Expert: Marc Rubin, RPh Asthma Educator - 3/25/2010

Question
I am a student in highschool, and I am curious to know from an expert, which field of medicine would lead to the best cure: genetics, biochemistry, pharmaceutics, etc. Please give me a sincere answer, because I, as an asthmatic, am sincerely devoted to finding that cure.

Answer
Hi Drake,

The view of medicine towards disease has evolved from seeking "cures" to seeking "control" allowing as normal a quality of life, as well as expected lifespan. While cures are sought, as in infectious disease, that doesn't work out quite the same as when we have grown to realize that diseases we label as asthma and cancer, for example, are actually disorders with many variations, so there would never be a single magic bullet. That being said, the most promising avenue to achieve control is through a thorough understanding of genetics.

Already, we have discovered in asthma that there are genetic variations that affect the response to different medications. This is seen in the response (or lack thereof) to using albuterol as a rescue medication. One gene variant results in the patient having no response to the treatment. We have also seen some patients respond better to one inhaled steroid over another. There has also been breakthroughs in the treatment of high  blood pressure, where the genetic variant responds well to a specific medication.

Unfortunately, at the present time it costs over $1000.00 to do a genetic map of an individual. When that testing cost drops down considerably, then the future of drug treatment will be guided by our genetics, and not trial and error.

In the area of cancer, we look at the control factor there also. It is generally impossible to remove or kill all the deviant cells, but with proper therapy, we can stop the cells from replicating (birth control for cancer) which then keeps it under control. Just like treating high blood pressure. We control, but rarely cure.

Bottom line, genetics, followed by biochemistry, will lead to the greatest successes. You cannot really fix something that is broke if you don't fully understand all the moving parts.

Hope this helps you.

Good luck and my best wishes for a bright future!

Sincerely,

Marc