Medical futurists see a health revolution on the horizon — and City of Hope researchers were recently cited in a prominent article about it.
In the coming years, physicians will use detailed characteristics about each patient to determine the cancers they are likely to develop, and then work as partners with patients to prevent these diseases and promote wellness. The concept is called predictive, personalized, preventive and participatory, or P4, medicine, according to cancer systems biologists Leroy Hood, M.D., Ph.D., and Stephen H. Friend, M.D., Ph.D.
Writing in the March issue of Nature Reviews Clinical Oncology, part of the prestigious Nature family of journals, the two Seattle-area scientists explained that medicine is becoming an information science: Countless variations in genes, epigenetic changes, RNA alterations and other characteristics come together in one system to make up each individual’s unique body — both its strengths and its vulnerabilities to disease. Emerging technologies are allowing scientists to gather and analyze this information digitally.
|The Army of Women recruits its legions of participants online.|
At the same time, researchers are drawing on social networking and the Web to make their clinical studies bigger, broader and more inclusive than ever before. These large, patient-driven studies will provide a rich resource to understand the many factors that drive disease.
City of Hope researchers are leading one such research project.
The article cited innovative work under way involving City of Hope, the National Cancer Institute’s cancer Biomedicine Informatics Grid (caBIG) and the Love/Avon Army of Women, an effort launched in 2008 to recruit diverse women from across the country to sign up for research investigating the causes and prevention of breast cancer.
In 2009, the partners drew from the Army of Women to open the Health of Women Study, the first study to use the power of the Web to recruit participants. It aims to recruit the more than 350,000 women who have signed up for the Army of Women so far.
Women who enroll in the study fill out an ongoing series of Internet-based surveys covering questions about lifestyle, family history and other factors. With the bioinformatics support of caBIG, City of Hope researchers will look for relationships between these factors and important questions about breast cancer and other diseases. Within the next two years, they plan to be able to collect patient samples and even enable patients to upload their own medical records safely on the Web.
Leslie Bernstein, Ph.D., professor and director of City of Hope’s Division of Cancer Etiology, leads the study in collaboration with Katherine Henderson, Ph.D., assistant research professor, and Susan Love, M.D., of the Dr. Susan Love Research Foundation, who established the Army of Women.
Bernstein said information technology and the Web will likely become valuable tools for epidemiologists. “Recruiting and communicating with participants on the Internet enables us to gather data fairly quickly, and participants may find it easier to provide information from their desktops rather than filling out and mailing paper questionnaires back to us.
“This sort of study also enables us to draw on the interest of participants who are highly invested in answering important questions in women’s health, and it helps us stay in touch with them more effectively, as well.”
Bernstein believes that future studies will increasingly seek information about participants’ lifestyle and family history together with genetic, molecular and other biologic information to better identify who is at risk for disease. The countless pieces of data will require complex analysis, but the result will translate to better public health.
“In the end,” Bernstein said, “our ultimate aim is to turn our findings into interventions that directly reduce disease risk and prevent cancer altogether.”