ABSTRACT
Precision Medicine and Care of the Older Patient (by Anne Croudass, RN, MSc and Donald White, PhD) The eminent Dr Donald White, who manages the Stratified Medicine Program at Cancer Research UK, has delivered the largest genetic screening program for molecular aberrations of non-small cell lung cancer of its type in the world. He and his co-author, Anne Croudass, the lead research nurse at Cancer Research UK, have contributed a chapter that begins with an illustrative vignette that describes the symptoms of NSCLC, leading to diagnosis and ultimately chemotherapy with its side effects, and the emotional, psychological, social, and financial toll. This vignette is astutely contrasted with a follow-up in which the patient is placed on a compound designed to target specific molecular changes within his cancer cells. The target was the Epidermal Growth Factor Receptor (EGFR). A mutation in EGFR had been identified in the tumour by sequencing DNA from the biopsy.
The emergence and delivery of precision medicine is discussed, including the monitoring of disease by blood test, detecting DNA fragments from residual tumour. Precision medicine is transformative, having the potential to revolutionize the impact of cancer treatments for elderly patients and their families, who often reside in fragile, co-dependent relationships, relying on each other for aspects of care and activities of daily living.
