Skip to Main Content

Personalized Cancer Treatment

Personalized Cancer Treatment

Dr. Mark Evers and Dr. Susan Smyth discuss personalized, genomic medicine in cancer treatments. Evers is the director of the Markey Cancer Center at the University of Kentucky; Smyth is the medical director of the Gill Heart Institute at the University of Kentucky.
S10 E35 Length 28:21 Premiere: 7.25.15

Getting Personal with Cancer and Heart Disease Treatment

Imagine a time when your health records don’t simply contain a history of the conditions you’ve been treated for, but instead include a personal genetic map that reveals the diseases you’re at greatest risk of developing and the best way to treat those conditions if they do arise.

That’s the promise of precision medicine, and with continued advances in genetic testing, some patients are already seeing the benefits of these new, highly personalized treatments.

University of Kentucky physicians Mark Evers, director of the Markey Cancer Center, and Susan Smyth, medical director of the Gill Heart Institute, appeared on KET’s One to One to discuss the future of precision medicine.

The Roots of a More Personalized Approach
You could say origins of precision medicine date back to the 1950s when researchers Francis Crick and James Watson discovered the double-helix structure of DNA. But it would take another three decades before efforts to sequence the entire human genome started to gain momentum. Then in 2003 scientists announced they had mapped 99 percent of the 3 billion base-pairs – or rungs – in the DNA “ladder” of humans.

That’s about the time Dr. Evers says he saw personalized medicine begin to take off. He recalls that when he started as an oncologist 20 years ago, most colon cancer patients would be treated the same way whether they were a 35-year-old woman or an 85-year-old man.

“We know that each individual is different, so why should they be treated the same?” Evers says. “But it’s only been within the last 10 years I would say that there’s been an explosion of techniques [and] technologies that really have allowed us to identify biomarkers to be able to treat patients differently.”

Heart Specialists Slower to Respond
Evers says breast cancer provided the one of the first major forays into precision medicine. (He uses the terms precision medicine and personal medicine interchangeably.) Researchers identified estrogen and progesterone receptors and later a receptor called HER2 that helped doctors better focus treatment protocols for individual breast cancer patients. Now Evers says scientists are looking at other genetic mutations to help oncologists understand why some patients respond better to certain treatments than others.

Dr. Smyth laments that her fellow cardiologists have been slower to embrace the new genetic approaches.

“A relatively recent survey by the American College of Cardiology indicated that probably less than 10 percent of cardiologists right now are applying personalized or precision medicine in their practices,” Smyth says.

She attributes a large part of the delay to her specialty’s traditional focus on clinical trials for new devices or drug strategies that would benefit thousands of heart patients who shared a similar risk factor. Smyth says that’s slowly changing as researchers explore blood plasma biomarkers, genetic signatures, and electrical conduction abnormalities that can indicate a greater likelihood of cardiovascular problems.

“There’s a huge amount of heart disease that we know has a component that’s genetic and a component that’s environmental,” Smyth explains. “And we’re just beginning to scratch the surface to understand how those factors interact.”

Moving from Treatment to Prevention
Smyth and Evers say environmental exposures like air pollution, for example, and lifestyle habits like poor diet further complicate the process of developing highly personalized strategies for cancer or heart patients. But they say researchers are working to integrate those factors into the treatment mix.

But precision medicine isn’t just about treating a disease that’s already manifested. Evers and Smyth say these genetic markers can tell patients the conditions they’re at greater risk of developing so that they can take preventive health measures and be on guard for signs of the disease onset.

A high profile example of this came in 2013 when actress Angelina Jolie announced that she had a preventive mastectomy because tests showed she had a flaw in a gene called BRCA1 that normally suppresses cancer tumors. She later opted to also have an oophorectomy to remove her ovaries. Jolie had lost her mother and grandmother to ovarian cancer, and other family members to breast cancer.

Evers says not everyone who demonstrates a genetic risk for a certain type of cancer may choose or need to take such extensive measures. But he credits Jolie for making her decisions public as a way to foster discussion about these emerging health issues.

The Future of Personalized Medicine
Evers says he believes genomic medicine will eventually help with prevention, diagnosis, and treatment of a wide variety of conditions ranging from colds and flu to diabetes. He’s heartened that research funding through the National Institutes of Health could be set to increase, and that more philanthropic support is being devoted to studying precision treatments.

But both doctors are reluctant to say personalized medicine will eradicate cancer or heart disease. They say that’s because so many genetic and environmental factors can play into the formation of a disease, not to mention how disease cells themselves can mutate over time. Evers says that’s especially true for cancer, which he calls a very smart disease.

“I don’t think eradicate is the correct word,” Evers says. “I’m hoping for a world where cancer is a chronic disease…I think we’re always going to be plagued with cancer… but if it could be a treatable disease like diabetes… then to me, that’s a huge win for us.”

Program Details

One to One

About One to One

Host Bill Goodman and a variety of interesting and engaging people talk about the state and world we live in. Important, memorable, and provocative, this series offers an array of interviews with guests including politicians and philosophers, artists and authors, and the leading thinkers in Kentucky.

TV Schedules


No upcoming airdates


No recent airdates

Season 10 Episodes

Jeff Smith and Jonathan Miller

S10 E53 Length 28:01 Premiere Date 12.27.15

Economic Boom for Kentucky Bourbon

S10 E52 Length 28:02 Premiere Date 12.20.15

Steve Beshear Reflects on Service

S10 E51 Length 28:46 Premiere Date 12.13.15

Dr. R. Albert Mohler

S10 E50 Length 28:00 Premiere Date 11.22.15

Governor-elect Matt Bevin

S10 E49 Length 29:03 Premiere Date 11.15.15

Kentucky Life Host Doug Flynn

S10 E48 Length 28:26 Premiere Date 11.8.15

Al Cross on the 2015 Election

S10 E47 Length 28:32 Premiere Date 11.1.15

Trey Grayson

S10 E46 Length 28:01 Premiere Date 10.11.15

Tony Kemper of the de Paul School

S10 E45 Length 27:26 Premiere Date 10.4.15

U.S. Rep. John Yarmuth

S10 E44 Length 28:27 Premiere Date 9.27.15

David Gregory on His Journey of Faith

S10 E43 Length 28:01 Premiere Date 9.20.15

U.S. Rep. Thomas Massie

S10 E42 Length 28:01 Premiere Date 9.13.15

Sen. Mitch McConnell

S10 E41 Length 28:37 Premiere Date 9.5.15

Education Chief Reflects on Service

S10 E39 Length 28:01 Premiere Date 8.23.15

Making the Case for Higher Academic Standards

S10 E38 Length 28:11 Premiere Date 8.15.15

Emily Bingham Discusses Aunt's Biography

S10 E36 Length 28:31 Premiere Date 8.1.15

Personalized Cancer Treatment

S10 E35 Length 28:21 Premiere Date 7.25.15

Stu Silberman and Brigitte Blom Ramsey

S10 E34 Length 28:07 Premiere Date 7.18.15

Coding - Part 2

S10 E33 Length 28:01 Premiere Date 7.11.15

Scott Terrell on the Lexington Philharmonic

S10 E30 Length 28:21 Premiere Date 6.20.15

Jane Chu and Lori Meadows Discuss Kentucky Arts

S10 E29 Length 28:02 Premiere Date 6.13.15

Giving Voice to Kentucky Women

S10 E28 Length 28:01 Premiere Date 6.6.15

The Heroin Epidemic in Kentucky

S10 E26 Length 28:01 Premiere Date 5.23.15

Al Cross Discusses May 2015 Primary

S10 E25 Length 28:00 Premiere Date 5.16.15

Immigration Laws in Louisville

S10 E24 Length 28:17 Premiere Date 5.9.15

Cameron Ludwick and Blair Hess

S10 E23 Length 28:01 Premiere Date 5.2.15

Len Peters Discusses the EPA

S10 E22 Length 27:46 Premiere Date 4.25.15

Kim Baker Discusses the Arts

S10 E21 Length 28:56 Premiere Date 4.18.15

U.S. Agriculture Secretary Tom Vilsack and Dr. Alison Davis

S10 E20 Length 27:46 Premiere Date 4.11.15

Archbishop Joseph Kurtz

S10 E19 Length 28:01 Premiere Date 4.4.15

Dr. Mark Evers

S10 E18 Length 27:11 Premiere Date 3.28.15

Teddy Abrams

S10 E17 Length 28:01 Premiere Date 3.21.15

Dr. Robert Davies

S10 E16 Length 28:01 Premiere Date 2.22.15

Brad Jones: Black Walls Turn Gray

S10 E15 Length 28:12 Premiere Date 2.15.15

SOAR Executive Director Jared Arnett

S10 E14 Length 28:16 Premiere Date 2.8.15

University of Kentucky President Eli Capilouto

S10 E13 Length 28:03 Premiere Date 2.1.15

Rep. Andy Barr: One to One from Washington

S10 E12 Length 28:22 Premiere Date 2.4.15

Rep. Thomas Massie: One to One from Washington

S10 E11 Length 28:06 Premiere Date 2.3.15

Rep. John Yarmuth: One to One from Washington

S10 E10 Length 27:41 Premiere Date 2.2.15

Rep. Brett Guthrie: One to One from Washington

S10 E9 Length 28:46 Premiere Date 1.30.15

Rep. Ed Whitfield: One to One from Washington

S10 E8 Length 28:01 Premiere Date 1.29.15

Rep. Hal Rogers: One to One from Washington

S10 E7 Length 28:01 Premiere Date 1.28.15

Sen. Rand Paul: One to One from Washington

S10 E6 Length 27:31 Premiere Date 1.27.15

Sen. Mitch McConnell: One to One from Washington

S10 E5 Length 28:01 Premiere Date 1.26.15

U.S. Senator Mitch McConnell

S10 E4 Length 28:06 Premiere Date 1.6.15

Kentucky Senate President Robert Stivers

S10 E3 Length 28:01 Premiere Date 1.18.15

Speaker of the House Greg Stumbo

S10 E2 Length 28:21 Premiere Date 1.11.15

Gov. Steve Beshear

S10 E1 Length 28:41 Premiere Date 12.26.14

Explore KET