During the last decade, findings of the way genome and chromosomal rearrangements function were made. Those led to new conclusions regarding many severe diseases people are suffering globally while also contributed to the approaches toward treating them. In the framework of this essay, the role genetics information plays in treating cancer will be assessed. Besides, we will discuss laboratory testing, existing Food and Drug Administration’s (FDA) regulations, the role of grants in the scientific advances, and the involvement of families into decisions regarding health care.
Description of the Disease
First of all, it is essential to describe the disease, its prevalence, and incidence. Cancer is the word that describes the malevolent forms of neoplasia, the process of uncontrolled cellular proliferation that leads to a tumor (Nussbaum et al., 2016). It comes from an imbalance between the cellular proliferation and attrition processes, but to become a cancer, a neoplasm should be malignant (Nussbaum et al., 2016). That, in turn, means the capability to invade neighboring tissues and metastasize (Nussbaum et al., 2016). As for the genetic basis of cancer, it was discovered that most mutations were passenger, meaning they did not directly caused progress in the development of cancer, yet some of them were found to be driver gene mutations (Nussbaum et al., 2016). Driver genes are those that frequently mutated in many samples of different types of cancer and proved to be involved in disease progression (Nussbaum et al., 2016). Besides, chromosome mutations can also be driver mutations, as well as chromosome rearrangements, also known as chromosome shattering (Nussbaum et al., 2016). Another process that also causes the disease to develop is called gene amplification and refers to the situation of the emergence of multiple copies of the same gene (Nussbaum et al., 2016). As for the higher incidence of cancer in families, it is often due to the inheritance of one mutant gene, but it is also known that many other genetic disorders cause one’s predisposition to cancer (Nussbaum et al., 2016). Thus, it is apparent that there are different scenarios of genetics’ influence on cancer development, which vary even greater depending on the specific types of cancer discussed.
Laboratory Testing
Laboratory testing of cancer takes multiple forms based on the type of cancer suspected and the purpose of testing itself. Tests may be taken to determine the stage of the disease development, formulate treating strategy, screen high-risk groups, or evaluate the efficiency of treatment (“Cancer Treatment Centers of America,” n.d.). It can take the form of Cellsearch Circulating Tumor cell test (CTC) for metastatic breast, colorectal, or prostate cancers or Complete Blood Count test (CBC) for leukemia or monitoring blood counts throughout treatment (“Cancer Treatment Centers of America,” n.d.). Another testing system is called Flow Cytometry and is used to diagnose leukemia and lymphoma – it measures cells’ properties in bone marrow, blood, or lymph nodes (“Cancer Treatment Centers of America,” n.d.). In order to determine the chance of recurrence of breast cancer, oncologists use the Mammaprint test, while the Blueprint test is used to determine which mutation influences cancer’s behavior (“Cancer Treatment Centers of America,” n.d.). Oncotype DX test is the one used to investigate the likeness of chemotherapy’s efficiency for patients with breast cancer (“Cancer Treatment Centers of America,” n.d.). Tumor marker tests are also widely utilized. CA-125 test evaluates how much of the cancer antigen 125 is present in the blood and is used for different types of cancer (“Cancer Treatment Centers of America,” n.d.). In contrast, the Prostate-Specific Antigen test (PSA) is applied only during prostate examination (“Cancer Treatment Centers of America,” n.d.). Thus, there are numerous testing options, depending on the type of cancer and the purpose for which the results will be used.
Guidelines and Reasons behind FDA Regulations
FDA regulations and guidelines on cancer-related issues are updated regularly. Besides, it hosts public meetings, allows comments on the current draft guidelines, and promotes patient engagement through its committees (“Food and Drug Administration,” n.d.). With the help of the Oncology Center of Excellence (OCE) established in 2017, experts across the FDA are united with the purpose of increasing efficiency in reviewing drugs and devices (“Food and Drug Administration,” n.d.). FDA product centers work with OCE in order to implement clinical reviews and deliver safe oncology products (“Food and Drug Administration,” n.d.). These product centers then decide whether to approve the products based on the clinical review and non-clinical characteristics or not (“Food and Drug Administration,” n.d.). They are responsible for vaccines, gene therapy, radiology, all types of oncology, and hematologic malignancies (“Food and Drug Administration,” n.d.). Therefore, the decisions made by the FDA are based on the clinical tests and information discovered after the thorough examination by its units.
The Role of Money and Grants in Scientific Advances
Scientific advances come hand in hand with grants and monetary stimulus, but this issue is much more multi-faceted. One of the problems coming up is that clinical research makes clinicians pick sides – dedicate their time to treating patients or focus on studies that could potentially introduce advances and benefit both sides (Rosenbaum, 2017). Another source of the problem is that the government spending on R&D, contrary to the widespread belief, has been decreasing, making researchers ask private agents for investment (Jahnke, 2015). That, in turn, led to another revelation – the industry is only interested in applied research that would bring commercial benefits shortly, thus, for many researchers, funding opportunities shrink tremendously (Jahnke, 2015). As the debate goes, fewer healthcare professionals believe the situation will improve, and, most importantly, these cuts will have a negative long-term impact on the field (Jahnke, 2015). Consequently, these policies, if not cut back, will most likely slash the new generations of researchers in the country and the relevant findings.
The Role and Involvement of Family in the Health Care Decision
The involvement of families into health care processes is a trend picked up by hospitals worldwide. Patient- and family-centered care (PFCC) proved to positively change the results of treatment and decrease costs (Clay & Parsh, 2016). This approach enhances the importance of family in health care experiences lived by the patients and the fact that those should be contextualized in terms of broader life aspects (Clay & Parsh, 2016). PFCC signals the tendency of medical care to become more collaborative, investigating ways of ensuring patients’ health and well-being not to exclude one another (Clay & Parsh, 2016). It also promotes health literacy, increasing understanding, contrary to the leaving patients and their families confused and having to look for information in possibly unverified sources (Clay & Parsh, 2016). Families undoubtedly are moral participants in the process of decision-making and should be treated as such; that is why the introduction of PFCC is a long-awaited and essentially important measure.
References
Cancer Treatment Centers of America. (n.d.). Web.
Clay, M., & Parsh, B. (2016). Patient- and family-centered care: It’s not just for pediatrics anymore. Web.
Food and Drug Administration. (n.d.). Web.
Jahnke, A. (2015). Who picks up the tab for science?Web.
Nussbaum, R. L., McInnes, R. R., & Huntington, F. W. (2016). Thompson & Thompson genetics in medicine (8th ed.). Philadelphia, PA: Elsevier.
Rosenbaum, P. (2017). The yin and yang of clinical research. Developmental medicine & child neurology. Web.