Ten themes around personal health

Personalized medicine today
In which ways is personalized medicine being applied today? To what extent are genetic variations considered when prescribing drugs? What are the success stories, what are the challenges?

Personalized medicine in the future
Which possibilities are emerging as the consequence of developments such as the sequencing of the complete genomes of individual people, the large-scale measurement of gene-expression and metabolite profiles, and simulations of the physiological consequences of all these parameters? What are we learning about the complexity of disease, about the interaction between environment (food, for example) and body? What effect will the new possibilities have on medical treatments in 5, 10 or 20 years?

Traditional medicine
What can we learn from traditional forms of medicine, such as Traditional Chinese Medicine (TCM), Kampo, the Japanese adaptation of TCM, and Ayurveda? What is the value of the different diagnostic methods, the more individualized prescription of treatments, and the use of composite medicines where we use drugs consisting of a single chemical component? And what can be learned from totally different treatments such as acupuncture?

Body-mind interaction
Evidence is accumulating that body and mind are in reality a unity, and respond as an integrated whole to external and internal influences. What do we already know about the links between immune, hormonal and neuronal subsystems? What are the possibilities of “psychosomatic medicine”, like stress-reduction and meditation? How can we apply body-mind knowledge in the development of effective disease treatments?

Placebo effect
The placebo effect is an amazing phenomenon. What can it teach us about the power of the body-mind unit to regulate itself? Is it possible to learn to exploit this effect, instead of only viewing it as a nuisance in clinical testing of drugs?

Healing stories
What makes people better? Is it the regular medical treatment? Is it complementary medicine? Is it a life style change or a belief shift? What are people themselves reporting? What can be learned from anecdotal stories about “spontaneous healing”, that perhaps are less rare or anecdotal than imagined, and that can at least be relevant for fellow patients?

Renewal of the pharmaceutical industry
The present way of working of the pharmaceutical industry seems unsustainable, both economically and socially. The way in which research is conducted, will have to be changed: more collaborations with different kinds of organizations, and another approach to clinical trials, in which drugs are evaluated in people sooner and in which we learn to steer the treatment based on the observed responses. The transition will not be easy. Which collaborative arrangements are needed? Which role do patients, doctors, government and health care payers and providers have in the transition? What are the limitations and possibilities of personalized medicine in this process?

Dealing with choices and uncertainties
A growing body of knowledge enlarges the number of possibilities, but does not necessarily create greater certainty. It is to be expected that the introduction of personalized medicine generates many new choices: how should one react to the message that a chance of x percent exists to develop disease Y? In view of the large number of risk factors that will be identified, a serious challenge emerges to weigh all possible courses of action and to make a choice that is appropriate for the person involved. How can we learn to deal with all uncertainties? How are we going to share information and knowledge? How do we find the balance between inner knowing and information from outside? How do you as a person take charge (again)?

Subjectivity in research
Attention for the personal aspects requires a different kind of research methodology. A special event cannot be easily repeated. Not every experiment is possible or allowed. An inner experience cannot easily be made objective. All this does not imply that it impossible to speak about the subjective in a scientific manner, or to do research on it. Can we find ways to overcome the separation between laboratory situation and the anecdotal? Can we learn to not only value the subjective element in health and disease (body-mind interaction, choices, experiences etc.), but also to make use of it in a systematic way?

Spirituality and self determination
Disease and health acquire a certain meaning in the life of a person. The way in which someone deals with his or her disease, and the meaning and possibly purpose attributed to the disease, can have a large impact on the appreciation of medical care, and sometimes (or perhaps often) also on the course of the disease. In other words: curing and healing are not the same. If we take self-determination of the patient seriously, than the spiritual aspect can not be neglected. In last, and first, instance it is the patient who judges whether a certain action is appropriate or meaningful. Can we engage in dialog about these aspects, and can we make them resonate in medical care an research?