asu in the news 02-06-08 to - ASU News - Arizona State University

ASU in the News
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Source: azcentral.com
Title: ASU’s Robert comments on gene testing
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Full Text: The eternal search to live longer, healthier lives is driving technology faster every day, with
advances in diagnosing and treating many diseases.
One of the newest technologies is personal genome testing, marketed directly to consumers by labs
that collect, test, analyze and report people’s individual genetic information - at about $1,000 a pop.
At the end of 2007, three Web sites - 23andme.com, navigenics.com and decodeme.com - were
selling genome-testing packages to people who wanted them, sidestepping doctors and insurance
companies.
Interest in genetic testing is fairly strong. A 2002 Harris poll found that 69 percent of adults would be
somewhat likely to seek a comprehensive genetic test that could indicate the likelihood they might get
several major diseases. advertisement ’I don’t think anyone in this field has a doubt that the day will
come when it will be useful and a routine test for everybody,’ says Heather Shappell, a genetic
counselor. But she adds a word of caution: ’That day is not here now.’ Here are some reasons why
you might want to hold off on paying $1,000 out of pocket for your genetic snapshot:
The genetic information is presented out of context. ’Everything we know about genetics is
contextual, and these are decontextualized samples of DNA,’ says Jason Robert, a bioethicist at
Arizona State University School of Life Sciences. The ’risks’ presented by the test results don’t take
the individual client’s factors into consideration, such as nutrition, stress levels or exposure to
environmental toxins. ’One thing we do with the medical students at the ASU medical school
downtown is to emphasize personalized medicine, including things like genotype. But we also
emphasize that each person leads a very individual life from conception onward. Impacts can occur at
any point in that lifeline, such as diet or the timing of diet or environmental exposure.’ Diseases such
as heart disease and diabetes are extremely complex, says Emily Zaragoza Lao, medical director at
St. Joseph’s Family Medicine Center in Phoenix. ’Genetics is so vast that you can’t say, ’I have the
gene so I’m going to get it.’ Certain diseases, yes, but it’s not black or white,’ she says. The medical
community hasn’t caught up.
Most physicians have neither the time nor the expertise to interpret the type of genetic information
provided in the testing for individual patients.
Shappell is founder of Informed Medical Decisions, a national genetic-counseling company based in
Palm Springs, Calif. ’Doctors order tests all the time, but a genetic test is not a cholesterol test, where
it’s either good or bad,’ she says. Genetic tests are filled with subtle nuances, many of which are not
yet understood even by geneticists in terms of predicting disease risk, she says.
As a family doctor, Zaragoza Lao says that a personal genome report is useless to her. ’When
patients bring me the report, I’m not going to be able to interpret it. I don’t have a standard to go by.
Do they have a family history? Symptoms? Let’s find out about that first,’ she says. Not everyone
benefits from genetic testing.
Shappell, whose company specializes in telephone counseling for cancer, says there are clear
guidelines established for who should be tested for hereditary cancer. ’Most people who have cancer
or cancer in their family don’t have hereditary cancer caused by a single gene mutation that causes
high risk in the family,’ she says. In fact, only 10 percent of cancers are caused by specific genetic
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