentially prevent the onset of disease. We go beyond the typical diagnostic application of genetic testing. Our geneticists and genetic counselors will review your personal and family medical histories in order to provide genetics education and counseling specific to your needs. They will help you make an individualized decision on which genes should be examined and discuss the limitations and potential benefits of broader genetic tests, such as whole genome sequencing....For some patients, the results will offer the ability to make proactive healthcare decisions that may improve your future health and provide important information for your family.
I would personally take issue with the use of the word "preventive" in connection with this clinic at Brigham and Women's. I believe that measures can be taken to treat the sequelae of genetic disease such as in the case of cystic fibrosis (see: FDA approves new breakthrough therapy for cystic fibrosis). However, the word preventive conjures up in my mind the idea of gene engineering using techniques like CRISPR (see: HUMAN GENETIC MODIFICATION). I am sure that this new clinic is not offering services like this at the present time.
One of the first questions in my mind regarding this new clinic is how its activities differ from the genetic counseling clinics that may been available in health centers for decades. Here is a definition of genetic counseling from the Wikipedia (see: Genetic counseling):
Genetic counseling is the process of advising individuals and families affected by or at risk of genetic disorders to help them understand and adapt to the medical, psychological and familial implications of genetic contributions to disease. The process integrates:
* Interpretation of family and medical histories to assess the chance of disease occurrence or recurrence
* Education about inheritance, testing, management, prevention, resources
* Counseling to promote informed choices and adaptation to the risk or condition.
I am left with the idea that this new clinic differs from the genetic counseling clinics of both the past and present by offering a much more sophisticated set of genomic testing. It will then provide services, as the field expands, to provide "genomic prevention" by gene manipulation. However, that day has not yet come. So, in a sense, the use of the word "preventive" in the name reflects a mission for the future.
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