The human genome is integral to understanding the complex history of human health and disease. Dr. Siddhartha Mukherjee is a cancer geneticist and a 2011 Pulitzer Prize-winning author of The Emperor of All Maladies. Our reporter Anh Gray talks with him about his recent book, The Gene: An Intimate History, which explores the origins of gene science and examines the ethical conundrums involving genetic research.
Mukherjee will be discussing his book The Gene: An Intimate History and exploring the implications of gene science on humanity at the University of Nevada, Reno School of Medicine on November 15th. He’s the featured guest for the 2017 Health Nevada Speaker Series.
The Gene is also personal as Mukherjee recounts his family’s experiences with mental illness. One paternal uncle struggled with schizophrenia and another uncle dealt with bipolar disorder.
As an oncologist, to understand and treat cancer, Mukherjee says it’s essential to comprehend the science of genes.
“Cancer is fundamentally a genetic disease at its very core. And by that, I mean that we now know that cancer is caused by mutations that accumulate in cells and change the physiology of the cells,” Mukherjee explains, “that the growth properties of the cells are no longer the same, the cells keep growing without appropriate controls.”
According to the National Human Genome Research Institute, the human body is made up of more than 20,000 genes. Mutations happen when there’s an alteration in the DNA sequence that makes up a gene, which can cause a variety of diseases, including cancer. In order to develop better treatments for cancer, Mukherjee says advancements in genetic research is imperative.
“Understanding how these genetic mutations arise,” Mukherjee says, “whether they arise from environmental carcinogens, whether they arise because of random errors when cells divide, whether they arise because viruses can tamper with genetic material, is one of the crucial ways to understand how to treat cancer.”
But biology is not always destiny.
“One thing that we’re finding out is that many, many diseases turn out to have subtle or non-subtle genetic links; it really depends on the disease in question,” Mukherjee explains. “Now, when I say subtle genetic links, it might turn out that one disease, there might be tens of thousands of genes, variants of which nudge us toward a greater or lower risk of that illness."
While heredity can play a role in diseases, as it does in some types of heart disease, Mukeherjee explains that environmental factors can influence the outcome.
“We know that several versions of heart disease have powerful genetic links, but if you change the diet, we know that you can almost mitigate against the genetic risk by changing lifestyle or habits,” Mukherjee says. “Or you can multiply or add to the risk, again, by having adverse lifestyle and habits.”
While the prospect of preventing or reversing disease through genetic manipulation holds a lot of medical promise, research can lead to moral conundrums. Understanding the human genome holds the promise of preventing or reversing illnesses. But, as a society, Mukherjee says it’s also important to ask: Who gets to decide what are desirable or undesirable human conditions?
“This is an exciting, but also challenging, time because the questions thrown open are simultaneously extraordinarily exciting,” Mukherjee says, “but also there’s a sense that we’re heading into territory that we don’t know what to do with.”
And eugenics has a sordid history. In particular, the racially-based social policies and atrocities committed during Nazi Germany cast a shadow on eugenics, but Mukherjee says he’s doubtful society will revert back to that type of abuse. “I don’t think that we will go back to the era of explicit eugenics, the crude and rather despicable eugenics that emanated out of Nazi, Germany.”
But he does say that societies must still exercise restraint and careful monitoring. What parents decide to do based on prenatal screenings is an example of the moral complexity of gene science.
“There is a fear—and I think a genuine fear—that the impact of trying to control the destiny of our children using genetic means can enter a very wrong place and once it enters that wrong place, societies can be led astray.”
But Mukherjee says the future of gene science is also exciting. As an oncologist, he’s particularly interested in developing an even deeper understanding about the role of biology on diseases like cancer. He also views genetic research as a personal quest since it could reveal how biological factors may influence the lives of an individual and his or her descendants.
“Obviously, given my own family history," Mukherjee says, "I’m interested in understanding the genetics of mental illness, [and how it] can have an impact on patients’ lives.”
As researchers work to develop genome-based strategies for the diagnosis and treatment of disease, these scientific explorations will continue to raise questions about the ethical, legal and social implications of genetic research.
To learn more about the 2017 Healthy Nevada Speaker Series hosted by the University of Nevada, Reno School of Medicine, click here.