Stuff You Should Know - How Personalized Medicine Works

Episode Date: January 26, 2016

Hippocrates realized that it is even more important to understand the patient than to understand the disease and now, 2000 years later, we are coming back to that way of thinking with personalized medicine. ? Learn more about your ad-choices at https://www.iheartpodcastnetwork.comSee omnystudio.com/listener for privacy information.

On the podcast, Hey Dude, the 90s called, David Lasher and Christine Taylor, stars of the cult classic show, Hey Dude, bring you back to the days of slip dresses and choker necklaces. We're gonna use Hey Dude as our jumping off point, but we are going to unpack and dive back into the decade of the 90s.

We lived it, and now we're calling on all of our friends to come back and relive it. Listen to Hey Dude, the 90s called on the iHeart radio app, Apple Podcasts, or wherever you get your podcasts. Hey, I'm Lance Bass, host of the new iHeart podcast, Frosted Tips with Lance Bass. Do you ever think to yourself, what advice would Lance Bass

and my favorite boy bands give me in this situation? If you do, you've come to the right place because I'm here to help. And a different hot, sexy teen crush boy bander each week to guide you through life. Tell everybody, ya everybody, about my new podcast and make sure to listen so we'll never, ever have to say. Bye, bye, bye.

Listen to Frosted Tips with Lance Bass on the iHeart radio app, Apple Podcasts, or wherever you listen to podcasts. All right, Josh. So the first part of our winter tour is over. That was fun, huh? A lot of fun. But we are going back out this week and next to Atlanta.

Well, we're not going anywhere. Well, we're going down the road. 10 minutes from my house. Sure. Atlanta, Birmingham, we would still love to see you and you can still get great seats. Yeah, and this is a brand new show unless you were in San Francisco, San Diego,

Austin, or Dallas, you ain't seen the show. True. And it is bringing down the house all over the country. That's right. Eventually, probably all over the world. Yes, and you can get tickets. Just go to sysklive.com.

It's our Squarespace-powered site. Yep. And they were powering our tour and they were powering me on a daily basis. That's true. So we will see you guys very soon. Welcome to Stuff You Should Know from HowStuffWorks.com.

We'll see you next time. See you. Bye. Bye. Bye. Bye. Hey, and welcome to the podcast. I'm Joshua M. Clark.

There's Charles W. Wayne, Chuckers, Chuck Tran, Breont. Chuck Tran, I remember that. And then, no one ever even made sense. No. Who said that? Me. Yeah, I don't get it. It doesn't mean anything.

That's why I never made sense, you know. And then there's Jerry, Jerry's Jerome Rowling. Here, Tran. And Josh, Tran. Yeah. The Tran's. I'm excited to record this and then leave because I just quickly on my phone saw

that Billy Joel did a doo-wop performance in the commercial break of a talk show and the video was up. Oh, yeah? So I got things to do. Okay, well, let's go. Personalized medicine, Chuck. Uh-huh.

So let's take it back. Let's take it way back. Okay. Let's talk about medicine in general, right? Are we way back machining it or no? No, no, no. All right. So there's this idea that to best understand

how to treat a person. You should understand, Hippocrates said, it's far more important to know what person the disease has than what disease the person has. Boy, that is smart for back then. It is, you know. And I think that this was the original idea behind medicine, that we can understand a disease,

but when you apply it to a person, it's going to be different than when you apply it to another person. Sure. And that is the heart of personalized medicine is that understanding. Unfortunately for many hundreds of years, well, actually for a shorter time than that,

but in Western medicine, the idea has been that if it works for most people, it'll probably work for you. Or that's good enough for us. Yeah. It's called a trial and error approach and that should scare you to death. Well, I get it because until the Human Genome Project, we didn't have a lot of choices as a society

other than to do our best for the majority, you know? Well, yeah. Like that changed everything. It did. But even before that, like that was what, 2000, 2001, something like that, the Human Genome Project? Yeah. I mean, before that, there were some precursors

to personalized medicine like, let's look at family histories and stuff like that. Yeah, but even like, that's not that old. No, it's not. It wasn't until World War II that people started noticing, huh, you know, different people have different reactions to different kinds of medicine. There's actually an anti-malarial drug

that was given to troops in World War II, American troops. And if you're an African-American, there's a high likelihood that you might develop anemia after you're given this anti-malarial drug. But that didn't show among white troops. And doctors thought, what's behind this? And they went and looked and saw that genetically speaking, African-Americans were less likely to have a gene active

that produces a protective enzyme that keeps you from developing anemia when you're given this particular anti-malarial drug. And that, in the middle of the 20th century, was the first time we really started in the Western medicine tradition, thinking that, no, people have different reactions to different types of treatments

and can have different experiences with different types of disease. Did they do something about it in that case? I don't know. I was curious. It depends on the time period in this country, shamefully, that they might have said like, yeah, but who cares?

Yeah, that was the same time the Tuskegee. Yeah, exactly. Yeah, the Tuskegee experiments were going on. We were also infecting people in Guatemala with syphilis. Yeah. Crazy. Crazy stuff. So you mentioned Hippocrates.

More than 2,000 years ago, he was pretty advanced for thinking that Xerxes needs a bleeding, but Zeus does not. Right. Zeus never needs a bleeding, by the way. No, he just does a lightning bolt at the problem. Exactly.

But he was way ahead of his time to be thinking that way back then. Some other pioneers, since then, I think we talked about these two, Ruben Otenberg and Ludwig Hechtun. Nice job. I don't know. That was not good.

Hechtun. In 1907, and I think in our blood episode, we might have talked about this. That was such a good episode. It was a really good one, I think. They were the first ones to say, you know what? People have different blood types as it works. So that's why people keep dying

when we're putting this blood into someone that doesn't have the same blood. So that was Landsteiner, who came up with the idea that we had different blood types. These two were the ones who first started to match people. Like, well, let's match these people. Gotcha. Yeah, that's a pretty good first example

of personalizing medicine. On the most basic level, like let's not kill people with blood, right? Yeah. And then, like I said, family histories and such, they finally started saying, hey, you know what? Maybe we'll look at your father and your mother and your grandparents,

because if they have this disease, you might have it as well. But everything changed when the Human Genome Project came along, and all of a sudden, we found out we could learn a lot more about our predisposition for certain diseases. Yeah, because if you think about it, our reactions to different diseases,

and also those same medicines that treat different diseases can be traced down to the genetic level, to the molecular level, to whether a gene is turned off and expressing a certain kind of protein or enzyme, or whether our genes are going to allow for a tumor that expresses a certain kind of protein

that can be tracked. If you, conceivably, can look at a person's genome, sequence the whole thing, analyze it, and then look at what genes are turned on or off, what proteins are being expressed, that kind of thing, then you, if you also know that a certain kind of drug tracks a certain kind of tumor that's associated with that type of genome

or genetic sequence, then you can put patient and drug together under its ideal form. Dude, we should stop and just walk away. That's a mic drop statement. I don't think we need anything else. Okay. Can I go watch Billy Joel sing you up?

Yeah. All right, so if you think you go to the doctor and you get personalized medicine, in a sense you sort of are, but what we're talking about is what Josh has said, which is your own individual biology being the most overriding factor in how you were treated. Your biology, not just, you know.

You're a human being. Yeah. This works on human beings and horses. Right. And your mom had cancer, your grandma had cancer, so you might have cancer. No, we're talking about looking inside of you to find out what your likelihood to get these things are,

and like you said, matching you with the best treatment plan. Right. And one of those courses of study, there's a lot of different things that really kind of fall under personalized medicine. Sure. But one of those subfields is called pharmacogenetics, right?

Yes. And that is, again, if you can take a person's genome and then analyze it, you can say, well, I see this sequence right here, would react very well to this particular drug. That's pharmacogenetics, matching the drug to the person, right? Yeah, which is the opposite of,

hey, it works for eight out of 10 people, and if you're just one of those 20% then T.S. T.S. And that, seriously, that is the basis of Western medicine as it stands right now. It's a trial and error approach. And they don't usually stop at T.S. No, of course not.

They just say like, oh, you survived that round of drugs, but it didn't work. Let's try something else. Let's try something else. Maybe this other one that doesn't work for that 80%, tends to work for that 20% might work for you. And then it just goes on and on and on until they finally hit upon that drug.

Hopefully that doesn't work. I say hopefully because within that trial and error period, a lot of people die. Sometimes that first time, that first trial results in a fatal error. And those are called ADEs or adverse drug events. There's 770,000 people in the U.S. alone. They either die or are injured by an ADE every year

in the U.S. alone. Almost a million people, 770,000 people every year. You give that person a drug and they might die. And one of the goals of pharmacogenetics is to avoid ADEs so that you can say before you give anybody a drug. Like this won't kill you. Yes, exactly.

This won't kill you. We know that because we scanned your genome. We're not guessing here. We know you genetically will not die from this drug. Yeah, I think we should caveat here when we say things like guessing and like, I don't wanna paint the medical industry as, you know, just throwing darts with a blindfold.

They did the best job they could, I think, to treat massive amounts of people in the most efficient way possible. But things are getting better now because of the human biome or the human genome and what we've learned about it. Like when I look about the future of medicine, it is like super rosy.

Yeah, oh, I agree. You know, like a hundred years from now, it's gonna be amazing what we're gonna be doing. Maybe like 30. Oh, yeah. Like we're right there in the cusp right now where we went through a fairly dark age as far as medicine goes where we were taking shots

in the dark, figuring things out as we went along. And now we are right there at the age where we're about to just take off like a rocket and really understand health and wellness and treatment of disease. All right, well, I feel like we're on the cusp of a message break as well. I think you're right.

["The Cusp of a Message Break"] On the podcast, Pay Dude, the 90s called David Lasher and Christine Taylor, stars of the cult classic show, Hey Dude, bring you back to the days of slip dresses and choker necklaces. We're gonna use Hey Dude as our jumping off point, but we are going to unpack and dive back

into the decade of the 90s. We lived it, and now we're calling on all of our friends to come back and relive it. It's a podcast packed with interviews, co-stars, friends, and nonstop references to the best decade ever. Do you remember going to Blockbuster? Do you remember Nintendo 64? Do you remember getting Frosted Tips?

Was that a cereal? No, it was hair. Do you remember AOL Instant Messenger and the dial-up sound like poltergeist? So leave a code on your best friend's beeper, because you'll want to be there when the nostalgia starts flowing. Each episode will rival the feeling

of taking out the cartridge from your Game Boy, blowing on it and popping it back in as we take you back to the 90s. Listen to Hey Dude, the 90s called on the iHeart radio app, Apple Podcasts, or wherever you get your podcasts. Hey, I'm Lance Bass, host of the new iHeart podcast, Frosted Tips with Lance Bass.

The hardest thing can be knowing who to turn to when questions arise or times get tough, or you're at the end of the road. Ah, okay, I see what you're doing. Do you ever think to yourself, what advice would Lance Bass and my favorite boy bands give me in this situation? If you do, you've come to the right place,

because I'm here to help. This, I promise you. Oh, God. Seriously, I swear. And you won't have to send an SOS, because I'll be there for you. Oh, man. And so, my husband, Michael.

Um, hey, that's me. Yep, we know that, Michael. And a different hot, sexy teen crush boy bander each week to guide you through life, step by step. Oh, not another one. Kids, relationships, life in general, can get messy. You may be thinking, this is the story of my life. Just stop now.

If so, tell everybody, ya everybody, about my new podcast and make sure to listen, so we'll never, ever have to say bye, bye, bye. Listen to Frosted Tips with Lance Bass on the iHeart radio app, Apple podcast, or wherever you listen to podcasts. So, Chuck, I was talking about pharmacogenetics, right? Yeah.

There's actually some examples of pharmacogenetics already taking place. This isn't necessarily in the future. Like, this is already starting. Yes. I think it started in the 90s, right? Yeah, and we'll get to this later. One of the big reasons that things are cooking now,

cooking with gas, as my dad used to say, is because the massive drop in cost for mapping your genome. Yeah. Like, massive. In fact, I'll go ahead and tease you here. And the first time it was done to James Watson in 2007. That was 2007, not even the human genome. That was 2001.

Yeah, 2007 was the first time they mapped the person in full. It cost a million dollars. Now, you can get it done, a good one, not a full. You can't map out the entire genome for this amount of money. No, you can't. You can sequence it. You can sequence it for less than $200. And pretty soon, it's going to be about $50.

And then from what I saw in that, I think that was like a Business Insider article. There was a dude who gave this really interesting lecture. He very strongly asserted that they were pretty confident by 2020, thanks to economies of scale, genome sequencing will cost about a penny. Yeah, they won't cost a penny. You won't pay a penny, I guarantee you that.

No, no, but it'll be... But it might be like $50. And someone will be making a $49.99 profit. No, I think what he was saying was, if you take all of the genomes that are sequenced in a year, ultimately, that's what it will have cost, is about a penny each, right? But it's going to pop up in different ways

than what you have now. Like, it's a pretty common thought that you will pee into your toilet, and your toilet will have a genome sequencer attached to it. And when you pee, your urine will be analyzed for any changes from that morning or the night before or anything like that, so that your baseline health is monitored

on a several times a day basis, right? If my toilet starts telling me to cut down on my drinking, then I'm going to start peeing outside. I imagine that you can probably set it to kind of take it easy on this area, you know, that kind of thing. And when I say start peeing outside, I mean full-time, I pee outside almost every night

off of my deck. Right, sometimes you even stand up. Yeah, that's Raymond McCauley, by the way. He is the Biotechnology and Bioinformatics Chair at Singularity University. Yeah. What's their mascot? The Fighting Kurzweil.

So he's a smart guy, and he's the one that is saying that this is just getting cheaper and cheaper. Right, and when you look at the graph, in 2007, it took a nosedive in price. Yeah, he compared it to Moore's Law, where Moore's Law is like the amount of computing power doubles every 18 months

or something like that, 24 months, I can't remember. And it was pointed out that genome sequencing was actually moving at a rate of five to 10 times the rate of Moore's Law. That's awesome. That is awesome as far as genome sequencing is concerned. The problem is computing power is still following Moore's Law. And here's the big problem.

This is why we're not all getting our genome sequenced right now, because it might be very cheap to sequence a human genome. It's still very expensive because it requires a lot of computing power to analyze that genome. Yeah, that's the main stumbling block, is you can't sequence your genome, stick it in a machine, and have it say, you'll get cancer.

Yet. That's the future. But not too far off. No, that's like Gattaca. Yeah, but this guy, Macaulay, was saying, probably in about 10 years, they'll have machines like that. Yeah, which is what we need. That's the main stumbling block right now,

is there's so much data that computers can't even keep up. So right now, you could conceivably get a decent genome sequenced and analyzed for like 15 grand, which is not, I mean, that's not all the realm of, it's not the reach of everybody. You don't have to be a billionaire for that. Right. Um, the big change will come

when all of us get our genome sequenced, basically for free. And the holy grail in the not too distant future is to not only have a genome sequencer, an analyzer in your toilet, but also you'll be wearing like a wearable or have an implantable. And like a Fitbit or something?

Yeah, or maybe something that's under the skin that is like Fitbit. But that's analyzing everything, including your hormone levels, things like that. So you're not only analyzing your pee, you're also analyzing your body on a moment to moment basis. And all this stuff is run through an app that you have on your phone

that is tied in to your health records and other kinds of medical data that you control and you share with your healthcare provider rather than the opposite. That's another big change coming that we talked about in Will Computers Replace My Doctor episode. Oh yeah, yeah. That medical information about the person

is going to be wrestled away from healthcare and healthcare providers and insurance companies and placed in the hands of the individual. And that's gonna be a huge change that will probably come from this personalized medicine. Exactly, one of the positive changes. All right, so there have been some early stories that have given us all hope for the future

when it comes to looking at these biomarkers for potential of disease. And one of them, there was a drug called K-A-L-Y-D-E-C-O, Caledico, Caledico? I think so. In 2012, to treat a rare form of cystic fibrosis, which is a deadly lung condition, and the FDA here in the US approved this drug

basically because they found out certain people have genetic markers, these biomarkers, that they wouldn't respond to other drugs treating cystic fibrosis. So they said, this is a new drug that will work for you, success story, boom. And this is the future of personalized medicine all over the place, right?

Yeah. It covers about 4% of cystic fibrosis patients. So in the US, it's 1,200 people that this drug was targeted for. That's awesome. Right? Because you would think, I'm just cynical, but you would think there's so few people

that somebody'd be like, why bother? I'll bet it costs a bunch of money for the drug. But yes, you're right. And then secondly, it also kind of shows how personalized medicine shifts our understanding of disease too, right? The reason these people with cystic fibrosis didn't respond to regular medicine

is because their cystic fibrosis was developed because their genes didn't, that regulated salt and water movement across the surface of their lungs were mutated and not functioning properly. So this specific drug that targets these 4% of cystic fibrosis patients goes in and messes with that gene. Well, if you do the other 96% of cystic fibrosis patients,

their salt and water movement is just fine. That's not why they have cystic fibrosis. So it changes your understanding of cystic fibrosis. It's not like you have cystic fibrosis, this is why you have it. This is how your body is showing that you have cystic fibrosis. You have cystic fibrosis and you can have all these,

you can have it under these different mechanisms. That's what personalized medicine is changing too. It's changing our understanding of disease itself. Same with cancer, right? Certain tumors express certain proteins. And although, yes, you have an out-of-control growth that makes it cancer, it really doesn't bear that much of a resemblance to this other kind of cancer.

And the more we dig into how people respond differently to cancer treatments and how they can host different kinds of tumors, it's changing our understanding of cancer. And a lot of people are like, cancer's too big of an umbrella. These are really almost different diseases. Yeah, and I think the Macaulay guy said,

the hope one day is to stop cancer before it even starts at such a small molecular level with these advanced, I guess. Like a blood test. Yeah, basically, the blood test will be so advanced that they'll say, you know, you're gonna develop cancer in five years. Like we can tell that already, so let's just stop it now. Before there's a tumor.

Yeah, or before it gets big enough that it's a problem. Yeah, exactly. If you have type one diabetes, I think it is, good news, there is a new system. It's basically an artificial pancreas device. And they are wearable. And the clinical developed by UVA and Harvard, Go Cavaliers and Crimson.

The Crimson Smarties, that's Harvard, right? They're not the Crimson type too, are they? No, not the type, they're just the Crimson. Okay, I think you guys left the part off there, Harvard. Well, they do have a mascot, I think, like John Harvard, but it's not like. It's just a square of Crimson. I don't know, I think so.

Maybe they're above it, they don't need it. Crimson Knights? Crimson Knights? No. Is that Rutgers? Yeah, that's Scarlet Knights. Anyway, UVA and Harvard developed this thing together, and it starts clinical trials in the next month or two.

And for six months, 240 people are gonna wear this thing, this artificial pancreas. This is so cool. To tell your body exactly when you need the optimal level of insulin in your body at all times. Oh, well, it introduces the optimal level. Oh, does it? Uh-huh.

How so? So it's like, it's monitoring your blood glucose level. Yeah. And you know, if you have diabetes, you have to inject insulin. This stuff, say, is connected to a port in your chest. Oh, I don't think this one particularly is. This is just a wearable monitor.

Oh, it is, okay. But I think eventually they're gonna have what you're talking about. Sure, I guess I'm just getting ahead of myself. That's actually, regulates not monitors in the future, I think, is what you're talking about. Or injects like an optimal dose. Yeah, regulating your glucose.

Yeah. So you don't have to do it. Right. I think this is just a wearable monitor. So you could just like press and say, okay, what kind of, how much insulin do I need right now? And it tells you the exact like milligrams. I guess so.

But you still have to like a dope go and inject it yourself, right? I think so. I don't see how it could be wearable on your arm and then also be attached to your body. Like the insides of your body. Through like an IV. Yeah, I don't think that's what this is.

All right. Sounds like there's two different things. But it's still monitoring exactly what your blood glucose level is. Absolutely. And it's your blood glucose level. Ergo, it's personalized medicine. That's right.

If you have tinnitus like our buddy Aaron Cooper. Aaron Cooper. He probably didn't hear that. I heard it was a ringing. He just heard. Yeah. They're working on customizable devices that adjust the audio signal

that's unique to your own ear. In other words, hey, just put this hearing aid in there that may or may not work for you. Right. From what I understand it actually. So, you know, noise canceling headphones. Yeah, I don't like those.

Well, it kind of works like those. It, I guess it figures out what pitch you're hearing that tinnitus at and it just gets rid of it. Yeah. I think that's neat. I do too. And then check.

There's another early example of a good, a big win. There's something called Herceptin. And in 1998, the FDA said, yes, go ahead with this. They figured out that this particular drug worked for a specific group of people whose tumors expressed a specific protein. And it was a breast cancer tumor targeting drug. But again, it wasn't like, oh, you have breast cancer.

Here, try Herceptin. It'll work for you. It's, we believe that you have this kind of tumor because it's expressing this kind of protein. So Herceptin is going to treat this. Hooray for Herceptin. Yeah. It's pretty neat stuff.

Well, let's take another break and we'll get back and finish up with some of the obstacles in the future. Oh, oh, oh, oh. On the podcast, Hey Dude, the 90s, called David Lasher and Christine Taylor, stars of the cult classic show Hey Dude, bring you back to the days of slip dresses

and choker necklaces. We're gonna use Hey Dude as our jumping off point, but we are going to unpack and dive back into the decade of the 90s. We lived it and now we're calling on all of our friends to come back and relive it. It's a podcast packed with interviews, co-stars, friends, and non-stop references to the best decade ever.

Do you remember going to Blockbuster? Do you remember Nintendo 64? Do you remember getting Frosted Tips? Was that a cereal? No, it was hair. Do you remember AOL Instant Messenger and the dial-up sound like poltergeist? So leave a code on your best friend's beeper

because you'll want to be there when the nostalgia starts flowing. Each episode will rival the feeling of taking out the cartridge from your Game Boy, blowing on it and popping it back in as we take you back to the 90s. Listen to, hey dude, the 90s called on the iHeart radio app, Apple Podcasts, or wherever you get your podcasts. Oh god. Seriously, I swear.

And you won't have to send an SOS because I'll be there for you. Oh man. And so will my husband, Michael. Um, hey, that's me. Yep, we know that, Michael. And a different hot sexy teen crush boy bander each week to guide you through life step by step. Oh, not another one.

Uh-huh. Kids, relationships, life in general can get messy. You may be thinking, this is the story of my life. Oh, just stop now. If so, tell everybody, yeah, everybody about my new podcast and make sure to listen so we'll never, ever have to say bye-bye-bye. Listen to Frosted Tips with Lance Bass on the iHeart radio app, Apple Podcasts, or wherever you listen to podcasts.

All right. So this all sounds rosy, but there are some obstacles. We already talked about one. The previous biggest one was cost. Yeah. This article itself is way out of date because it said $17,000 a person. And now it's already at like 200 bucks. I think that might be though with the, with the analysis.

Oh, really? Yeah. I think that's what they're saying. Okay. Oh yeah. Follow up on the data. Yeah. Yeah.

All right. So now it's down to 15 grand. Roughly. So it's up by $2,000. Right. So it was written a week ago. Yeah. All right.

That's it. But the cost of the, the genome was a previous hurdle. Now that's coming down. Another hurdle is that we mentioned was just processing the data. And then another hurdle is just overstating the impact of this, of the findings. Right. Just because, and it's a slippery slope. Just because you are susceptible to something doesn't mean you're going to get it.

No. And that's actually, there's something called the, the Jolie effect, the Angelina Jolie effect. Oh boy. I've got 8,000 jokes. Have you heard about that? No. So do you remember when she did genetic testing and found that she was, there was a likelihood

that she would develop breast cancer? Oh, I thought you were going to say pouty lips. No, no. Okay. I think perhaps like if her mother may have had breast cancer, I'm not sure. But she was convinced that there was a good chance she was going to get breast cancer. So she went ahead and had a double mastectomy without breast cancer. No tumors, no nothing.

She just preventatively had mastectomies. Angelina Jolie did? Yeah. Yes. And it created what's called this Angelina Jolie effect. And Christina Applegate did something like that too. Well, she had breast cancer. Angelina Jolie didn't have breast cancer.

Gotcha. Believe that she would conceivably get breast cancer. So just had her breasts removed. And then had implants. Right. And it created what's called this Angelina Jolie effect, which is this idea that the more we know about our bodies, the more focused on all the things that could conceivably go wrong. Hypothetically could go wrong.

That we may take radical steps like prophylactic surgery, basically, to prevent something that may or may not even happen. And this is a big concern among bioethicists about this kind of understanding that will come from personalized medicine is, are we going to all become obsessed with our health? Right. Well, I think people that already are, this will just be the next step of that. Yeah. But I could see it could bring more people into the fall. I'm sure there's a lot of people who don't think about their health just because they don't have that kind of awareness.

But if it was in their face like, Hey, buddy, here's your genome. Look at this crazy stuff that could happen to you. You may start thinking about it, even if you weren't predisposed to it before. Right. But you would have to go get that done to begin with. Well, that's another question too. So right now, if getting your genome done costs 17 grand, right? Should that be just the providence of the rich?

Or is it a human right to know what your genome says? If anybody can know what their genome says, should everybody? I predict that the answer will ultimately be yes to that, that it is a right and the government will probably fund a program for every American to get their genome sequenced. 20 years. Another big problem is the FDA is just overtaxed. It's a rapidly moving field and they just can't keep up at this point. Which there are a lot of new things that come along, new drugs, new devices,

that the FDA has to test. Well, not just that, the understanding of it as well. Sure. Like they used to have this open database from the Human Genome Project to where all of these anonymous subjects, genes, or genomes were just sitting out there for anybody to go and data mine, right? Yeah. And then somebody proved that you can actually find, you can de-anonymize these people because

again, this is their genome and figure out whose genome you're looking at specifically. And the FDA had to shut it down. But they shut it down after somebody proved that this could already be done. So they're having to react rather than being able to keep up with the genes in the field. And that's one of the other huge slippery slopes in the future is, well, a couple of things. How insurance companies deal with this? A, can they deny someone based on a biomarker?

Right now, there's legislation that has been signed into law that says no. You cannot, it's called biological discrimination. Which is profoundly insightful or foresightful for the government. Sure. I'm really surprised by that one. And you know what? Canada is the only G7 country that doesn't have this protection. Really?

Biological discrimination. Wow. And it's a big deal. There's a lot of people that are going like, why are we the only one? That's really surprising. Like we're Canada. I predict Trudeau will change that. Well, there's a big push to for sure.

And it's funny when they voted in the, what was the act called? The Genetic Information Non-Discrimination Act of 2008. Right. It passed by a vote of 95 to nothing in the Senate and 414 to one in the House. Who is the one? It was Ron Paul of all people. Huh, I'd be interested to know what his thinking was there. I've got it.

Because I was, I thought the same thing. Here's his thinking because it doesn't make sense that he's, because he's pretty obsessed with the government staying out of your biz. Sure. He said uniform federal mandates are a clumsy and ineffective way to deal with problems such as employers. And one of the rubs is either you'll be denied insurance or maybe you won't get hired for a job. Right.

Or promoted if they know that you might, you know, keep the bucket soon. That guy can't push a broom. He's got a defect on his G-489 gene. But it says right here in his experience that he can push a broom. Genetics. He said uniform federal mandates are a clumsy and ineffective way to deal with problems such as employers making hiring decisions on the basis of a potential employee's genetic profile.

Imposing federal mandates on private businesses merely raises the cost of doing business and thus reduces the overall employment opportunities for all citizens. Yeah, I see what he's saying, but I don't know. It's kind of surprised. Seems like something you'd want to protect. Sure. But it passed by the widest of margins regardless. Yeah, that might be a record.

No, I'm sure there's been unanimous ones. One of the, I would like to know what those were. Yeah. You know, like honoring Girl Scouts on Patriot Day or something. No, there was one person who was like, no. No. That was Bernie Sanders. I choked on a tag along once, never by them again.

There's another obstacle, Chuck, and it is gathering the information to get this understanding of what kind of genes lead to certain kinds of diseases so that we can treat people on an individual basis when we stumble across that same genome on a person later. You have to have a big database of genes. So where do you get it? 23andMe. That's apparently where you go get it. It sounds like Forever 21, like a mall store.

Yeah. 23andMe. Yeah. Yeah, they are a company now and the leading company, I think, for the personal genome test market and how they're making their money now is not by selling these test kits. Which is 99 bucks, which supposedly they were selling at a loss. Right. So they could eventually have this database that they could then sell to whoever, not whoever,

but namely like pharma companies and people doing research. So 23andMe amassed a database of, I think, about 800,000 people. 600,000 people who took the 23andMe test and paid 99 bucks for it agreed to donate their DNA, their genome to research. Right. So 23andMe said, thanks a lot, guys. Now we have 600,000 individuals, genomes, just sitting there waiting to be analyzed. And very recently, they closed a deal with a company called Gene Tech.

Gene Tech paid 23andMe $60 million just to analyze 3,000 people with Parkinson's genomes. That's why they were selling the kits at a loss. Yes. Because they knew the big payoff was in something else entirely. Yeah. And from what I read in a MIT technology review article, 23andMe, you shouldn't paint them, and I don't mean to paint them as nefarious or anything like that. But there's a guy named Charles Seif who writes for Scientific American.

In 2013, he called the idea of a private company amassing a private database of human genomes. Yeah. Terrifying. Yeah. I mean, it definitely is like the stuff of science fiction movies. For sure. I couldn't decide whether or not it was bad or not. I think what people are most concerned about is like, well, what happens in the future?

What if it becomes just like Facebook where they have the rights to sell your personal information to whoever wants? It's exactly what it is. So Facebook data mines your behavior and you get to use their application for free. 23andMe analyzed your DNA and sent you some stuff back for 99 bucks, and they're data mining your genes. Yeah. I'm like... It's the same thing as Facebook.

Yeah. It's just instead of behavior, they're analyzing genes. They're data mining or amassing a database of it for sale. But right now they're saying, but yeah, we're selling it to researchers who are out to make medicines to make people better. Yeah. And that's... You can't really argue with that.

Right. It's just the potential for it. Can you can understand how somebody could make it? It could be made very uncomfortable by that. Yeah. The evil overlord son of the current head of 23andMe is the one who will do it. Well, the founder... The guy is like 12 now.

The founder used to be married to Sergey Brin of Google. Oh, really? Yeah. I think they since split up, but she still is the founder and I believe the person who's running 23andMe. Wow. Hopefully she subscribes to the don't be evil thing too. Seriously.

If you want to know more about personalized medicine, we should probably revisit this every six months, I think, Chuck. Yeah. You can type those words into the search bar at howstuffworks.com. You should also check out these awesome episodes. Your limbs torn off now. What can your grandfather's diet shorten your own life? Look how blood works.

Yeah, blood. That was a good one. And then will computers replace my doctor? Yeah. If this episode floated your boat, you will love this too. And I said float your boat, which means it's time for Listener Mail. That means it's almost time for Billy Joel Dewock. Yep.

I'm going to call this Satanic Panic Movies. Hey guys, my wife Jody and I just listened to the episode on Satanic Panic. And we loved it and reminisced about our childhoods. We were both children of the 80s. And she remembers all the daytime talk shows about Satanic Panic. We both had no idea it was taken so seriously by so many people. For me, I always assumed that stuff was just legend, although there was a devil's drive street in my own town growing up that kept all this 10-year-old spooked into our teenage years.

And it was a rite of passage when you finally got your license to drive down that street. Mostly, I remember Satanism through movies and pop culture, though, given your penchant for cinema tangents. We were both expecting to hear more on that topic in this episode. That was too serious. Agreed. Here's my top 10 list of mainstream 80s Satanic Panic movies. Nice.

Number 10, Dragnet. Nice. Number nine, The Golden Child. He said this one does not hold up well. I'm surprised to hear that. It doesn't hold up well. Yeah. Number eight, Children of the Corn.

Seven, Witches of Eastwick. Eastwick. Six, Every Popular Horror Movie in the 80s. Friday the 13th, Nightmare on Elm Street, Halloween. I take issue with that, man. Yeah, that's not the same thing. Nightmare on Elm Street. Friday the 13th is certainly not Satanic.

Those are just creepy killer guys. Yeah. Slasher plucks. Come on, dude. Number five, The Burbs. Yeah. Number four, The Evil Dead series. No.

Number three, Indiana Jones in the Temple of Doom. Ritual Sacrifice. Yeah, I'm not Satanic. I think he's just broadened. Oh, OK. Number two, Poltergeist. No. No, not even close.

And number one, I don't think he asked which ones are you going to say don't belong. Number one, Young Sherlock Holmes. Yeah. I love that movie, but I don't remember much about it. Oh, yeah. There was a whole cabal. It was very, it was more like Indiana Jones in the Temple of Doom.

It was like an ancient Egypt worshiping Victorian cult. That was cool. I saw it like in the last year or so. Oh, really? I remember enjoying it when I was a kid. Where'd that guy go? No idea. I was wondering that myself.

Huh. Thanks for an amazingly delightful and consistently entertaining podcast, guys. We came out to your Boston show and absolutely loved it. Happy New Year. That is from Brian Gladstein of Framingham, Massachusetts. Thanks, Brian. Thank you for half of that list you sent as well. We appreciate it.

If you want to get in touch with us, send us a list that we may or may not trash. You can tweet to us at syskpodcast. You can join us on facebook.com, stuff you should know. You can send us an email to stuffpodcastathowstuffworks.com. And as always, join us at our home on the web, stuffyoushouldknow.com. For more on this and thousands of other topics, visit howstuffworks.com. We're going to use Hey Dude as our jumping off point, but we are going to unpack

and dive back into the decade of the 90s. We lived it. And now we're calling on all of our friends to come back and relive it. And a different hot sexy teen crush boy bander each week to guide you through life. Tell everybody, yeah, everybody about my new podcast and make sure to listen. So we'll never, ever have to say bye, bye, bye. Listen to Frosted Tips with Lance Bass on the iHeart radio app, Apple Podcast or wherever you listen to podcasts.