A PERSONAL MESSAGE FROM DR. FOSTER

When it comes to personal healthcare, I would say there are three different personas. Type one is generally unconcerned about their health- they smoke if they want to, they eat whatever they want, and they go to the doctor if they’re forced. Type two is what I would call reactive- they generally ‘follow the rules’ in terms of diet, exercise, and health maintenance, but nothing proactive and generally just seek treatment when they are having problems. Type three is the renegade. They attempt to be proactive in their healthcare, have a well-disciplined diet and exercise program, and stay up to date with their healthcare maintenance. This is the type of patient for which precision, or targeted medicine was meant.

Up until this point in time we have mostly been a victim to our genetics, meaning that we can treat our health conditions as they arise but do very little to do much more than ‘manage’ them as we encounter them.  Times have changed. Due to multiple advancements- the sequencing of the human genome, better understanding of our health, and recent advances in pharmacology- we are at a place in time where we are able to actually alter the course of our genetics.

This type of medicine goes by several different names – precision medicine, preventative medicine, targeted medicine, proactive medicine, personalized medicine, but they all have the same connotation.  We are now able to combine your own personal DNA analysis with a very complete laboratory analysis of your blood and generate a detailed ‘snapshot’ of your current state of health as well as your likelihood of developing several treatable chronic health conditions. These diseases constitute what have been coined the ‘Four horsemen of chronic disease’.

Atherosclerotic cardiovascular disease (ASCVD). This is an all-encompassing term for the buildup of plaques in your blood vessels and is a significant risk factor for heart attacks and strokes. By analyzing some very specific blood markers and aggressively managing them we can essentially render you immune to the future development of ASCVD. We do this with a combination of diet, exercise, lifestyle modification, and in some cases, medications.

Metabolic syndrome is a combination of conditions that have a very negative impact on your long-term health and longevity. It is the combination of hypertension, obesity, abnormal lipids, and either poor insulin sensitivity or outright diabetes. In the early stages these can be managed by better lifestyle choices, but in more advanced stages some medications have to be used until the lifestyle modifications take effect.

Neurocognitive disorders are a collection of conditions, with Alzheimer’s being the most prominent, that lead to severe mental decline in the later years. While it is true that there is a significant genetic component to this condition, there is mounting evidence that aggressive early prevention of cardiovascular disease and metabolic syndrome may be able to prevent the occurrence even with increased genetic risk factors and/or family history.

Cancer. We continue to see advances in cancer therapies and there may be a ‘magic bullet’ at some point in time, but for the present our best defense continues to be adherence to recommended cancer screenings. These include routine scheduled colonoscopies, mammograms, prostate screening, skin exams, etc. The reason these are important is because they are able to prevent the initiation of cancers by intervening on ‘pre-cancerous’ lesions before they turn rogue. One recent advancement in this field is the Galleri test. This is a blood test that screens for fifty-two different cancers by looking for markers in the blood, allowing for detection well before any clinical signs of cancer are evident.

Byron Foster MD, PHD