The End of Illness by David B. Agus
My rating: 3 of 5 stars Dr. Agus is a professor of medicine and engineering at the University of Southern Calorfina Keck School of Medicine and Viterbi School of Engineering. He also heads USC's Westside Cancer Center and the Center for Applied Molecular Medicine. Finally, he is a cofounder of Navigneics and Applied Protenomics, two companies that are focused on the concept of personalized medicine. At times this felt like a prolonged commercial for Statins, which is unfortunate as it seemed to undermine the overall message which appeared to be promoting a new model of medicine which is customized to the individual and that focuses on the health of the entire human system as opposed to focusing on eradicating a specific disease. After all, an ounce of prevention is worth a pound of cure. While Agus acknowledges the benefits of understanding our genetics, he also points out that our genes only reflect our genetic predispositions and reveal almost nothing about the health of an individual in the moment. He discusses new frontiers of medicine that include proteomics, a system of identifying proteins present in the blood, which he claims has the potential to tell us more about the health status of an individual at a given point in time. He also spends a lot of time warning readers against the use of supplements. And he makes several valid points. For starters, the perfect packing of nutrients in foods may make all the difference when it comes to how effective those nutrients are in doing what they do. When we eat an orange, we not only get vitamin C. We get fiber, natural sugars, a whole slew of phytonutrients, and we get them in doses that we (and our microbiome) have evolved to thrive on. Not only do supplements not replace nutrients derived from foods, when taken in pill form, they can actually upset a delicate balance. Of course, there are always exceptions, and he acknowledges this. The point he makes is more to debunk this idea that supplements are innocuous at worst and good for us at best. And I think if you look at the research, it is on his side. He advocates for using and developing technology as a way to advance our understanding of disease, disease prevention, and the treatment of disease all with an end goal of promoting a personalized approach to medicine. And of course he advocates for a healthy diet, exercise, adequate sleep, and stress management as these are all factors known to impact our bodies, promoting an environment for disease or health. Most importantly, he points out that unlike infectuous diseases in which we are fighting a foreign invader, in the case of cancer, we are fighting our own cells. In his opinion, this requires a shift in the way we think about preventing and curing disease. In the case of cancer, we need to understand what internal enviroments keep cells healthy and assist the body's immune system so that it can effectively manage damaged cells that ultimately lead to cancer. Occasionally he reaches too far with examples that seem counterproductive. For example, the chapter title "The Fallacy of Fresh" is a distraction and even silly. It certainly adds nothing of value to the narrative. All in all, an interesting read. I enjoyed learning about proteomics and the future implications for personalized medicine as the technology is developed. Unfortunately, this is a little over-written with too many sections the reader is tempted to skip over or wish they had.
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April 2020
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