Laura Doherty-Reynolds was diagnosed with cancer in 1996, before personalized medicine became part of our vocabulary and before patients began experiencing its benefit. Now, ten years after her diagnosis and successful treatment, Laura reflects on her experience and considers the potential of personalized medicine for today's cancer patients. Her battle with cancer has given her a new perspective on her work for a life sciences company that provides technology to researchers.

Q: Take us back to 1996 when you were initially diagnosed with cancer.

A: The whole thing was actually pretty surreal. I was 29 when I was diagnosed. I considered myself to be rather healthy; there was no cancer in my immediate family. I'd gone to my primary care physician because I could feel a swelling in my abdomen. After many blood tests, CT scans, some x-rays, and consultations, I was scheduled for surgery to remove what turned out to be two tumors - we still didn't know at that time it was cancer. But after the surgery, I could tell by the demeanor of the doctors that something was wrong. It was metastatic undifferentiated carcinoma at stage four. The prognosis was actually very, very bad. They gave me some statistics on what my chances were - it wasn't encouraging. Still, I really wasn't sure what that all meant because it was a diagnosis that I've never heard of before.

The tumor cells were undifferentiated. Pathology was unable to confirm a cell type of origin, so the primary cancer - where the tumor actually originated - was undetermined, making it difficult to select the optimal chemotherapy strategy.

Q: The test results gave some hints of an origin but it wasn't a clear picture?

A: Right. I had elevated levels of CA 125 which can be indicative of ovarian cancer but the morphology of the tumor didn't support an ovarian origin. There were other indicators that helped contribute to the diagnosis as well, but because of the ambiguity of the diagnosis, the treatment was difficult to develop. It was like trying to piece a puzzle together or unravel a mystery.

Q: If we fast-forward to today, we see that personalized medicine is enabling doctors to better understand the genetic and molecular signatures of cancer cells - to recognize patterns of biomarkers, for example. This information was only in its early stages ten years ago.

A: I don't even know if the word "biomarkers" was in our vocabulary ten years ago! At the time, my doctors didn't have a real understanding of what the origin of these cells and the tumor were, or what their molecular signature looked like. The chemo I received was a combination of drugs that had worked in the past for different types of tumors. The course of my treatment after the removal of the two tumors was multiple rounds of a combination of three different types of chemotherapy in conjunction with radiation treatment.

And really, at the time we just kind of prayed that it would work because that was the best thing that we could come up with. But it wasn't certain that it was the right thing or that it was going to work.

Q: What are your thoughts on how personalized medicine might have affected you ten years ago, and how might it affect cancer patients now who can actually benefit from personalized medicine?

A: If we think of personalized medicine as using information about a person's genetic makeup to tailor strategies for detection, treatment, or prevention of cancer and other diseases, I can easily imagine it having an affect on my situation and that of patients today.

In a very real way, I can imagine how things could have changed specifically for my treatment. First of all, the surgery that I endured to remove the tumors was very, very invasive, and it's painful, and it's terrifying, and it's risky. If there was a way better to understand and then chemically target my tumors, maybe we could have obliterated the tumor without having to do invasive surgery. That would have been awesome.

The other place that I could really imagine personalized medicine being helpful is the possibility of knowing, after the surgery, whether I would likely be in remission or if there was high probability of recurrence. If there could have been some sort of marker that could have told us the chemo did the trick, that would have been a relief.

My doctors also had no idea how I would react to the chemotherapy and other drugs I had to take. Part of personalized medicine is an understanding of how a person might respond or not respond to drugs. Before chemo, I'd go into the nurse's office and they would prep me for the IV's to administer the chemo. But before the chemo went in, I would get all kinds of anti-inflammatory drugs just so I wouldn't react, to counter the side effects of the chemo drugs. And then once they started to run the chemotherapy, they would wait and they would just watch me to see if I had an adverse response.

So even at that level, personalized medicine could potentially change the experience.

Q: Can you reflect on the scientists out there who are devoting their life's work to discovering and developing new drugs such as the ones you took?

A: I always get goose bumps when I think about the researchers and the doctors behind my success. They have amazing dedication. They are steadfast in what they do and are really heroes because it can be thankless work. The dedication and vision that these people have to have in order to stick with their ideas and their dreams.

It really is amazing that it takes years to develop a new drug. A scientist might have one or two opportunities during their careers to discover and develop a drug that ends up impacting patients. Think about it. Think about how long you've been doing your job and if you had to wait ten or twenty years to reach your goal. We live in a society that is such immediate and instant gratification - these people have an amazing endurance.

Q: You work at a life sciences company whose technology played an integral role in the sequencing of the human genome. What's that vantage point like for you?

A: I work for a company that provided the technology that supported the sequencing of the human genome. I'm with the proteomics division and we're very focused on tools and technologies for biomarker studies, another aspect of personalized medicine.

Because I work in marketing, I often hear customers talk about how they use our tools for research they're doing on cancer and that's when it all brings it home for me.

Q: Any thoughts on encouraging lay people out there to understand personalized medicine and what it can mean to them?

A: I think the general public should definitely pay attention because this is going to be the future of medicine - in varying capacities, but it's going to be there. There's going to be a lot of legal and social implications for all of us and there's going to be issues around privacy as you start talking about our specific genetic patterns and how they're accessed and who has access.

All of those issues are going to be coming to the forefront and people should be aware of what that means and they should stay informed as best they can. The other avenue is that the more informed you are about what is available as a healthcare consumer the better you are able to speak intelligently and ask informed questions of your doctors. Personalized medicine is going to have an impact on all of us, hopefully through improved medical care and medications that we can access. But there are a lot of implications that we all need to understand like in the area of health insurance and who would have access to our genetic information. It's a tremendous era that we're participating in and we really all should educate ourselves.