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If you are unlucky enough to be diagnosed with a cancer tomorrow, you will be treated with one or a combination of these 3 techniques:

  1. Chemotherapy (These are poisons that, for reasons we don’t always completely understand, work to kill cells in the body that rapidly divide. Cancer cells rapidly divide – but so do cells in the hair follicle which is why you sometimes see hair loss in cancer patients. The hope of chemotherapy is for the poison to kill all of the cancer cells before it kills the patient)
  2. Surgery (Cut out the cancerous tumour)
  3. Radiotherapy (Zap the cancerous cells with as much precision as possible because healthy cells that are just a cell-width away can be altered and made cancerous by the radiotherapy)

At some point in the future, generations will look back on these techniques with the same pity as we have today when we recall the use of leeches in medicine.

If 1 million people have lung cancer, 1 million have prostate cancer and 1 million have breast cancer then it is highly unlikely there is a single cure for cancer. Based on our current knowledge it seems more likely that there will be 3 million cures for these 3 million patients as the development of the cancer and the response of the body to our best current techniques will be different in every body.

In his recent book, “The End of Illness”, David Agus argues that current medicine developed to treat invading viruses and bacteria in the body. The invader was identified with symptoms and the treatment prescribed. However, cancer is no invader. It is caused by a regular process going awry in the body and not being halted by all of the automatic checks and balances that our body does so well without us even knowing it day in and day out. Any other auto-immune disorder and many more conditions could be grouped with cancer as an “internal error”. In these cases, and with human health in general, a treatment for one condition could lead to complications elsewhere in the body. We begin tinkering with an outrageously complex system that we do not completely understand. There is a need for medicine to be more personalised.

The human genome has been mapped and represents Gb of data. In every single cell in our body. The genome and it’s awesome scale is not even the finest level of detail we can measure in the body . The genome is referred to by David and others now as “like an ingredient list at a restaurant” in the sense that you can see obvious issues (like the use of MSG or way too much salt or sugar compared with fruit and vegetables) but the way in which those ingredients are combined in the “restaurants” of every body will differ widely. The gene for growing a neck is the same in a mouse as it is in a giraffe, it is just switched on for longer in a giraffe. These switches are then as important as the genome itself. Our genes express themselves by producing proteins which control everything in our bodies from neck growth to the overall health of the system so now we must measure and observe all of the proteins in the body. This is the Proteome and the volume of data here is potentially more vast than the genome.

So given the need to analyse the genome and proteome, we no longer have a medical challenge but an IT and engineering challenge. Medicine can now be aided by tools capable of processing large volumes of data quickly. HANA is well placed to establish a strong role in the new era of personalised medicine. Here are some thoughts and observations on the potential for HANA and Personalised Medicine:

  • What if a cancer patient’s genome is recorded and uploaded to HANA upon diagnosis. Within HANA their genome is then compared with all of the genomes of all of the cancer patients who have gone before them (including the way in which they were treated and the outcome of their battle with cancer). The result of the analysis is a tailored treatment program for the patient where potentially everybody wins. The patient may benefit from less chemotherapy or surgery but maintain the same successful outcome. The hospital system could save money on now unnecessary chemotherapy and other expensive treatments. SAP earns money as more and more institutions use HANA. And yes the analysis will be fast thanks to HANA. This vision is fast becoming reality with the amazing work of the HPI/Innovation Center and Charité Hospital and their planned next steps with the Oncolyzer. See more on the Oncolyzer at http://www.sap-tv.com/video/#/7678
  • What if a cloud based HANA App for Personalised Medicine (In the spirit of TLAs we could even call it HPM) could store all of the information you have about your own health. Every Corporate Health Screening result (are yours all paper based like mine?), every bit of information from your GP (after all, it is your information – not the GP’s), everything that happened in that emergency room visit when you were young. And now what if that information could be taken with you wherever you went in your life, wherever you travelled. The potential user base of such an app is 7 Billion. A “killer app” that does the opposite.
  • What if you could measure your proteome at home and upload your proteome to that same cloud based HANA App, HPM? The App could then analyse your real-time proteome and issue warnings or even suggest what to eat today and how to exercise this week to maintain a healthy system. That would be personalised medicine, and the technology of HANA has the power to help the human race achieve this milestone in medicine and health care.

Mark Heff
SAP CSA EMEA

26 July 2012

See also:

Blog: Genome Analysis

Blog: Personalized Patient Treatments

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