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ONCOLOGY Nurse Edition. Vol. 24 No. 2
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Integrating Genetics and Genomics Into Oncology Nursing

By Dale Halsey Lea, MPH, RN, CGC, FAAN
Health Educator, National Human
Genome Research Institute

Kathleen A. Calzone, MSN, RN, APNG, FAAN
Senior Nurse Specialist, Research, National Cancer
Institute, Center for Cancer Research—Genetics Branch

National Institutes of Health, Bethesda, Maryland | February 16, 2010

The Cancer Genome Atlas (CGA) project is another area of research that is further illuminating the genetic basis of cancer. The CGA applies genome analysis technologies to systematically investigate the entire spectrum of genomic changes involved in human cancer.[8] Cancer involves many gene changes, or mutations, that accumulate over a person's lifetime and have an impact on cell growth control mechanisms. As cell growth control mechanisms are altered, a normal cell can change to a cancerous one.

With new gene-sequencing technologies and analytic tools, researchers are able to sequence many of the genes suspected to cause cancer. Researchers can also compare the entire genomes of cancerous tissue to those of healthy tissue, to identify the mutations that have occurred. Investigators are beginning to use this information to design new and improved diagnostics and treatments for many cancers.[5]

Personalized Healthcare
The growing body of information in human genetics and genomics is leading towards a revolutionary new approach that is transforming healthcare—personalized healthcare. Discovering the influence of genetic and genomic factors in health and disease is creating opportunities for earlier diagnosis, more effective and individualized prevention and treatment of disease, better response to treatments, and improved health outcomes. In recognition of the importance and increasing use of a personalized approach to healthcare, the US Department of Health and Human Services has created a Personalized Healthcare Initiative.

The overall goal of this Initiative is to improve the safety, quality, and effectiveness of healthcare in the US through a proactive approach. Using the identification of genes and their relationship to drug treatment, the Initiative supports and enables tailoring of medical treatment to each person's specific genetic profile and needs. This personalized approach is expected to give individuals the opportunity to become more involved in their health and wellness.[9]

Cancer genetic and genomic research is on the forefront of personalized healthcare. For example, the Tumor Sequencing Project (TSP) consortium has identified 26 genes frequently mutated in lung adenocarcinoma. This achievement more than doubles the number of genes known to be associated with lung adenocarcinoma. The TSP research team also was able to detail key pathways involved in the disease, and describe patterns of genetic mutations among different subgroups of lung cancer patients, including smokers and nonsmokers. This research is advancing understanding of the complexities of lung cancer, and supporting efforts to develop new strategies for prevention, diagnosis, and treatment of this disease.[10]

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