Genomics Q&A with Professor Miles Prince
Since 2014, Snowdome has funded cutting-edge research into genomics and supported the incredible advancements in genomic profiling of various blood cancers. This often life-changing service is particularly useful for patients who don’t respond well to standard therapy, as it can identify other treatments that may work for them. Professor Miles Prince recently participated in a podcast, giving an easy to understand explanation on the basics of genomics.
Here are some of the highlights from this podcast.
What is genomics?
Genomics is the study of gene structure. Within a cancerous cell, the normal genetic material is disrupted, it is mutated. It can become mutated from external insults, such as with skin cancers that are caused from excessive sun exposure, or lung cancers that are caused by cigarette smoke. Yet often this mutation can just occur spontaneously, with the cause unknown.
One way to look at mutations in cells is to compare it to a computer. What happens in cancer is that the Hard Drive of the cell (the genes inside the cells) gets corrupted. This genetic material is actually chemicals (amino acids) joined together in a string – each chemical is like an individual musical note on a page. When those ‘notes’ are joined together they make a short tune. Each little tune can be thought of as a specific gene – genes that decide the colour of our hair, how tall we are going to be, how big our nose is, and so on. What happens in cancer is that a lot of those genes get messed up. The tune is lost and the result is a mess of individual nonsensical notes.
These days we are actually able to determine every gene in the body, every chemical (amino acid) that makes up our genetic material. We can now work out what the template is and then put on top of it an abnormal cell and work out where it is mutated. It is a bit like putting a negative over a photo and trying to match the two together so we can see where any abnormalities are.
Seeing so many patients with blood cancer, do you see some common overlaps with lifestyle conditions precipitating cancers?
There is no question that the immune system is critical in controlling disease in many ways, cancer being one of them. The difficulty is that the immune system is so broad and complex. We know that exercise is really important for boosting aspects of the immune system. We also know that sleep deprivation will suppress the immune system. And if you are sleep deprived you also get less exercise and you might not eat as well. But issues like stress, exercise and eating interact. The difficulty is working out how they effect the immune system and if modifications actually help. It is difficult to give good advice on how to modulate things to improve the immune system.
Looking back at genomics, the study of gene structure, and how it relates to cancer treatment, can you describe that relationship?
Take the old-fashioned way of looking at cancer with a microscope. Many different types of lung cancer, lymphomas, and leukaemias can actually look identical under the microscope but the mutations, the abnormalities, i.e. what is making that cell grow is genetically, very different. Genomic medicine can, therefore, help in a number of ways. One is that it can help us get a more accurate diagnosis, the second is that there are treatments that can directly target some of these mutations and lastly, it is going to be an incredibly powerful way for us to monitor the effectiveness of treatment.
If we look at the traditional model of cancer therapy, it is chemotherapy, radiotherapy and/or surgery. How is this new area of genomics going to potentially change the face of cancer management?
We will always have surgery and radiotherapy because they are so powerful in killing cancers, particularly when detected early. We now need to develop treatments that will be able to replace chemotherapy. Genomic medicine is not the ultimate answer for every situation, but it is very helpful.
Can you explain what precision medicine is?
Precision medicine, also termed personalised medicine or individualised medicine, is trying to match the treatment to the specific condition in an individual. Precision medicine is about saying that you have a genomic or genetic problem and we are going to provide a therapy that is very specific for that.