Mark Henderson, Wellcome Trust
Now itís time to take a look forward to the upcoming Genetics Society Spring Meeting, which is focusing on genomics for health and society. Scientists from around the world will be looking at the potential benefits of the genetics revolution, but also exploring what this explosion of information and technology might mean for our society. To get a taste of what we might expect, I spoke to one of the speakers at the meeting, Mark Henderson. Heís Head of Communications at the Wellcome Trust and author of the books The Geek Manifesto and 50 Genetics Ideas You Really Need to Know.
Mark - I think we're at a really interesting point. It's now 10 years since the publication of the final version of the human genome sequence. In the 10 years since then, we have in certain areas of medicine particularly, really progressed our understanding to the point that genetics and genomics is no longer just about research. Itís actually about treating patients.
I think there are three particular areas where thatís already having a real impact. One of them is rare disease thatís children born with syndromes often causing mental retardation, that kind of thing, but really difficult to diagnose. What is increasingly happening is that itís becoming possible to diagnose at least some of those children using genome sequencing. The second area is infectious disease. Thatís actually sequencing bugs rather than people. Using that, itís now possible to for example track down the precise origin of now break of MRSA Ė the hospital superbug in a hospital. And the third area is cancer where cancer is a disease of the genes. Itís a disease that happens when genetic mutations accumulate and as a result of that, itís been possible to develop some targeted medicines that actually attack the specific mutations that go wrong in cancer.
Where we are I think is with those areas and a couple more where weíre now at a point where genomics is not a technology of the future. Itís a medical technology of now. The big question is how we exploit that technology properly on the NHS and also, how we answer some of the deeper questions for society that genomics raises.
Kat - Because it does seem to me that the technology and the science has raced on far faster really than we can cope with it. Who do you think are the most important people to get across the stage of progress where we are and understanding these ideas and talking about them because this is happening now?
Mark - So, I think there are at least three key audiences that really need to understand this better. The first one is policy makers Ė people within government who will be taking decisions over the coming 2, 3, 4 years about how we fit up the NHS in particular to take proper advantage of these technologies. At the moment, I think understanding is improving and there's certainly a great deal of enthusiasm. But itís important that that enthusiasm is matched by realism as to what genomic medicine can but also can't deliver and that we donít end up with expectations raised too high, only for them to be dashed. Thatís the first audience.
The second audience is actually the medical profession where beyond certain specialist kinds of doctors who have always been very well-versed in genetics - the clinical geneticists, the oncologists - I think something that will happen increasingly is that genomics becomes embedded in the practice of medicine throughout the clinical care pathway. And even those going those going through medical school right at the moment are not really taught in a systematic way about how complex genomics might influence things such as drug prescribing, some of the options that might be available for cancer patients, rare disease, infectious disease.
Kat - And I guess the final group is the public.
Mark - Thatís right and I think itís very important here that we try to achieve the communication of genomics in a more realistic way. The way in which genomics and genetics are often covered seems to suggest that they're deterministic sciences - we read a lot about genes for being fat, genes for being tall, genes for getting cancer. Itís actually very rare that genes work in a deterministic way like that. There are one or two conditions - Huntingtonís disease would be the prime famous example - where there is a one to one relationship between inheriting a certain mutation and getting a certain disease. But actually, thatís not how genetic risk works more normally. More normally, thereíll be 10s, 100s, even thousands of genes working in concert with the personís environment to raise or lower their risk of often a large number of different disease.
And I think that as soon as you start to think of genetics like that, it actually starts to become a little bit less scary that your genetic code is a very important factor in your health and well-being, but itís only one factor. It certainly doesnít mean that your diet is unimportant, how much exercise you take is unimportant. Other lifestyle and environmental factors work together with the genome to form outcomes, not in isolation from them. And your genome very rarely determines either who you are or what diseases you have.
Kat - That was Mark Henderson. The Genetics Society spring meeting will be held at the Royal Society in London on Friday 19th April. For more information, go to genetics.org.uk