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How genomics is changing nursing

 Linda Bailey 7 Mar 2018 Public Health Forum

Even if it hasn’t impacted on your work yet, every branch of nursing will be affected by advances in knowledge about genomics and the human genome.

DNA structure

There is a real possibility that some hereditary conditions, such as haemophilia, will disappear altogether, while treatments for other conditions, such as cancer, will change dramatically.

Nurses and midwives working in infertility and maternity services may also find the care, treatment and advice they have traditionally given will change in future.

The recent, rapid advances in what we know about genomes, genetics and epigenetics all have implications for nursing.

The work of Francis Crick and James Watson in identifying the structure of DNA in 1953 kick started advances in knowledge about genetics.

Then, in 1990, new and very rapid advances began with the inception of the human genome project – an international collaboration to map the human genome.

The plan was for the project to run for 15 years, but it actually only took 13 years.

Genes can play a role both directly and indirectly in the development of a disease or condition.

There are specific genetic disorders such as cystic fibrosis or Huntington’s disease, and then there are illnesses influenced by genes which can increase the risk of someone developing a condition, such as cancer.

Gene advances 

The first genetic disease to be mapped was Huntington’s Disease in 1983, and in 1994 the BRCA1 gene was first isolated.

BRCA1 and BRCA2 have a role in suppressing tumours, but harmful BRCA mutations give women a breast cancer risk five times higher than the normal risk, and an ovarian cancer risk between 10 and 30 times higher.

Many other conditions are currently being researched including prostate cancer, type 2 diabetes, macular degeneration and myocardial infarction.

According to the Journal of Gene Medicine, there are currently nearly 2,500 clinical trials involving gene therapy in progress or completed, with the majority of these (64.6%) addressing various cancers.

With the advances in knowledge gained through such trials comes a rise in ‘personalised medicine’ with many more treatments being tailored directly at individuals.

In December 2017 the New England Journal of Medicine reported a successful trial using gene therapy with people with haemophilia B and another reporting on significant advances in gene therapy for haemophilia A.

If you want to find out more, Health Education England have a free online course for all UK NHS staff Introduction to Genomics.

5-9 March is Genomics Conversation Week. Find out more about this week of action.

Linda Bailey

RCN Public Health Forum steering committee member

Consultant in public health

Linda began nursing in 1984 and was one of the first nurses in England to qualify for Fellowship of the Faculty of Public Health and membership of the UK Voluntary Register for Public Health in 2006. In 2013 she moved to south Wales where she works as consultant in public health for Public Health Wales.