There was talk of taxes and economics, a call for more federal spending on child care and equal wages for women. But tucked away in President Obama’s State of the Union address Tuesday were a few sentences that left medical researchers sitting at the edge of their seats.
“I want the country that eliminated polio and mapped the human genome to lead a new era of medicine, one that delivers the right treatment at the right time,” Obama said. “So tonight, I’m launching a new Precision Medicine Initiative to bring us closer to curing diseases like cancer and diabetes, and to give all of us access to the personalized information we need to keep ourselves and our families healthier. We can do this.”
Long the story of painstaking work inside research labs and analysis in medical journals, precision medicine is the growing approach in health care that combines the advances of genomics and digital data to design targeted treatments for cancer and other diseases. In practice, it would offer a more effective, individualized treatment instead of the “one size fits” approach.
By mentioning it, Obama launched a wave of hope and speculation among researchers who call precision medicine a revolutionary way of caring for cancer patients. Despite the promising work, however, researchers have had to compete for funding to push their discoveries into reality.
Obama’s statement also raised another question: Who will benefit from it? Some physicians say Americans who have purchased health care plans under the Affordable Care Act, known as Obamacare, are finding that their provider networks are so narrow, they may never get to access cancer research centers where precision medicine is already in use.
Obama offered no details about funding the initiative, but a White House spokeswoman said details would be released in a few weeks. What is known is that Obama is calling for a major increase in research and development investments, including precision medicine, combatting antibiotic resistance and mapping the activity of every neuron in the human brain.
That’s good news for researchers who have seen federal dollars for some cancers dry up, said Dr. Chirag G. Patil, neurosurgeon at the Brain Tumor Center and director of the Center for Neurosurgical Outcomes Research in the Department of Neurosurgery at Cedars-Sinai Medical Center.
His specialty includes conducting studies on novel brain tumor therapies.
“Things like cancer and heart disease that are common and that are extremely serious should get the attention they deserve,” Patil said. “This could close the gap. I have no doubt that the future of medicine will be precision medicine.”
Obama cited the success of precision medicine as an example of how those with cystic fibrosis are living longer. Bill Elder is a 27-year-old medical student from Ohio who was invited to the State of the Union address by first lady Michelle Obama and was diagnosed with the disease when he was 8. He is an example of the benefits of precision medicine, according to the president.
Patil said such drugs will one day treat the most difficult cancer cases.
“The funding from a government standing has been stalled,” Patil said. “I hope that President Obama will back up his recommendation with concrete funding and share this vision that this type of precision medicine is the future.”
Despite challenges, research into targeted therapy moves forward, said Dr. Steven Rosen, an oncologist, provost and chief scientific officer atCity of Hope in Duarte, but he is concerned about access to those therapies.
“The complicated issue is that the ACA has done many wonderful things, but one of the things it hasn’t done is making the latest technologies available to patients,” due to narrow provider networks, he said. Some health insurance plans, for example, no longer include access to City of Hope. Rosen called that lack of access to care a shame, since there are so many more treatment options available.
“With certain diseases, we’ve made enormous strides already,” Rosen said. “From an oncologist’s perspective, there’s been an enormous evolution over the decade or two. The hope is that in the future, for almost all cancer patients, we may be more precise in treatments.”
For those whose focus is to raise awareness and funding for research for therapies for a specific cancer, Obama’s words raised hope.
“Obviously my ears perked right up,” said Kim Norris, who founded theLung Cancer Foundation of America.
The foundation’s goal is to raise funds that lead to lung cancer research and treatment, which has traditionally been underfunded and underresearched.
More people die from lung cancer than any other type of cancer, according to the federal Centers for Disease Control and Prevention. Lung cancer deaths account for more than breast, prostate and colon cancer deaths combined.
“In the past, when you had lung cancer, you were given a general chemo regime; some people did well, most did not, and it was like that for 30 years,” Norris said. “Then in the early 2000’s, we started discovering that every tumor is unique. It just opened a whole new world for cancer in general and very specifically lung cancer.”
Like Patil and Rosen, Norris agreed that too many researchers have been left to scrounge for funding. If funded, precision medicine would be a turning point in health care.
“We’re very excited to move forward in this world of developing new treatments and we’re smack in the middle of it,” Norris said.
By Susan Abram, Los Angeles Daily News