Salzman H. Your Genes, Your Health, and Personalized Medicine. Fam Med 2013;46(1):59.
Your Genes, Your Health, and Personalized Medicine
R.C. Michaelis, K.M. Sweet
Nottingham, England, Nottingham University Press, 2012, 157 pp., $39.95, paperback
With the completion of the Human Genome Project, the ever-dropping cost of gene sequencing, and the advent of direct-to-consumer marketing of gene analysis through the Internet, interest in how this might affect an individual’s health is skyrocketing. Your Genes, Your Health, and Personalized Medicine provides an introduction to understanding genes and how they influence health and describes how in the future, genes will be used to determine level of risk for many diseases, as well as to tailor medical treatment to the individual based on genetic profile.
Your Genes begins by reviewing genes and how they work at a cellular basis and then covers principles of inheritance as well as penetrance. It goes on to discuss how family history can be used to provide initial information on risk for specific diseases and looks to the future as to how genetic testing can augment these predictions. Your Genes details the limits of genetic testing, as well as the potential psychological and emotional impact on both the patient and the patient’s family, stressing the importance of a genetic counselor in helping patients to make sense of the results. Finally, it covers how diet, lifestyle, and environmental factors (nutrigenomics and epigenetics) influence genes themselves as well as their function. It concludes with a list of electronic web-based resources for those seeking greater detail, as well as updated information as it becomes available.
Your Genes is aimed at a non-medical audience (the patient) and does an excellent job of maintaining accuracy while simplifying these complex processes through the use of metaphors and illustrations so that they might be comprehended by the average patient. It provides a candid discussion of the limits of genetic science and highlights the importance of interpreting the results in light of family history as not all mutations lead to disease. It also stresses the emotional and psychological consequences of testing on not just the patient but on other family members as well who may not wish to know results. An entire well-written chapter is dedicated to making the decision whether or not to have genetic testing done. Finally, it underscores the importance of nutrition, lifestyle, and environmental factors on our gene function, not allowing the patient to abrogate responsibility for their own health by chalking it up to unavoidable genetic history and perhaps motivating them to make the appropriate changes.
This book is an excellent resource for those interested patients who always seek cutting-edge care. It will help them to understand what is and is not possible, as well as the risks of pursuing gene sequencing. Your Genes will also be a valuable review for the practicing physician faced with such patients, particularly those physicians whose Human Genetics course is far behind them. The electronic resources provided will prove invaluable for both physician and patient as genetic science progresses and becomes an integral part of daily medical care.
Holly Salzman, MD
San Diego, CA
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