Personalized Cancer Diagnostics

As technology develops, scientists are able to identify certain mutations in oncogenes and tumor suppressor genes. Many labs have introduced multiplex screens that can detect several hundreds of mutations in multiple genes. However, new technology has prompted many to wonder, "Why not sequence the entire genome of a patient's tumor" (Corless)? A research group led by Rowchowdhury has sequenced the whole genome, exome, and transcriptome of individual tumors "in an effort to identify all potentially important anomalies" (Corless).

The genes can then be classified into one of three groups: "those that may have direct impact on care of the current cancer, those that may be biologically important but not currently actionable, those that are of unknown importance" (Corless). The complete sequencing can be done within about 24 days for a cost of approximately $3600.

Although this technology seems very valuable, I could not help but think of the problems that may arise. If such sequencing can prove vital, do we not have an ethical obligation to provide sequencing to all cancer patients? Do patients have the right to know about untreatable genetic conditions if they are discovered?

Additionally, I thought this related to Dr. Verghese's lecture last week in that scientists may eventually know everything about a patient on the molecular level, but does that really lead to better treatment? In other words, will significant increases in technology cause doctors to abandon their bedside manners?

All things considered, this technology could be very promising not only to doctor's but also to patient's and their emotions as they battle cancer. I was wondering if there was any study, if even possible, that correlates a patient's emotional state to success of treatment? I know this is far fetched but it seemed interesting to me (i.e. do depressed cancer patients die faster than optimistic canner patients?)